Clark Clancy J, Whang Susan, Paige Keith T
Seattle, Wash. From the Departments of General Surgery and Plastic and Reconstructive Surgery, Virginia Mason Medical Center.
Plast Reconstr Surg. 2009 Oct;124(4):1033-1039. doi: 10.1097/PRS.0b013e3181b45801.
Reduction mammaplasty is the fifth most common reconstructive surgical procedure in the United States. The incidence of invasive breast cancer in breast reduction specimens is between 0.06 and 0.4 percent. However, the incidence of atypical hyperplasia and other precancerous lesions is not well described.
The authors conducted a single-center retrospective chart review examining the incidence of benign and precancerous lesions in breast reduction specimens over a 5-year period.
Of the 562 patients who underwent reduction mammaplasty, 52.7 percent had nonproliferative or proliferative breast lesions. Twenty-five patients (4.4 percent) had a specimen containing atypical ductal or lobular hyperplasia. Six patients (1.1 percent) had ductal carcinoma in situ and four patients (0.7 percent) had lobular carcinoma in situ. No occult invasive breast cancer was identified in the breast reduction specimens, but one patient with ductal carcinoma in situ was found to have invasive breast cancer on completion mastectomy (0.2 percent).
This study demonstrates the importance of systematic analysis of breast reduction specimens to help identify and guide the management of patients with increased risk of breast cancer following reduction mammaplasty.
在美国，缩乳术是第五大最常见的重建外科手术。缩乳标本中浸润性乳腺癌的发病率在0.06%至0.4%之间。然而，非典型增生和其他癌前病变的发病率尚无详尽描述。
作者进行了一项单中心回顾性图表审查，研究5年期间缩乳标本中良性和癌前病变的发病率。
在接受缩乳术的562例患者中，52.7%有非增殖性或增殖性乳腺病变。25例患者（4.4%）的标本含有非典型导管或小叶增生。6例患者（1.1%）有导管原位癌，4例患者（0.7%）有小叶原位癌。缩乳标本中未发现隐匿性浸润性乳腺癌，但1例导管原位癌患者在完成乳房切除术后被发现患有浸润性乳腺癌（0.2%）。
本研究表明系统分析缩乳标本对于帮助识别和指导缩乳术后乳腺癌风险增加患者的管理具有重要意义。
