Comparison of mammography sensitivity after reduction mammoplasty targeting the glandular and fat tissue

Abstract

Objective: Mammography may have some limitations in the diagnosis and screening of breast cancer for women who have previously undergone breast reduction surgery. This study aimed to investigate how the structural defects in the breast tissue formed by postoperative changes are reflected on mammography. Material and Methods:The records of patients who had previously undergone breast reduction surgery and who were requested to undergo mammography for breast cancer screening by the general surgery clinic were retrospectively studied. The patients' ages, surgical procedures, postoperative follow-up periods, amount of removed material, and histopathological and mammographic results were studied. The patients were classified into 3 groups: those older than 40 years who underwent reduction mammoplasty targeting predominantly the glandular tissue (group 1), those younger than 40 years who underwent reduction mammoplasty targeting predominantly the fat tissue (group 2), and those older than 40 years who were diagnosed with breast hypertrophy and were not operated (group 3). Results:The mean follow-up period of the patients was 6 (2-10) years. The mean value of resected tissue was 1120 g (680-2070) in group 1 and 1220 g (720-1980) in group 2. The mean age at the time of surgery was 45 (40-70) years for group 1 and 35 (24-40) years for group 2. All patients in group 1 were classified in Breast Imaging-Reporting and Data System (BI-RADS) category 1-2; 28 patients in group 2 were classified in BI-RADS 1-2, 4 were classified in BI-RADS 3, and 8 were classified in BI-RADS 0. In group 3, 35 patients were classified in BI-RADS 1-2, 4 were classified in BI-RADS 3, and 1 was classified in BI-RADS 0. Conclusion:We believe that breast reduction surgery targeting predominantly the glandular tissue in patients older than 40 years increases mammographic sensitivity.

Radiation doses in mammography exams: Effects of oncological treatments

“…There are reports of histological changes in the breast's tissues, after the radiotherapy [41]. These changes may affect later diagnostic and follow up imaging performed months or years later [42].…”

Multimodality Review of Imaging Features Following Breast Reduction Surgery

“…Moreover, postoperative changes and fat necrosis can easily be attributed to fat-containing masses with or without associated coarse or rim calcifications. However, dystrophic calcifications associated with fat necrosis that appear in the early postoperative stage infrequently may have a questionable morphology and/or distribution (12). The risk of malignancy is still very low in these cases, and calcifications associated with fat necrosis should gradually evolve, assuming a more classic dystrophic appearance and confirming the benign etiology (12).…”

“…However, dystrophic calcifications associated with fat necrosis that appear in the early postoperative stage infrequently may have a questionable morphology and/or distribution (12). The risk of malignancy is still very low in these cases, and calcifications associated with fat necrosis should gradually evolve, assuming a more classic dystrophic appearance and confirming the benign etiology (12). Therefore, reporting these calcifications in the Breast Imaging Reporting and Database System 3 (BI-RADS 3) category (0% to ≤2% likelihood of malignancy) with a recommendation for a short- term close interval follow-up to document morphologic stability is appropriate.…”

Breast cancer screening outcomes and risk assessment among women of Abha city, Saudi Arabia

“…Mammogram screening decreases the mortality by 15-20%. Ultrasonography (USG) is another tool for screening; the sensitivity of USG is about 36% in detecting neoplastic lesions [26]. With the help of USG differentiation between cystic and solid lesions can be done, also utilized well for the evaluation of dense breast tissue where MMG has a limited role and for evaluation of preoperative and postoperative follow-up as well.…”