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Front. Surg. | doi: 10.3389/fsurg.2018.00017

Occurrence of occult malignancies in reduction mammoplasties

 Matthias Waldner1*, Holger J. Klein1, Walter Künzi2,  Merlin Guggenheim3,  Jan A. Plock1 and Pietro Giovanoli1
  • 1Division of Plastic Surgery and Hand Surgery, UniversitätsSpital Zürich, Switzerland
  • 2Euro-Policlinic Switzerland, Switzerland
  • 3Swissparc Zurich, Switzerland

Objectives: Patients undergoing reduction mammoplasty (RM) bear the risk of having occult breast cancer nests. The detection rate of malignant neoplasms in the resected specimens, varies greatly in the literature. The aim of our present study was to analyze risk factors and evaluate histopathological findings in our cohort of patients who underwent RM towards our center.
Material and methods: In this retrospective single center study we analyzed 559 female patients (median age 35.99 (±13.34)) who underwent RM between 2000 and 2010. The presence of carcinoma and ductal- (DCIS) or lobular carcinoma in situ (LCIS) were considered as pathological findings. Body mass index (BMI), age, surgical technique and mass of resected tissue were included into the analysis.
Results: There were 6 cases of occult neoplasia (1.08 %) including 2 cases of breast cancer, one multicentric DCIS and 3 cases of LCIS (0.54 %) in 559 patients. Patients with breast cancer showed a significant increased median age: 49y median (IQR ±18) vs. 35y (IQR ±21) (p=0.004) and a trend towards increased BMI: 25.88 median (IQR ±7.3) vs. 24.50 (IQR ±4.09) (p=0.219), compared to patients without pathological results. One patient with occult carcinoma had a negative preoperative mammography, a patient with LCIS a negative preoperative breast ultrasound.
Conclusions: In our study the occurrence of occult neoplasia was associated with increased age and showed a trend towards increased BMI when compared to patients without pathological findings. The study demonstrates the necessity of thorough medical history, preoperative diagnostic screening and histopathological analysis of all resected specimens.

Keywords: Mammaplasty, breast cancer, histopathological analysis, Retrospective Studies, Ductal carcinoma in situ (DCIS)

Received: 25 Nov 2017; Accepted: 12 Feb 2018.

Edited by:

Warren M. Rozen, Plastic Surgery Research Group, Monash University, Australia

Reviewed by:

Fatih Zor, Wake Forest Institute for Regenerative Medicine, United States
Michael P. Chae, Peninsula Health, Australia  

Copyright: © 2018 Waldner, Klein, Künzi, Guggenheim, Plock and Giovanoli. This is an open-access article distributed under the terms of the Creative Commons Attribution License (CC BY). The use, distribution or reproduction in other forums is permitted, provided the original author(s) and the copyright owner are credited and that the original publication in this journal is cited, in accordance with accepted academic practice. No use, distribution or reproduction is permitted which does not comply with these terms.

* Correspondence: MD. Matthias Waldner, UniversitätsSpital Zürich, Division of Plastic Surgery and Hand Surgery, Rämistrasse 100, Zurich, 8091, Switzerland, matthias.waldner@gmail.com