Proliferative Lesions Found at Reduction Mammoplasty: Incidence and Implications in 995 Breast Reductions

PURPOSE: Reduction mammoplasty relieves symptomatic macromastia. Pathology specimens occasionally reveal unsuspected proliferative lesions or carcinoma. Few studies examine incidence, risk factors, and outcomes in this population. METHODS: Retrospective review was performed between 2000 and 2012. Pathology was categorized as benign, proliferative, or cancer (DCIS or invasive). RESULTS: Five hundred seventy-two patients had 995 reduction mammoplasties (85% bilateral, 15% unilateral). Cancer was detected in 23 (2.3%) specimens and proliferative lesions in 137 (13.8%). Compared to patients with benign pathology, patients with proliferative lesions or cancer were older (p0.5). Forty-one percent of patients with proliferative lesions and no history of cancer had a change in management with increased surveillance, hormones, radiation, chemotherapy, or surgery. If there was a history of cancer, fifty-four percent had a change in management. Of patients with DCIS or cancer, all received oncologic treatment. CONCLUSIONS: Proliferative lesions of the breast may be more common that previously reported. Age and a history of breast cancer increase risk for proliferative lesions. All should be referred to oncology as nearly half of these patients will have a change in management. Presented at the American Association of Plastic Surgeons Meeting in Austin, Tx 2017. Financial Disclosure Statement: The authors have no relevant financial relationships to disclose. This work was not supported by any sources of external funding. This work has not previously been published. All authors agree on the content of this manuscript and have contributed to its production. Corresponding Author: Amy S. Colwell, MD, Associate Professor Harvard Medical School, Massachusetts General Hospital , 55 Fruit Street, WACC 435, Boston, MA 02214, acolwell@mgh.harvard.edu ©2018American Society of Plastic Surgeons

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