Incidental breast carcinoma in reduction mammoplasty

Acta Chir Belg. 2017 Oct;117(5):308-311. doi: 10.1080/00015458.2017.1328767. Epub 2017 Jun 13.

Abstract

Aim: The objective of this study was to analyze the incidence and treatment options of occult cancer or atypical lesions found in the histopathological examination of reduction mammoplasty (RM) specimens. The role of preoperative mammography and systematic histopathological examination are discussed.

Methods: We performed a retrospective single-center database review of all patients who underwent a RM between January 2005 and December 2014. Preoperative examination, histopathological findings and follow-up were documented.

Results: A total of 1045 patients underwent RM, of which 97% were bilateral (1021). All patients received a mammography and routine clinical examination to exclude cancer preoperatively. The overall mean patient age was 40.2 years (14.2-73.4). A total of 19 patients (1.18%) had significant histopathological findings, all of whom were over 40 years of age. There were 4 incidental carcinomas (0.38%), of which 2 were DCIS (0.19%) and 2 invasive ductal carcinomas (0.19%).

Conclusions: Incidence of postoperative diagnosis of occult breast cancer in RM specimens remains low, but poses significant therapeutic challenges. While emphasis should lay on preoperative diagnostics, routine histological analysis of RM specimens is recommended.

Keywords: Breast reduction; breast pathology; macromastia; occult breast carcinoma.

MeSH terms

  • Breast / abnormalities
  • Breast / surgery
  • Breast Neoplasms / diagnosis*
  • Breast Neoplasms / pathology
  • Female
  • Follow-Up Studies
  • Humans
  • Hypertrophy / surgery
  • Incidental Findings*
  • Mammaplasty*
  • Mammography
  • Preoperative Care
  • Retrospective Studies

Supplementary concepts

  • Gigantomastia