Screening for breast cancer post reduction mammoplasty

Muir, Tracey; Tresham, Janette J.; Fritschi, Lin; Wylie, Elizabeth

doi:10.1016/j.crad.2009.09.015

Cited by 29 publications

(8 citation statements)

References 15 publications

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“…found a significantly higher recall rate for women with a prior biopsy for benign disease,12 whereas Muir et al . did not observe an increase in recall rate for women post reduction mammoplasty 25. Unfortunately, both studies did not provide information about the influence of breast surgery on the sensitivity of screening mammography.…”

Section: Discussionmentioning

confidence: 83%

Lower sensitivity of screening mammography after previous benign breast surgery

Smallenburg

Duijm

Voogd

et al. 2011

Intl Journal of Cancer

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Few data are available on the effect of previous benign breast surgery on screening mammography accuracy. We determined whether sensitivity of screening mammography and tumor characteristics are different for women with and without previous benign breast surgery. We included a consecutive series of 317,398 screening mammograms of women screened between 1997 and 2008. During 2-year follow-up, clinical data, breast imaging, biopsy and surgery reports were collected from women with screen-detected or interval breast cancers. Screening sensitivity, tumor biology and tumor stages were compared between 168 women with breast cancer and prior ipsilateral benign breast surgery and 2,039 women with breast cancer but without previous ipsilateral, benign breast surgery. The sensitivity of screening mammography was significantly lower for women with prior surgery [64.3% (108/168) versus 73.4% (1,496/2,039), p 5 0.01]. The concomitant increased interval cancer risk remained significant after logistic regression adjustment for age and breast density (OR 5 1.5, 95% CI: 1.1-2.1). Comparing screen-detected cancers in women with and without prior breast surgery, no significant differences in estrogen receptor status (p 5 0.56), mitotic activity (p 5 0.17), proportions of large (T21) tumors (p 5 0.6) or lymph node positive tumors (p 5 0.4) were found. Also for interval cancers, no differences were found in estrogen receptor status (p 5 0.41), mitotic activity (p 5 0.39), proportions of large tumors (p 5 0.9) and lymph node positive tumors (p 5 0.5) between women with and without prior breast surgery. We conclude that sensitivity of screening mammography is significantly lower in women with previous benign breast surgery than without, but tumor characteristics are comparable both for screen detected cancers and interval cancers.Mammography screening aims to detect breast cancer at an early stage and several studies have shown that screening significantly reduces breast cancer mortality.1-3 Many countries have introduced regional or nationwide breast cancer screening programs in the last two decades. The Netherlands has a long history of screening mammography and their nationwide breast cancer screening program offers biennial screening mammography for women aged 50-75 years.Breast conserving treatment for breast cancer may cause rigorous mammographic changes, due to surgery and radiation therapy. [4][5][6] These changes frequently hamper the mammographic interpretation and may result in a lower sensitivity of mammography for breast cancer detection. On the other hand, post-treatment changes may simulate breast cancer at mammography and lead to an increase of false positive assessments and thus a lower specificity. The Dutch guidelines on breast cancer screening advise that mammographic follow-up for women after breast conserving therapy should take place in an outpatient hospital setting for a period of 5-10 years before returning to routine screening. 7Mammographic alterations occurring after breast surgery for benign disease and r...

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Section: Discussionmentioning

confidence: 83%

Lower sensitivity of screening mammography after previous benign breast surgery

Smallenburg

Duijm

Voogd

et al. 2011

Intl Journal of Cancer

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“…However, when looking at outcomes in women who do not have known cancer diagnoses and have undergone reduction mammoplasty for symptom relief, numerous studies have demonstrated that the incidence of abnormal mammographic findings and need for increased surveillance is not significantly increased compared with controls. 26,31 This has been attributed to the observation that postsurgical mammographic findings in these patients are distinguishable from the mammographic findings associated with breast cancer. 32 In the current study, we found that the majority of mammographic findings in oncoplastic reduction patients were associated with benign postsurgical changes, similar to lumpectomy patients.…”

Section: Discussionmentioning

confidence: 88%

Comparison of Mammographic Findings Following Oncoplastic Mammoplasty and Lumpectomy Without Reconstruction

et al. 2015

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Although substantial tissue rearrangement is performed at the time of oncoplastic reduction mammoplasty, our results reveal no increased incidence of postoperative mammographic abnormalities or unnecessary biopsies compared to lumpectomy alone. This demonstrates that fear of increasing mammographic abnormalities and biopsies after reduction mammoplasty is unfounded and should not prevent utilization of this technique if it can optimize cosmetic outcomes and extend the option of breast conservation.

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“…Several studies have stressed that breast cancer is rare in patients with previous reduction mammoplasty (13,14). The reason for this has been stated to be linked to the removal of the glandular tissue of the breast.…”

Section: Discussionmentioning

confidence: 99%

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

Çakır

Küçükkartallar

Tekın

et al. 2015

UCD

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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.

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Screening for breast cancer post reduction mammoplasty

Cited by 29 publications

References 15 publications

Lower sensitivity of screening mammography after previous benign breast surgery

Lower sensitivity of screening mammography after previous benign breast surgery

Comparison of Mammographic Findings Following Oncoplastic Mammoplasty and Lumpectomy Without Reconstruction

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

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