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Pathology Examination of Breast Reduction Specimens: Dispelling the Myth
Mark Fisher1, Aaron L Burshtein1, Joshua G Burshtein1
1Division of Plastic and Reconstructive Surgery, Northwell Health, Zucker School of Medicine at Hofstra/Northwell, Great Neck, N.Y.
Plastic and Reconstructive Surgery. Global Open
|December 10, 2020
Summary
Histologic review of breast reduction specimens is crucial, revealing a higher incidence of cancerous and high-risk lesions than previously reported. Factors like family history of breast cancer and larger tissue removal increase this risk.
Area of Science:
- Plastic Surgery
- Surgical Pathology
- Oncology
Background:
- Over 100,000 reduction mammaplasties are performed annually in the U.S.
- Reported incidence of cancerous/high-risk lesions in these procedures varies widely (0.06%–4.6%).
- The necessity of routine histological review for breast reduction specimens remains debated.
Purpose of the Study:
- Determine the incidence of cancerous and high-risk lesions in reduction mammaplasty specimens.
- Identify risk factors associated with the occurrence of these lesions.
Main Methods:
- Retrospective review of 310 reduction mammaplasties performed in 2018.
- Collected data included patient demographics, comorbidities, surgical history, family/personal cancer history, and specimen weight.
- All specimens underwent pathological evaluation, categorized as benign, proliferative, or malignant.
Main Results:
- 11 out of 155 patients (7.1%) had positive findings, including 9 (5.8%) with proliferative lesions and 2 (1.29%) with cancerous lesions.
- Patients with positive pathology were older, had a family history of breast cancer, and a greater weight of resected tissue.
- Multivariable analysis identified family history of breast cancer, prior breast surgery, and greater resected tissue weight as significant risk factors.
Conclusions:
- The study found a higher incidence of positive pathology in reduction mammaplasty specimens than previously reported.
- Histologic review of breast reduction specimens is essential for detecting potentially significant lesions.
- Family history of breast cancer, prior breast surgery, and increased resected tissue weight are associated with a higher risk of proliferative or cancerous lesions.
