Skip to main content
Erschienen in: European Journal of Plastic Surgery 2/2020

22.10.2019 | Original Paper

Approach to histopathological incidental lesions after reduction mammoplasty

verfasst von: Handan Derebaşınlıoğlu, Sarper Yılmaz

Erschienen in: European Journal of Plastic Surgery | Ausgabe 2/2020

Einloggen, um Zugang zu erhalten

Abstract

Background

The importance of analyzing tissue removed during reduction mammoplasty in healthy and asymptomatic patients has been emphasized in many publications. Pathological analysis can reveal many important findings that may be used to determine the patient’s risk of breast cancer.

Methods

The pathology findings of patients who underwent reduction mammoplasty and mastopexy due to breast asymmetry and/or breast hypertrophy between January 1995 and May 2018 were analyzed retrospectively.

Results

A total of 283 women underwent breast reduction during the study period (560 breasts). Of all of the specimens, 273 had histopathological findings, most of which were fibrocystic breast tissue pattern (85.71%). In 11 specimens, 16 lesions considered proliferative in nature were detected. The mean follow-up period of the proliferative lesions was 6.1 years. No malignancy was observed during the follow-up period.

Conclusions

Age is not the only significant factor affecting pathology results. Risk factors should be determined and imaging findings should be considered as well. Every reduction mammoplasty procedure should be regarded as an opportunity for screening the breast tissue of the candidates.
Level of evidence: Level IV, risk/prognostic study.
Literatur
1.
Zurück zum Zitat Akintayo RM, Rosenkranz KM, Wells WA, Ridgway EB (2017) Reviewing the evidence to guide clinical care: proliferative breast lesions in breast reduction specimens. Ann Plast Surg 79(4):410–414CrossRef Akintayo RM, Rosenkranz KM, Wells WA, Ridgway EB (2017) Reviewing the evidence to guide clinical care: proliferative breast lesions in breast reduction specimens. Ann Plast Surg 79(4):410–414CrossRef
2.
Zurück zum Zitat Aytac B, Sahsine T, Erturk FY, Kahveci R, Gokgoz S (2013) Evaluation of incidence and histolopathological findings of breast lesions in reduction mammoplasty specimens: Uludag University experience. J Pak Med Assoc 63(7):878–881PubMed Aytac B, Sahsine T, Erturk FY, Kahveci R, Gokgoz S (2013) Evaluation of incidence and histolopathological findings of breast lesions in reduction mammoplasty specimens: Uludag University experience. J Pak Med Assoc 63(7):878–881PubMed
3.
Zurück zum Zitat Degnim AC, Visscher DW, Hoskin TL, Frost MH, Vierkant RA, Vachon CM, Shane Pankratz V, Radisky DC, Hartmann LC (2012;133[1) Histologic findings in normal breast tissues: comparison to reduction mammaplasty and benign breast disease tissues. Breast Cancer Res Treat 133:169–177CrossRef Degnim AC, Visscher DW, Hoskin TL, Frost MH, Vierkant RA, Vachon CM, Shane Pankratz V, Radisky DC, Hartmann LC (2012;133[1) Histologic findings in normal breast tissues: comparison to reduction mammaplasty and benign breast disease tissues. Breast Cancer Res Treat 133:169–177CrossRef
4.
Zurück zum Zitat Merkkola-von Schantz PA, Kauhanen SMC, Jahkola TA, Krogerus LA, Hukkinen KS (2017) Breast cancer detection by preoperative imaging in reduction mammaplasty patients: a single center study of 918 patients. World J Surg 41:2013–2019CrossRef Merkkola-von Schantz PA, Kauhanen SMC, Jahkola TA, Krogerus LA, Hukkinen KS (2017) Breast cancer detection by preoperative imaging in reduction mammaplasty patients: a single center study of 918 patients. World J Surg 41:2013–2019CrossRef
5.
Zurück zum Zitat Clark CJ, Whang S, Keith TP (2009) Incidence of precancerous lesions in breast reduction tissue: a pathologic review of 562. Plast Reconstr Surg 124:1033–1039CrossRef Clark CJ, Whang S, Keith TP (2009) Incidence of precancerous lesions in breast reduction tissue: a pathologic review of 562. Plast Reconstr Surg 124:1033–1039CrossRef
6.
Zurück zum Zitat Guest AR, Helvie MA, Chan HP, Hadjiiski LM, Bailey JE, Roubidoux MA Adverse effects of increased body weight on quantitative measures of mammographic image quality AJR Am J Roentgenol 2000;175(3):805–810 Guest AR, Helvie MA, Chan HP, Hadjiiski LM, Bailey JE, Roubidoux MA Adverse effects of increased body weight on quantitative measures of mammographic image quality AJR Am J Roentgenol 2000;175(3):805–810
7.
Zurück zum Zitat Sree SV, Ng EY-K, Acharya RU, Faust O (2011) Breast imaging: a survey. World J Clin Oncol 2(4):171–178CrossRef Sree SV, Ng EY-K, Acharya RU, Faust O (2011) Breast imaging: a survey. World J Clin Oncol 2(4):171–178CrossRef
8.
Zurück zum Zitat Prats E, Aisa F, Abós MD, Villavieja L, García-López F, Asenjo MJ, Razola P, Banzo J (1999) Mammography and 99mTc- MIBI scintimammography in suspected breast cancer. J Nucl Med 40:296–301PubMed Prats E, Aisa F, Abós MD, Villavieja L, García-López F, Asenjo MJ, Razola P, Banzo J (1999) Mammography and 99mTc- MIBI scintimammography in suspected breast cancer. J Nucl Med 40:296–301PubMed
9.
Zurück zum Zitat Munnink TH, Nagengast WB, Brouwers AH, Schr oder CP, Hospers GA, M. N. Lub-de Hooge MNL et al (2009) Molecular imaging of breast cancer. The Breast 18(S3):S66–S73CrossRef Munnink TH, Nagengast WB, Brouwers AH, Schr oder CP, Hospers GA, M. N. Lub-de Hooge MNL et al (2009) Molecular imaging of breast cancer. The Breast 18(S3):S66–S73CrossRef
10.
Zurück zum Zitat Huysmans M, Bronckaers M, Schillebeeckx C, Servaes D (2017) Incidental breast carcinoma in reduction mammoplasty. Acta Chir Belg 117(5):308–311CrossRef Huysmans M, Bronckaers M, Schillebeeckx C, Servaes D (2017) Incidental breast carcinoma in reduction mammoplasty. Acta Chir Belg 117(5):308–311CrossRef
11.
Zurück zum Zitat Usón Junior PLS, Callegaro Filho D, Bugano DDG, Geyer FC, de Nigro Corpa MV, Gonçalves PDS, Simon SD, Kaliks RA Incidental findings in reductionn mammoplasty specimens in patients with no prior history of breast cancer. An analysis of 783 specimens. Pathol Oncol Res 2018;24[1]:95–99 Usón Junior PLS, Callegaro Filho D, Bugano DDG, Geyer FC, de Nigro Corpa MV, Gonçalves PDS, Simon SD, Kaliks RA Incidental findings in reductionn mammoplasty specimens in patients with no prior history of breast cancer. An analysis of 783 specimens. Pathol Oncol Res 2018;24[1]:95–99
12.
Zurück zum Zitat Abiy B. Ambaye, MD; Andrew J. Goodwin, MD; Susan E. MacLennan, MD; Shelly Naud, PhD; Donald L. Weaver, Recommendations for pathologic evaluation of reduction mammoplasty specimens a prospective study with systematic tissue sampling Arch Pathol Lab Med 2017;141:1523–1528 Abiy B. Ambaye, MD; Andrew J. Goodwin, MD; Susan E. MacLennan, MD; Shelly Naud, PhD; Donald L. Weaver, Recommendations for pathologic evaluation of reduction mammoplasty specimens a prospective study with systematic tissue sampling Arch Pathol Lab Med 2017;141:1523–1528
13.
Zurück zum Zitat Ambaye AB, MacLennan SE, Goodwin AJ, Suppan T, Naud S, Weaver DL Carcinoma and atypical hyperplasia in reduction mammaplasty: increased sampling leads to increased detection. A prospective study. Plast Reconstr Surg 2009;124[5]:1386–1392 Ambaye AB, MacLennan SE, Goodwin AJ, Suppan T, Naud S, Weaver DL Carcinoma and atypical hyperplasia in reduction mammaplasty: increased sampling leads to increased detection. A prospective study. Plast Reconstr Surg 2009;124[5]:1386–1392
14.
Zurück zum Zitat Talghini S (2013) Is makromastia a risk factor of breast cancer? A study on 198 patients Parkistan. Aust J Biol Sci 16(21):1348–1152 Talghini S (2013) Is makromastia a risk factor of breast cancer? A study on 198 patients Parkistan. Aust J Biol Sci 16(21):1348–1152
15.
Zurück zum Zitat Pinder SE, Ellis IO (2003) The diagnosis and management of pre-invasive breast disease: ductal carcinoma in situ [DCIS] and atypical ductal hyperplasia [ADH]--current definitions and classification. Breast Cancer Res 5(5):254–257CrossRef Pinder SE, Ellis IO (2003) The diagnosis and management of pre-invasive breast disease: ductal carcinoma in situ [DCIS] and atypical ductal hyperplasia [ADH]--current definitions and classification. Breast Cancer Res 5(5):254–257CrossRef
16.
Zurück zum Zitat Visscher DW, Nassar A, Degnim AC, Frost MH, Vierkant RA, Frank RD et al (2014) Sclerosing adenosis and risk of breast cancer. Breast Cancer Res Treat 144(1):205–212CrossRef Visscher DW, Nassar A, Degnim AC, Frost MH, Vierkant RA, Frank RD et al (2014) Sclerosing adenosis and risk of breast cancer. Breast Cancer Res Treat 144(1):205–212CrossRef
17.
Zurück zum Zitat Jacobs TW, Byrne C, Colditz G, Connolly JL, Schnitt SJ (1999) Radial scars in benign breast-biopsy specimens and the risk of breast cancer. N Engl J Med 340(6):430–436CrossRef Jacobs TW, Byrne C, Colditz G, Connolly JL, Schnitt SJ (1999) Radial scars in benign breast-biopsy specimens and the risk of breast cancer. N Engl J Med 340(6):430–436CrossRef
18.
Zurück zum Zitat Khan S, Diaz A, Archer KJ, Lehman RR, Mullins T, Cardenosa G, Bear HD (2017) Papillary lesions of the breast: to excise or observe? Breast J Khan S, Diaz A, Archer KJ, Lehman RR, Mullins T, Cardenosa G, Bear HD (2017) Papillary lesions of the breast: to excise or observe? Breast J
19.
Zurück zum Zitat Mastroianni M, Lin A, Hughes K, Colwell AS (2019) Proliferative lesions found at reduction mammaplasty: incidence and implications in 995 breast reductions. Plast Reconstr Surg 143(2):271e–275eCrossRef Mastroianni M, Lin A, Hughes K, Colwell AS (2019) Proliferative lesions found at reduction mammaplasty: incidence and implications in 995 breast reductions. Plast Reconstr Surg 143(2):271e–275eCrossRef
20.
Zurück zum Zitat Klement KA, Hijjawi JB, Neuner J, Kelley K, Kong AL (2019) Discussion of preoperative mammography in women undergoing reduction mammaplasty. Breast J 25(3):439–443CrossRef Klement KA, Hijjawi JB, Neuner J, Kelley K, Kong AL (2019) Discussion of preoperative mammography in women undergoing reduction mammaplasty. Breast J 25(3):439–443CrossRef
21.
Zurück zum Zitat Acevedo F, Armengol VD, Deng Z, Tang R, Coopey SB, Braun D, Yala A,Barzilay r and et al Pathologic findings in reduction mammoplasty specimens: a surrogate for the population prevalence of breast cancer and high-risk lesions Breast Cancer Res Treat. 2019;173(1):201–207 Acevedo F, Armengol VD, Deng Z, Tang R, Coopey SB, Braun D, Yala A,Barzilay r and et al Pathologic findings in reduction mammoplasty specimens: a surrogate for the population prevalence of breast cancer and high-risk lesions Breast Cancer Res Treat. 2019;173(1):201–207
22.
Zurück zum Zitat Clark CJ, Susan W, Paige KT (2009) Incidence of precancerous lesions in breast reduction tissue: a pathologic review of 562 consecutive patients. Plast Reconstr Surg 124(4):1033–1039CrossRef Clark CJ, Susan W, Paige KT (2009) Incidence of precancerous lesions in breast reduction tissue: a pathologic review of 562 consecutive patients. Plast Reconstr Surg 124(4):1033–1039CrossRef
23.
Zurück zum Zitat Acevedo F, Armengol VD, Deng Z, Tang R, Coopey SB, Braun D et al (2018) Pathologic findings in reduction mammoplasty specimens: a surrogate for the population prevalence of breast cancer and high-risk lesions. Breast Cancer Res Treat Acevedo F, Armengol VD, Deng Z, Tang R, Coopey SB, Braun D et al (2018) Pathologic findings in reduction mammoplasty specimens: a surrogate for the population prevalence of breast cancer and high-risk lesions. Breast Cancer Res Treat
24.
Zurück zum Zitat Titley OG, Armstrong AP, Christie JL, Fatah MFT (1996) Pathological findings in breast reduction surgery. Br J Plast Surg 49:447–451CrossRef Titley OG, Armstrong AP, Christie JL, Fatah MFT (1996) Pathological findings in breast reduction surgery. Br J Plast Surg 49:447–451CrossRef
Metadaten
Titel
Approach to histopathological incidental lesions after reduction mammoplasty
verfasst von
Handan Derebaşınlıoğlu
Sarper Yılmaz
Publikationsdatum
22.10.2019
Verlag
Springer Berlin Heidelberg
Erschienen in
European Journal of Plastic Surgery / Ausgabe 2/2020
Print ISSN: 0930-343X
Elektronische ISSN: 1435-0130
DOI
https://doi.org/10.1007/s00238-019-01576-0

Weitere Artikel der Ausgabe 2/2020

European Journal of Plastic Surgery 2/2020 Zur Ausgabe

Update Chirurgie

Bestellen Sie unseren Fach-Newsletter und bleiben Sie gut informiert.

S3-Leitlinie „Diagnostik und Therapie des Karpaltunnelsyndroms“

Karpaltunnelsyndrom BDC Leitlinien Webinare
CME: 2 Punkte

Das Karpaltunnelsyndrom ist die häufigste Kompressionsneuropathie peripherer Nerven. Obwohl die Anamnese mit dem nächtlichen Einschlafen der Hand (Brachialgia parästhetica nocturna) sehr typisch ist, ist eine klinisch-neurologische Untersuchung und Elektroneurografie in manchen Fällen auch eine Neurosonografie erforderlich. Im Anfangsstadium sind konservative Maßnahmen (Handgelenksschiene, Ergotherapie) empfehlenswert. Bei nicht Ansprechen der konservativen Therapie oder Auftreten von neurologischen Ausfällen ist eine Dekompression des N. medianus am Karpaltunnel indiziert.

Prof. Dr. med. Gregor Antoniadis
Berufsverband der Deutschen Chirurgie e.V.

S2e-Leitlinie „Distale Radiusfraktur“

Radiusfraktur BDC Leitlinien Webinare
CME: 2 Punkte

Das Webinar beschäftigt sich mit Fragen und Antworten zu Diagnostik und Klassifikation sowie Möglichkeiten des Ausschlusses von Zusatzverletzungen. Die Referenten erläutern, welche Frakturen konservativ behandelt werden können und wie. Das Webinar beantwortet die Frage nach aktuellen operativen Therapiekonzepten: Welcher Zugang, welches Osteosynthesematerial? Auf was muss bei der Nachbehandlung der distalen Radiusfraktur geachtet werden?

PD Dr. med. Oliver Pieske
Dr. med. Benjamin Meyknecht
Berufsverband der Deutschen Chirurgie e.V.

S1-Leitlinie „Empfehlungen zur Therapie der akuten Appendizitis bei Erwachsenen“

Appendizitis BDC Leitlinien Webinare
CME: 2 Punkte

Inhalte des Webinars zur S1-Leitlinie „Empfehlungen zur Therapie der akuten Appendizitis bei Erwachsenen“ sind die Darstellung des Projektes und des Erstellungswegs zur S1-Leitlinie, die Erläuterung der klinischen Relevanz der Klassifikation EAES 2015, die wissenschaftliche Begründung der wichtigsten Empfehlungen und die Darstellung stadiengerechter Therapieoptionen.

Dr. med. Mihailo Andric
Berufsverband der Deutschen Chirurgie e.V.