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High-risk incidental findings in reduction mammoplasty
Dr. Stephanie Dreifuss, Dr. Carolyn Delacruz
University of Pittsburgh Medical Center
2016-01-24
Presenter: Dr. Stephanie Dreifuss
Affidavit:
This project represents the original work of Stephanie Dreifuss.
Director Name: Joseph E. Losee, MD
Author Category: Resident Plastic Surgery
Presentation Category: Clinical
Abstract Category: Breast (Aesthetic and Recon.)
Background: Reduction mammoplasty is one of the most common procedures performed by plastic surgeons. This operation is indicated for symptomatic macromastia or for breast asymmetry following contralateral breast cancer surgery. Previous studies have compared the incidence of occult malignancy in resection specimens between these two groups. However, no study has compared the incidence of high-risk lesions (atypical lobular hyperplasia, atypical ductal hyperplasia, atypical papilloma, etc). Therefore, our study aims to compare the incidence of high-risk findings in bilateral reduction mammoplasty for symptomatic macromastia versus unilateral reduction mammoplasty for symmetry in oncologic cases.
Methods: Charts were reviewed from 436 consecutive patients undergoing breast reductions by a single surgeon over a 10-year period. Data collected include age, procedure, specimen weight, and histologic findings. Incidentally found high-risk lesions were compared between these two groups.
Results: 317 patients underwent bilateral reduction mammoplasty for macromastia. 119 patients underwent unilateral reduction mammoplasty for symmetry in cases of contralateral malignancy. Patients with a history of contralateral malignancy had a higher incidence of high-risk lesions (15.1%) than those with symptomatic macromastia (7.3%).
Conclusion: Patients undergoing unilateral breast reduction for symmetry following oncologic resection with or without reconstruction have a higher incidence of high-risk lesions versus those undergoing reduction mammoplasty for symptomatic macromastia. Though other groups have looked at incidental findings of breast cancer in patients undergoing elective versus reconstructive reduction mammoplasty, no group has compared the incidence of high-risk lesions. This data will prove valuable for preoperative counseling prior to reduction mammoplasty for either of these indications.
