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Updated: Jan 7, 2026
Endoscopic Bilateral Nipple-sparing Mastectomy via a Single Axillary Incision with Immediate Pre-pectoral Implant-based Breast Reconstruction
Published on: May 17, 2024
Resultados a Largo Plazo e Implicaciones Oncológicas de los Hallazgos Histopatológicos en Espécimenes de Reducción
Galip Gencay Üstün1, Alaz Çırak1, Ömer Sezer Yüceer1
1School of Medicine, Department of Plastic Surgery, Hacettepe University, Ankara, Turkey.
Background:
Breast reduction surgery provides both functional and aesthetic benefits and enables incidental detection of breast pathology. Although high-risk or malignant lesions are uncommon, their long-term clinical relevance remains unclear.
Objectives:
To evaluate the histopathological findings of breast reduction specimens and assess their relationship with long-term breast outcomes, including the development of new breast disease and need for subsequent biopsy or mastectomy.
Methods:
This retrospective cohort study included 1349 patients (2630 breasts) who underwent breast reduction with a minimum 5-year follow-up. Long-term clinical outcomes were assessed only in the subset of 377 patients (731 breasts) who completed a follow-up questionnaire. Histopathological findings were classified into three risk categories according to their association with malignancy. A follow-up questionnaire assessed breastfeeding ability, adherence to imaging, and the occurrence of new breast masses or interventions. Associations between baseline risk category, follow-up duration, and long-term outcomes were analyzed using Pearson chi-square tests.
Results:
High-risk or malignant lesions were identified in 1.3% of specimens, predominantly among women over 40 years. Specimen weight and prior contralateral breast cancer history were not associated with pathological risk. Among 731 breasts evaluated by questionnaire, 80.1% retained breastfeeding ability, while 38% reported no imaging follow-up. Biopsy incidence increased significantly with follow-up time (2.6%, 6.2%, and 13.8% at 5-10, 10-15, and >15 years; p<0.001). Mastectomy rates also rose with time (0%, 0.6%, and 8.3%; p<0.001), showing a trend toward higher incidence in baseline high-risk specimens.
Conclusions:
Breast reduction surgery facilitates incidental detection of high-risk lesions, particularly in women over 40 years. Higher baseline pathological risk and longer follow-up were associated with increased likelihood of mastectomy, underscoring the need for structured, risk-adapted surveillance to optimize long-term oncologic safety.
