I want to thank Drs. Marino et al. for their interest and kind words. As they emphasize,
the oncological aspect of reduction mammaplasty (RM) is an important consideration.
In breast hypertrophy, by reducing the amount of normal breast tissue or breast tissue
with increased risk of developing breast cancer, the subsequent risk for breast cancer
is diminished, although other unknown factors contribute.
1
Combined preoperative screening and histological examination of the specimen is supported
to detect occult breast carcinoma in RM patient populations.
2
However, if a selective approach is used based on age or family history, it is somewhat
unclear which patients without previous history of precancerous or cancerous findings
should be included. Nevertheless, the value of negative preoperative screening mammography
or other factors has been questioned by Dini et al., as all patients in their study
with abnormal histological findings were negative for preoperative screening, history
of breast carcinoma or intraoperative findings.
3
When pathological examination is performed, it should accurately focus on enabling
further oncoplastic procedures and oncological treatments.
4
Nonetheless, the cost of finding an occult breast cancer by routine and laborious
pathological screening of RM specimens has been questioned.
5
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References
- Screening for breast cancer post reduction mammoplasty.Clin Radiol. 2010; 65: 198-205
- Oncological screening for bilateral breast reduction: a survey of practice variations in UK breast and plastics surgeons 2009.J Plast Reconstr Aesthet Surg. 2011; 64: 878-883
- Unsuspected breast carcinoma in reduction mammaplasty specimens and the role of pathologic examination.Plast Reconstr Surg. 2011; 128 (815-6; author reply): 17-18
- Occult carcinoma in 866 reduction mammaplasties: preserving the choice of lumpectomy.Plast Reconstr Surg. 2011; 127: 525-530
- The price of pathology: is screening all breast reduction specimens cost effective.Plast Reconstr Surg. 2010; 125 (1575-6; author reply): 76-77
Article info
Publication history
Published online: March 30, 2012
Identification
Copyright
© 2012 British Association of Plastic, Reconstructive and Aesthetic Surgeons. Published by Elsevier Inc. All rights reserved.
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- The cost utility of reduction mammaplastyJournal of Plastic, Reconstructive & Aesthetic SurgeryVol. 65Issue 9
