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World J Surg. 2017 Aug;41(8):2013-2019. doi: 10.1007/s00268-017-3920-z.

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

Author information

1
Department of Plastic and Reconstructive Surgery, University of Helsinki and Helsinki University Hospital, P.O. Box 266, 00029, Helsinki, Finland. paivi.merkkola-vonschantz@hus.fi.
2
Department of Plastic and Reconstructive Surgery, University of Helsinki and Helsinki University Hospital, P.O. Box 266, 00029, Helsinki, Finland.
3
Department of Pathology, University of Helsinki and Helsinki University Hospital, P.O. Box 800, 00029, Helsinki, Finland.
4
Department of Radiology, University of Helsinki and Helsinki University Hospital, P.O. Box 263, 00029, Helsinki, Finland.

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.

PMID:
28255630
DOI:
10.1007/s00268-017-3920-z
[Indexed for MEDLINE]

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