Breast Cancer Detected in Specimens Following a Breast Reduction in Women With Normal Mammograms

Prior to undergoing a breast reduction, it is the standard of care to have an up to date mammogram for women of at least a certain age (which can vary). The purpose of this is to screen for any abnormalities that may need to be addressed prior to surgery. If a suspicious mass or area is noted that raises concerns for possibly being of malignant potential, a biopsy can be performed prior to the planned procedure. If the results are benign, then one can proceed with the breast reduction. Conversely, if the biopsy results reveal breast cancer, then treatment of this would be to be undertaken rather than the originally proposed breast reduction.

Mammograms do not identify every single case of breast cancer. A small percentage of breast cancers that are early or very small can evade detection with this method of screening but can be identified pathologically. These “occult” cancers are the reason why the breast tissue removed in the performance of a breast reduction is always sent for pathological evaluation.

Scientific studies have been done to investigate the incidence of these occult cancers in women who have undergone a breast reduction. The percentage is very low, somewhere in the range of 0.16% to 0.40%. Despite having been diagnosed with breast cancer, these women are lucky in that their tumors were identified early on, offering them a very high cure rate with appropriate treatment. If they hadn’t been seeking a breast reduction, it is likely that many of these cancers might not have been identified until they were larger and with a less favorable prognosis.

The following patient of mine exemplifies this scenario. She presented for a breast reduction at age 39, wearing a size 34G bra, no family history of breast cancer and with a normal mammogram. A reduction mammoplasty was successfully performed and she had an otherwise unremarkable postoperative course. However, the pathology report of her removed breast tissue revealed early cancer.

After consulting with a general surgeon, she underwent bilateral mastectomies with immediate reconstruction. The following photos illustrate her preoperative appearance, immediately following her breast reduction and appearance after reconstruction.

Before Breast Reduction - Frontal view

Before Breast Reduction - Frontal view

Before Breast Reduction - Side view

Before Breast Reduction - Side view

Immediately following Breast Reduction - Frontal view

Immediately following Breast Reduction - Frontal view

Immediately following Breast Reduction - Side view

Immediately following Breast Reduction - Side view

After Breast Reconstruction - Frontal view in bra

After Breast Reconstruction - Frontal view in bra

After Breast Reconstruction - Frontal view

After Breast Reconstruction - Frontal view

After Breast Reconstruction - Oblique view

After Breast Reconstruction - Oblique view

After Breast Reconstruction - Oblique view in bra

After Breast Reconstruction - Oblique view in bra

Following Breast Reconstruction - Side view

Following Breast Reconstruction - Side view

Following Breast Reconstruction - Side view in bra

Following Breast Reconstruction - Side view in bra

If you would like to obtain additional information on breast reduction, breast reconstruction or any other cosmetic surgery procedure that I perform or to schedule a consultation, you can contact my office at 480-451-3000.

Steven H. Turkeltaub, M.D. P.C.
Scottsdale and Phoenix, Arizona

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