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Processing of Human Reduction Mammoplasty and Mastectomy Tissues for Cell Culture
Published on: January 3, 2013
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Recommendations for Pathologic Evaluation of Reduction Mammoplasty Specimens: A Prospective Study With Systematic
Abiy B Ambaye1, Andrew J Goodwin1, Susan E MacLennan1
1From the Departments of Pathology and Laboratory Medicine (Drs Ambaye, Goodwin, and Weaver) and Surgery (Dr MacLennan), University of Vermont Medical Center, Burlington; and the Department of Medical Biostatistics, University of Vermont, Burlington (Dr Naud).
Archives of Pathology & Laboratory Medicine
|August 11, 2017
Summary
For breast reduction mammaplasty (RMP), microscopic evaluation is recommended for patients over 40. Younger patients (under 35) may only require gross examination for significant pathologic findings (SPF).
Area of Science:
- Plastic Surgery
- Pathology
- Oncology
Background:
- Breast reduction mammaplasty (RMP) is a common procedure in the US, with over 100,000 performed annually.
- The incidence of significant pathologic findings (SPF), including carcinoma and atypical hyperplasia, in RMP specimens varies widely (0.06%-12.8%).
- Currently, no standardized protocol exists for the pathological assessment of RMP specimens.
Purpose of the Study:
- To establish a standard sampling method for microscopic evaluation of RMP specimens.
- To determine the incidence of occult carcinoma and atypical hyperplasia in RMP specimens.
- To identify clinical risk factors associated with SPF in patients undergoing RMP.
Main Methods:
- Prospective examination of all RMP specimens from 2006 to 2013 at a single institution.
- Systematic additional sampling of specimens after baseline gross and microscopic evaluation.
- Tabulation of SPF incidence and analysis of variables including patient age, specimen weight, prior SPF history, and mammogram results.
Main Results:
- Significant pathologic findings (SPF) were identified in 9.8% of 595 evaluated patients.
- Carcinoma was detected in 2.4% of all patients, with higher rates in older age groups (3.6% in those ≥40 years, 4.3% in those ≥50 years).
- No SPF was found in patients under 40; preoperative mammograms did not identify any carcinoma or atypical hyperplasia. Increased sampling correlated with higher SPF detection rates in patients aged 40 and older.
Conclusions:
- Gross-only evaluation may be sufficient for RMP specimens in patients younger than 35 years.
- Increased microscopic sampling is recommended for RMP specimens in patients aged 40 years and older.
- This approach aims to improve the detection of occult malignancies and pre-malignant conditions in RMP specimens.
