Skip to main content
Erschienen in: World Journal of Surgery 8/2017

02.03.2017 | Original Scientific Report

Breast Cancer Detection by Preoperative Imaging in Reduction Mammaplasty Patients: A Single Center Study of 918 Patients

verfasst von: Päivi A. Merkkola-von Schantz, Susanna M. C. Kauhanen, Tiina A. Jahkola, Leena A. Krogerus, Katja S. Hukkinen

Erschienen in: World Journal of Surgery | Ausgabe 8/2017

Einloggen, um Zugang zu erhalten

Abstract

Background

The role of preoperative imaging and the usability of different imaging modalities is highly variable and controversial in reduction mammaplasty patients. Our study describes the imaging process in a single center in regard to modality selection, age and timing, and of the association between imaging and histopathological findings in reduction mammaplasty specimens.

Methods

Nine hundred eighteen women, who underwent reduction mammaplasty during 1.1.2007–31.12.2011, were retrospectively reviewed for demographics, preoperative imaging, further preoperative examinations, and pathology reports.

Results

Preoperative imaging had been conducted for 89.2% (n = 819) of the patients. In 49 (6.0%) patients, suspicious preoperative imaging led to further examinations revealing 2 high-risk lesions (atypical ductal hyperplasia (ADH), lobular carcinoma in situ (LCIS)), and 2 cancers preoperatively. Postoperatively abnormal histopathology specimens were revealed in 88 (10.4%) patients. The incidence of high-risk lesions was 5.5% (n = 47), and the incidence of cancer was 1.2% (n = 10). Preoperative imaging was normal (BI-RADS 1 and BI-RADS 2) in 80.8% of these patients. The sensitivity of the preoperative imaging for cancer detection was 20.0%, and the specificity was 100.0%.

Conclusions

Preoperative imaging and further examinations do not sufficiently detect malignant or cancer risk-increasing findings. Therefore, histopathological analysis of reduction mammaplasty specimens seems mandatory.
Literatur
1.
Zurück zum Zitat Hassan FE, Pacifico MD (2012) Should we be analysing breast reduction specimens? A systematic analysis of over 1,000 consecutive cases. Aesthetic Plast Surg 36:1105–1113CrossRefPubMed Hassan FE, Pacifico MD (2012) Should we be analysing breast reduction specimens? A systematic analysis of over 1,000 consecutive cases. Aesthetic Plast Surg 36:1105–1113CrossRefPubMed
2.
Zurück zum Zitat Clark CJ, Whang S, Paige KT (2009) Incidence of precancerous lesions in breast reduction tissue: a pathologic review of 562 consecutive patients. Plast Reconstr Surg 124:1033–1039CrossRefPubMed Clark CJ, Whang S, Paige KT (2009) Incidence of precancerous lesions in breast reduction tissue: a pathologic review of 562 consecutive patients. Plast Reconstr Surg 124:1033–1039CrossRefPubMed
3.
Zurück zum Zitat Ambaye AB, MacLennan SE, Goodwin AJ et al (2009) Carcinoma and atypical hyperplasia in reduction mammaplasty: increased sampling leads to increased detection. A prospective study. Plast Reconstr Surg 124:1386–1392CrossRefPubMed Ambaye AB, MacLennan SE, Goodwin AJ et al (2009) Carcinoma and atypical hyperplasia in reduction mammaplasty: increased sampling leads to increased detection. A prospective study. Plast Reconstr Surg 124:1386–1392CrossRefPubMed
4.
Zurück zum Zitat Boice JD Jr, Persson I, Brinton LA et al (2000) Breast cancer following breast reduction surgery in Sweden. Plast Reconstr Surg 106:755–762CrossRefPubMed Boice JD Jr, Persson I, Brinton LA et al (2000) Breast cancer following breast reduction surgery in Sweden. Plast Reconstr Surg 106:755–762CrossRefPubMed
5.
Zurück zum Zitat Colwell AS, Kukreja J, Breuing KH et al (2004) Occult breast carcinoma in reduction mammaplasty specimens: 14-year experience. Plast Reconstr Surg 113:1984–1988CrossRefPubMed Colwell AS, Kukreja J, Breuing KH et al (2004) Occult breast carcinoma in reduction mammaplasty specimens: 14-year experience. Plast Reconstr Surg 113:1984–1988CrossRefPubMed
6.
Zurück zum Zitat Kakagia D, Fragia K, Grekou A et al (2005) Reduction mammaplasty specimens and occult breast carcinomas. Eur J Surg Oncol 31:19–21CrossRefPubMed Kakagia D, Fragia K, Grekou A et al (2005) Reduction mammaplasty specimens and occult breast carcinomas. Eur J Surg Oncol 31:19–21CrossRefPubMed
7.
Zurück zum Zitat Slezak S, Bluebond-Langner R (2011) Occult carcinoma in 866 reduction mammaplasties: preserving the choice of lumpectomy. Plast Reconstr Surg 127:525–530CrossRefPubMed Slezak S, Bluebond-Langner R (2011) Occult carcinoma in 866 reduction mammaplasties: preserving the choice of lumpectomy. Plast Reconstr Surg 127:525–530CrossRefPubMed
8.
Zurück zum Zitat Freedman BC, Smith SM, Estabrook A et al (2012) Incidence of occult carcinoma and high-risk lesions in mammaplasty specimens. Int J Breast Cancer 2012:145630CrossRefPubMedPubMedCentral Freedman BC, Smith SM, Estabrook A et al (2012) Incidence of occult carcinoma and high-risk lesions in mammaplasty specimens. Int J Breast Cancer 2012:145630CrossRefPubMedPubMedCentral
9.
Zurück zum Zitat Merkkola-von Schantz P, Jahkola T, Carpelan A et al (2014) Adverse histopathology and imaging findings in reduction mammaplasty day-surgery patients. Scand J Surg 103:209–214CrossRefPubMed Merkkola-von Schantz P, Jahkola T, Carpelan A et al (2014) Adverse histopathology and imaging findings in reduction mammaplasty day-surgery patients. Scand J Surg 103:209–214CrossRefPubMed
10.
Zurück zum Zitat Dupont WD, Page DL (1985) Risk factors for breast cancer in women with proliferative breast disease. N Engl J Med 312:146–151CrossRefPubMed Dupont WD, Page DL (1985) Risk factors for breast cancer in women with proliferative breast disease. N Engl J Med 312:146–151CrossRefPubMed
11.
Zurück zum Zitat Page DL, Dupont WD, Rogers LW et al (1985) Atypical hyperplastic lesions of the female breast. A long-term follow-up study. Cancer 55:2698–2708PubMed Page DL, Dupont WD, Rogers LW et al (1985) Atypical hyperplastic lesions of the female breast. A long-term follow-up study. Cancer 55:2698–2708PubMed
12.
Zurück zum Zitat Blansfield JA, Kukora JS, Goldhahn RT Jr et al (2004) Suspicious findings in reduction mammaplasty specimens: review of 182 consecutive patients. Ann Plast Surg 52:126–130CrossRefPubMed Blansfield JA, Kukora JS, Goldhahn RT Jr et al (2004) Suspicious findings in reduction mammaplasty specimens: review of 182 consecutive patients. Ann Plast Surg 52:126–130CrossRefPubMed
13.
Zurück zum Zitat Carter CL, Corle DK, Micozzi MS et al (1988) A prospective study of the development of breast cancer in 16,692 women with benign breast disease. Am J Epidemiol 128:467–477CrossRefPubMed Carter CL, Corle DK, Micozzi MS et al (1988) A prospective study of the development of breast cancer in 16,692 women with benign breast disease. Am J Epidemiol 128:467–477CrossRefPubMed
14.
Zurück zum Zitat Dupont WD, Parl FF, Hartmann WH et al (1993) Breast cancer risk associated with proliferative breast disease and atypical hyperplasia. Cancer 71:1258–1265CrossRefPubMed Dupont WD, Parl FF, Hartmann WH et al (1993) Breast cancer risk associated with proliferative breast disease and atypical hyperplasia. Cancer 71:1258–1265CrossRefPubMed
15.
Zurück zum Zitat Hartmann LC, Sellers TA, Frost MH et al (2005) Benign breast disease and the risk of breast cancer. N Engl J Med 353:229–237CrossRefPubMed Hartmann LC, Sellers TA, Frost MH et al (2005) Benign breast disease and the risk of breast cancer. N Engl J Med 353:229–237CrossRefPubMed
16.
Zurück zum Zitat Fitzgibbons PL, Henson DE, Hutter RV (1998) Benign breast changes and the risk for subsequent breast cancer: an update of the 1985 consensus statement. Cancer Committee of the College of American Pathologists. Arch Pathol Lab Med 122:1053–1055PubMed Fitzgibbons PL, Henson DE, Hutter RV (1998) Benign breast changes and the risk for subsequent breast cancer: an update of the 1985 consensus statement. Cancer Committee of the College of American Pathologists. Arch Pathol Lab Med 122:1053–1055PubMed
17.
Zurück zum Zitat Morrow M, Schnitt SJ, Norton L (2015) Current management of lesions associated with an increased risk of breast cancer. Nat Rev Clin Oncol 12:227–238CrossRefPubMed Morrow M, Schnitt SJ, Norton L (2015) Current management of lesions associated with an increased risk of breast cancer. Nat Rev Clin Oncol 12:227–238CrossRefPubMed
18.
Zurück zum Zitat Hage JJ, Karim RB (2006) Risk of breast cancer among reduction mammaplasty patients and the strategies used by plastic surgeons to detect such cancer. Plast Reconstr Surg 117:727–735 discussion 736CrossRefPubMed Hage JJ, Karim RB (2006) Risk of breast cancer among reduction mammaplasty patients and the strategies used by plastic surgeons to detect such cancer. Plast Reconstr Surg 117:727–735 discussion 736CrossRefPubMed
19.
Zurück zum Zitat van der Torre PM, Butzelaar RM (1997) Breast cancer and reduction mammoplasty: the role of routine pre-operative mammography. Eur J Surg Oncol 23:341–342CrossRefPubMed van der Torre PM, Butzelaar RM (1997) Breast cancer and reduction mammoplasty: the role of routine pre-operative mammography. Eur J Surg Oncol 23:341–342CrossRefPubMed
20.
Zurück zum Zitat Campbell MJ, Clark CJ, Paige KT (2010) The role of preoperative mammography in women considering reduction mammoplasty: a single institution review of 207 patients. Am J Surg 199:636–640CrossRefPubMed Campbell MJ, Clark CJ, Paige KT (2010) The role of preoperative mammography in women considering reduction mammoplasty: a single institution review of 207 patients. Am J Surg 199:636–640CrossRefPubMed
21.
Zurück zum Zitat Hennedige AA, Kong TY, Gandhi A (2011) Oncological screening for Bilateral Breast Reduction: a survey of practice variations in UK Breast and Plastics surgeons 2009. J Plast Reconstr Aesthet Surg 64:878–883CrossRefPubMed Hennedige AA, Kong TY, Gandhi A (2011) Oncological screening for Bilateral Breast Reduction: a survey of practice variations in UK Breast and Plastics surgeons 2009. J Plast Reconstr Aesthet Surg 64:878–883CrossRefPubMed
22.
Zurück zum Zitat D’Orsi C, Sickles E, Mendelson E, et al (2013) In: ACR BI-RADS Atlas, Breast Imaging Reporting and Data System, Reston, VA D’Orsi C, Sickles E, Mendelson E, et al (2013) In: ACR BI-RADS Atlas, Breast Imaging Reporting and Data System, Reston, VA
23.
Zurück zum Zitat Butler CE, Hunt KK, Singletary SE (2003) Management of breast carcinoma identified intraoperatively during reduction mammaplasty. Ann Plast Surg 50:193–197CrossRefPubMed Butler CE, Hunt KK, Singletary SE (2003) Management of breast carcinoma identified intraoperatively during reduction mammaplasty. Ann Plast Surg 50:193–197CrossRefPubMed
24.
Zurück zum Zitat White J, Turton P, Dodwell D et al (2012) Issues in the management of occult neoplasia in breast reduction surgery. Breast J 18:198–199CrossRefPubMed White J, Turton P, Dodwell D et al (2012) Issues in the management of occult neoplasia in breast reduction surgery. Breast J 18:198–199CrossRefPubMed
25.
Zurück zum Zitat Houssami N, Abraham LA, Onega T et al (2014) Accuracy of screening mammography in women with a history of lobular carcinoma in situ or atypical hyperplasia of the breast. Breast Cancer Res Treat 145:765–773CrossRefPubMedPubMedCentral Houssami N, Abraham LA, Onega T et al (2014) Accuracy of screening mammography in women with a history of lobular carcinoma in situ or atypical hyperplasia of the breast. Breast Cancer Res Treat 145:765–773CrossRefPubMedPubMedCentral
26.
Zurück zum Zitat Saarenmaa I, Salminen T, Geiger U et al (2001) The effect of age and density of the breast on the sensitivity of breast cancer diagnostic by mammography and ultasonography. Breast Cancer Res Treat 67:117–123CrossRefPubMed Saarenmaa I, Salminen T, Geiger U et al (2001) The effect of age and density of the breast on the sensitivity of breast cancer diagnostic by mammography and ultasonography. Breast Cancer Res Treat 67:117–123CrossRefPubMed
28.
Zurück zum Zitat Alvarado R, Lari SA, Roses RE et al (2012) Biology, treatment, and outcome in very young and older women with DCIS. Ann Surg Oncol 19:3777–3784CrossRefPubMed Alvarado R, Lari SA, Roses RE et al (2012) Biology, treatment, and outcome in very young and older women with DCIS. Ann Surg Oncol 19:3777–3784CrossRefPubMed
Metadaten
Titel
Breast Cancer Detection by Preoperative Imaging in Reduction Mammaplasty Patients: A Single Center Study of 918 Patients
verfasst von
Päivi A. Merkkola-von Schantz
Susanna M. C. Kauhanen
Tiina A. Jahkola
Leena A. Krogerus
Katja S. Hukkinen
Publikationsdatum
02.03.2017
Verlag
Springer International Publishing
Erschienen in
World Journal of Surgery / Ausgabe 8/2017
Print ISSN: 0364-2313
Elektronische ISSN: 1432-2323
DOI
https://doi.org/10.1007/s00268-017-3920-z

Weitere Artikel der Ausgabe 8/2017

World Journal of Surgery 8/2017 Zur Ausgabe

Update Chirurgie

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

S3-Leitlinie „Diagnostik und Therapie des Karpaltunnelsyndroms“

CME: 2 Punkte

Prof. Dr. med. Gregor Antoniadis 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“

CME: 2 Punkte

Dr. med. Benjamin Meyknecht, PD Dr. med. Oliver Pieske Das Webinar S2e-Leitlinie „Distale Radiusfraktur“ 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“

CME: 2 Punkte

Dr. med. Mihailo Andric
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.