Breast reduction surgery may uncover cancer risk

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When women undergo surgery to reduce their breast size, examination of the removed tissue may sometimes point to a risk of developing cancer—even among women younger than 40—according to a presentation at this week’s American Society of Plastic Surgeons Plastic Surgery 2005 conference in Chicago.

The findings suggest that a policy of submitting breast tissue for pathologic examination only from patients age 40 and older could miss some important cases.

“Most hospitals have a rule that anything removed needs to be sent to pathology for examination,” said Dr. Kristin Stueber. “The question becomes, in a cost-conscious era, is there a way to potentially reduce costs by eliminating unnecessary testing?”

To look into the question, Stueber and her colleagues reviewed the records of 300 women who had undergone breast reduction surgery between 1991 and 1999 at Bay State Medical Center in Springfield, Massachusetts. Tissue specimens were sent to a pathology lab for examination.

Thirty-six (12 percent) of the patients, with ages ranging from 16 to 73 years, had abnormal pathology results indicating increased risk of developing breast cancer.

Twenty-six were low-risk lesions, but the other ten had lesions that were moderate or high risk. Two of these ten patients were younger than 40.

“Limiting pathologic examination of reduction mammoplasty specimens to women older than 40 years would fail to identify 20 percent of moderate to high risk pathology,” Stueber’s group maintains in their meeting materials. “Despite the potential cost savings, this is not an acceptable risk.”

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