Waldner Matthias, Klein Holger J, Künzi Walter, Guggenheim Merlin, Plock Jan A, Giovanoli Pietro
Division of Plastic Surgery and Hand Surgery, Universitäts Spital Zürich, Zurich, Switzerland.
Euro-Policlinic Switzerland, Zurich, Switzerland.
Front Surg. 2018 Feb 28;5:17. doi: 10.3389/fsurg.2018.00017. eCollection 2018.
Patients undergoing reduction mammoplasty (RM) bear the risk of having occult breast cancer nests. The detection rate of malignant neoplasms in the resected specimens, varies greatly in the literature. The aim of our present study was to analyze risk factors and evaluate histopathological findings in our cohort of patients who underwent RM towards our center.
In this retrospective single center study we analyzed 559 female patients [median age 35.99 (±13.34)] who underwent RM between 2000 and 2010. The presence of carcinoma and ductal- (DCIS) or lobular carcinoma in situ (LCIS) were considered as pathological findings. Body mass index (BMI), age, surgical technique and mass of resected tissue were included into the analysis.
There were 6 cases of occult neoplasia (1.08 %) including 2 cases of breast cancer, one multicentric DCIS and 3 cases of LCIS (0.54 %) in 559 patients. Patients with breast cancer showed a significant increased median age: 49y median (IQR ± 18) vs. 35y (IQR ± 21) ( = 0.004) and a trend towards increased BMI: 25.88 median (IQR ± 7.3) vs. 24.50 (IQR ± 4.09) ( = 0.219), compared to patients without pathological results. One patient with occult carcinoma had a negative preoperative mammography, a patient with LCIS a negative preoperative breast ultrasound.
In our study the occurrence of occult neoplasia was associated with increased age and showed a trend towards increased BMI when compared to patients without pathological findings. The study demonstrates the necessity of thorough medical history, preoperative diagnostic screening and histopathological analysis of all resected specimens.
接受缩乳术（RM）的患者存在隐匿性乳腺癌病灶的风险。文献中切除标本中恶性肿瘤的检出率差异很大。本研究的目的是分析我们中心接受RM的患者队列中的危险因素，并评估组织病理学结果。
在这项回顾性单中心研究中，我们分析了2000年至2010年间接受RM的559例女性患者[中位年龄35.99（±13.34）]。癌以及导管原位癌（DCIS）或小叶原位癌（LCIS）的存在被视为病理结果。分析纳入了体重指数（BMI）、年龄、手术技术和切除组织的重量。
559例患者中有6例隐匿性肿瘤（1.08%），包括2例乳腺癌、1例多中心DCIS和3例LCIS（0.54%）。与无病理结果的患者相比，乳腺癌患者的中位年龄显著增加：中位年龄49岁（四分位间距±18） vs. 35岁（四分位间距±21）（P = 0.004），BMI有增加趋势：中位值25.88（四分位间距±7.3） vs. 24.50（四分位间距±4.09）（P = 0.219）。1例隐匿性癌患者术前乳腺X线摄影为阴性，1例LCIS患者术前乳腺超声为阴性。
在我们的研究中，隐匿性肿瘤的发生与年龄增加相关，与无病理结果的患者相比，BMI有增加趋势。该研究表明详细病史、术前诊断性筛查以及对所有切除标本进行组织病理学分析的必要性。
