Suspicious Findings in Reduction Mammaplasty Specimens: Review of 182 Consecutive Patients

Abstract

Breast reduction mammaplasty allows examination of specimens from a seemingly healthy population for the presence of proliferative breast disease. The authors reviewed the charts of all reduction mammaplasty patients of a single surgeon over 7.5 years for age, family history, mammographic results, unilateral or bilateral nature of the procedure, and final pathologic diagnosis. Of 182 patients, 168 had bilateral and 14 had unilateral breast reductions. Ages ranged from 16 to 79 years (average and median: 37 years and 35 years respectively). Fifty-seven patients (31%) were younger than 30 years, 53 patients (29%) were between the ages 30 years and 39 years, for a total of 110 patients (60%) younger than 40 years in this study. A total of 163 patients (89%) had a diagnosis of normal breast tissue. Nineteen patients (10%) had proliferative changes: 9 patients (5%) without atypia, 5 patients (3%) with atypia, 3 patients (2%) with sclerosing adenosis, and 1 patient each (0.5%) with papillomatosis and lobular carcinoma in situ. A total of 95% of patients with proliferative changes were older than 30 years. Women ages 30 to 39 years may be at higher risk (15%) of having proliferative changes than previously reported, and histologic examination of all reduction mammaplasties is recommended.

Prevalence of pre-malignant and malignant lesions in prophylactic mastectomy specimens of BRCA1 mutation carriers: comparison with a control group

“…Thus, the presence of pre-malignant changes in RP specimens may have been underestimated. However, BlansWeld et al (2004) found proliferative changes with atypical features in 3% of RP specimens. The 5.8% rate of atypical features registered in our study is therefore indicative of the fact that no underestimation had occurred.…”

Breast lesions in reduction mammaplasty specimens: a histopathological pattern in 534 patients

“…Assessing only the benign lesions associated with a high risk of breast cancer according to the American College of Pathologists, we demonstrated that 2.8% of our patients had this type of lesions in their RM specimen. Two studies from the United States reported even higher prevalence rates (5.5% (Blansfield et al , 2004) and 10.7% (Ishag et al , 2003)). Therefore, we believe that reporting these findings should not be overlooked.…”

Adverse Histopathology and Imaging Findings in Reduction Mammaplasty Day-surgery Patients

“…Standard use of preoperative imaging is still controversial in the literature. Mammography is variously recommended from the age of 30 years (24), from the age of 40 years (3,10,25), or for patients over the age of 50 years (26). Colwell et al (10) examined the incidence of breast cancer in reduction mammaplasties, and in their study, all patients had preoperative mammograms with negative results.…”

“…Interestingly, incidental discovery of atypical hyperplasia or LCIS lesions was not significantly associated with abnormal preoperative mammographic results. Blansfield et al (24) retrospectively reviewed reduction mammaplasty patients, of which 10% had proliferative changes. The majority (95%) of proliferative changes were found in patients over 30 years, with a highest portion of patients between ages 30 and 39 years.…”