Niepel Albert, Schwake Sven, Zeichmann Mira, Noltze Ariel, König Viktoria, Sokullu Fuat, Schenk Clara, Pallikunnel Shanon, Hellekes Dirk, Koller Rupert, Steinkellner Lara
Department for Plastic and Reconstructive Surgery, Klinik Landstrasse, Vienna, Austria.
Medical University of Vienna, Vienna, Austria.
Breast Care (Basel). 2022 Jun;17(3):244-248. doi: 10.1159/000517816. Epub 2021 Jul 15.
Breast reduction surgery is one of the most frequently performed surgeries amongst plastic and reconstructive surgeons worldwide. Previous studies have shown decreased risk of breast cancer development in women undergoing breast reduction surgery of up to 28%. We aimed to evaluate the relative risk of breast cancer development in our patients after breast reduction surgery in relation to the general female population of Austria.
A total of 637 women underwent breast reduction surgery between 2003 and 2017 at our department. From those women, 513 patients completed a follow-up assessment of breast cancer development and were included into the study sample. The age-specific incidence rate data of the general female population of Austria served as the control group and basis for the calculation of the standardized incidence ratio (SIR) and Poisson test.
Relative to 5.66 expected cases of breast cancer, our cohort showed 1 subject with breast cancer after breast reduction surgery (SIR = 0.1765). An exact Poisson test was carried out to determine the level of significance of the difference between the incidence rate observed in the sample compared to the expected rate based on the age-specific incidence rates of the general population ( = 0.023, = 0.05).
Our study underlines the strong evidence of previous studies for significant breast cancer reduction in patients after reductive mammoplasty. In comparison to the general female population of Austria, our cohort showed a reduction in breast cancer incidence of about 82%. The authors believe that different techniques in reduction mammoplasty have different levels of safety regarding the prevention and risk reduction for breast cancer. Further investigation must be conducted to evaluate the reduction of breast cancer risk with different surgical techniques.
乳房缩小手术是全球整形和重建外科医生最常开展的手术之一。既往研究表明，接受乳房缩小手术的女性患乳腺癌的风险降低了28%。我们旨在评估乳房缩小手术后患者患乳腺癌的相对风险与奥地利普通女性人群的关系。
2003年至2017年期间，共有637名女性在我们科室接受了乳房缩小手术。其中，513名患者完成了乳腺癌发生情况的随访评估，并被纳入研究样本。奥地利普通女性人群的年龄别发病率数据作为对照组，并作为计算标准化发病率比（SIR）和泊松检验的基础。
相对于预期的5.66例乳腺癌病例，我们的队列中乳房缩小手术后有1例患乳腺癌（SIR = 0.1765）。进行了精确的泊松检验，以确定样本中观察到的发病率与基于普通人群年龄别发病率的预期发病率之间差异的显著性水平（P = 0.023，α = 0.05）。
我们的研究强调了既往研究中关于乳房缩小成形术后患者乳腺癌显著减少的有力证据。与奥地利普通女性人群相比，我们的队列显示乳腺癌发病率降低了约82%。作者认为，乳房缩小成形术中的不同技术在预防和降低乳腺癌风险方面具有不同程度的安全性。必须进行进一步的研究，以评估不同手术技术对乳腺癌风险的降低作用。
