Background
Preoperative, intraoperative and follow-up guidelines for managing occult carcinoma in
reduction mammoplasty specimens are scant.
Methods
We retrospectively analysed the records and pathology reports of 200 patients who had
undergone reduction mammoplasty at two major public hospitals in Johannesburg, South
Africa, during 2009 - 2014. Demographic data, their history of breast cancer and preoperative
screening, and the surgical techniques used and pathological reports were included. In all
cases, preoperative screening for breast cancer had been negative.
Results
All the patients were female, mean age 37.1 years, range 20 - 84 (standard deviation 11.9).
All reductions were performed using standard techniques. Benign pathology was observed in
98 patients (49%) and malignant pathology in four (2%). The most common benign
pathology observed was fibrocystic disease, and the most common malignant pathology
ductal carcinoma in situ. Patient age correlated significantly with benign or malignant
disease.
Conclusions
Reduction mammoplasty produces tissue that should always be sent for pathological
assessment. Patients should be stratified by risk, as doing so helps in selecting both the
surgical setting and the approach to pathological analysis of the specimen. While the
Pathologic findings in reduction mammaplasty specimens: A South African perspective
incidence of occult carcinoma in reduction mammoplasty specimens is low, all patients
undergoing the procedure should be informed that tissue will be sent for pathological
examination, allowing them to prepare to receive possible news of breast cancer and be
adequately equipped for subsequent decision-making.LG201
