Reduction mammaplasty in patients with history of breast cancer : The incidence of occult cancer and high-risk lesions

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http://hdl.handle.net/10138/297982

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Merkkola-von Schantz , P A , Jahkola , T A , Krogerus , L A & Kauhanen , S M C 2017 , ' Reduction mammaplasty in patients with history of breast cancer : The incidence of occult cancer and high-risk lesions ' , Breast , vol. 35 , pp. 157-161 . https://doi.org/10.1016/j.breast.2017.07.009

Title: Reduction mammaplasty in patients with history of breast cancer : The incidence of occult cancer and high-risk lesions
Author: Merkkola-von Schantz, Paivi A.; Jahkola, Tiina A.; Krogerus, Leena A.; Kauhanen, Susanna M. C.
Contributor: University of Helsinki, Department of Surgery
University of Helsinki, Clinicum
University of Helsinki, Plastiikkakirurgian yksikkö
Date: 2017-10
Language: eng
Number of pages: 5
Belongs to series: Breast
ISSN: 0960-9776
URI: http://hdl.handle.net/10138/297982
Abstract: Introduction: Contralateral reduction mammaplasty is regularly included in the treatment of breast cancer patients. We analyzed the incidence of occult breast cancer and high-risk lesions in reduction mammaplasty specimens of women with previous breast cancer. We also analyzed if timing of reduction mammaplasty in relation to oncological treatment influenced the incidence of abnormal findings, and compared if patients with abnormal contralateral histopathology differed from the study population in terms of demographics. Materials and methods: The study consisted of 329 breast cancer patients, who underwent symmetrizing reduction mammaplasty between 1/2007 and 12/2011. The data was retrospectively analyzed for demographics, operative and histopathology reports, oncological treatment, and postoperative follow-up. Results: Reduction mammaplasty specimens revealed abnormal findings in 68 (21.5%) patients. High-risk lesions (ADH, ALH, and LCIS) were revealed in 37 (11.7%), and cancer in six (1.9%) patients. Abnormal histopathology correlated with higher age (p = 0.0053), heavier specimen (p = 0.0491), and with no previous breast surgery (p <0.001). Abnormal histopathological findings were more frequent in patients with reduction mammaplasty performed prior to oncological treatment (p <0.001), and in patients with immediate reconstruction (p = 0.0064). Conclusion: The incidences of malignant and high-risk lesions are doubled compared to patients without prior breast cancer. Patients with abnormal histopathology cannot be preoperatively identified based on demographics. If reduction mammaplasty is performed before oncological treatment, the incidence of abnormal findings is higher. In the light of our results, contralateral reduction mammaplasty with histopathological evaluation in breast cancer patients offers a sophisticated tool to catch those patients whose contralateral breast needs increased attention. (C) 2017 Elsevier Ltd. All rights reserved.
Subject: Breast cancer
Reduction mammoplasty
Occult cancer
High-risk lesion
CARCINOMA IN-SITU
ATYPICAL HYPERPLASIA
SPECIMENS
WOMEN
DISEASE
MASTOPLASTY
EXPERIENCE
3123 Gynaecology and paediatrics
3122 Cancers
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