Time Trends in Histopathological Findings in Mammaplasty Specimens in a Dutch Academic Pathology Laboratory
Background:. Reduction mammaplasties are often performed at a relatively young age. Necessity of routine pathological investigation of the removed breast tissue to exclude breast cancer has been debated. Past studies have shown 0.05%–4.5% significant findings in reduction specimens, leading to an on...
| Main Authors: | , , , , |
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| Format: | Article |
| Language: | English |
| Published: |
Wolters Kluwer
2023-06-01
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| Series: | Plastic and Reconstructive Surgery, Global Open |
| Online Access: | http://journals.lww.com/prsgo/fulltext/10.1097/GOX.0000000000004966 |
| _version_ | 1797792000642121728 |
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| author | Hannah W. Stutterheim, MB Natalie D. ter Hoeve, BSc Wiesje Maarse, MD, PhD Elsken van der Wall, MD, PhD Paul J. van Diest, MD, PhD |
| author_facet | Hannah W. Stutterheim, MB Natalie D. ter Hoeve, BSc Wiesje Maarse, MD, PhD Elsken van der Wall, MD, PhD Paul J. van Diest, MD, PhD |
| author_sort | Hannah W. Stutterheim, MB |
| collection | DOAJ |
| description | Background:. Reduction mammaplasties are often performed at a relatively young age. Necessity of routine pathological investigation of the removed breast tissue to exclude breast cancer has been debated. Past studies have shown 0.05%–4.5% significant findings in reduction specimens, leading to an ongoing debate whether this is cost-effective. There is also no current Dutch guideline on pathological investigation of mammaplasty specimens. Because the incidence of breast cancer is rising, especially among young women, we re-evaluated the yield of routine pathological investigation of mammaplasty specimens over three decades in search of time trends.
Methods:. Reduction specimens from 3430 female patients examined from 1988 to 2021 in the UMC Utrecht were evaluated. Significant findings were defined as those that may lead to more intensive follow-up or surgical intervention.
Results:. Mean age of patients was 39 years. Of the specimens, 67.4% were normal; 28.9% displayed benign changes; 2.7%, benign tumors; 0.3%, premalignant changes; 0.8%, in situ; and 0.1%, invasive cancers. Most patients with significant findings were in their forties (P < 0.001), the youngest patient being 29 years. Significant findings increased from 2016 onward (P = 0.0001), 86.8% found after 2016.
Conclusions:. Over three decades, 1.2% of mammaplasty specimens displayed significant findings on routine pathology examination, with an incidence rising to 2.1% from 2016 onward. The main reason for this recent increase is probably attributable to super-specialization by the pathologists. While awaiting formal cost-effectiveness studies, the frequency of significant findings for now seems to justify routine pathological examination of mammaplasty reduction specimens. |
| first_indexed | 2024-03-13T02:26:49Z |
| format | Article |
| id | doaj.art-1f2e99622cbd419bb9bb2d0696b5bd8b |
| institution | Directory Open Access Journal |
| issn | 2169-7574 |
| language | English |
| last_indexed | 2024-03-13T02:26:49Z |
| publishDate | 2023-06-01 |
| publisher | Wolters Kluwer |
| record_format | Article |
| series | Plastic and Reconstructive Surgery, Global Open |
| spelling | doaj.art-1f2e99622cbd419bb9bb2d0696b5bd8b2023-06-30T01:49:20ZengWolters KluwerPlastic and Reconstructive Surgery, Global Open2169-75742023-06-01116e496610.1097/GOX.0000000000004966202306000-00054Time Trends in Histopathological Findings in Mammaplasty Specimens in a Dutch Academic Pathology LaboratoryHannah W. Stutterheim, MB0Natalie D. ter Hoeve, BSc1Wiesje Maarse, MD, PhD2Elsken van der Wall, MD, PhD3Paul J. van Diest, MD, PhD4From the * University College Roosevelt, Middelburg, the Netherlands† Department of Pathology, University Medical Center Utrecht, Utrecht, the Netherlands‡ Department of Plastic, Reconstructive and Hand Surgery, University Medical Center Utrecht, Utrecht, the Netherlands§ Department of Medical Oncology, University Medical Center Utrecht, Utrecht, the Netherlands.† Department of Pathology, University Medical Center Utrecht, Utrecht, the NetherlandsBackground:. Reduction mammaplasties are often performed at a relatively young age. Necessity of routine pathological investigation of the removed breast tissue to exclude breast cancer has been debated. Past studies have shown 0.05%–4.5% significant findings in reduction specimens, leading to an ongoing debate whether this is cost-effective. There is also no current Dutch guideline on pathological investigation of mammaplasty specimens. Because the incidence of breast cancer is rising, especially among young women, we re-evaluated the yield of routine pathological investigation of mammaplasty specimens over three decades in search of time trends. Methods:. Reduction specimens from 3430 female patients examined from 1988 to 2021 in the UMC Utrecht were evaluated. Significant findings were defined as those that may lead to more intensive follow-up or surgical intervention. Results:. Mean age of patients was 39 years. Of the specimens, 67.4% were normal; 28.9% displayed benign changes; 2.7%, benign tumors; 0.3%, premalignant changes; 0.8%, in situ; and 0.1%, invasive cancers. Most patients with significant findings were in their forties (P < 0.001), the youngest patient being 29 years. Significant findings increased from 2016 onward (P = 0.0001), 86.8% found after 2016. Conclusions:. Over three decades, 1.2% of mammaplasty specimens displayed significant findings on routine pathology examination, with an incidence rising to 2.1% from 2016 onward. The main reason for this recent increase is probably attributable to super-specialization by the pathologists. While awaiting formal cost-effectiveness studies, the frequency of significant findings for now seems to justify routine pathological examination of mammaplasty reduction specimens.http://journals.lww.com/prsgo/fulltext/10.1097/GOX.0000000000004966 |
| spellingShingle | Hannah W. Stutterheim, MB Natalie D. ter Hoeve, BSc Wiesje Maarse, MD, PhD Elsken van der Wall, MD, PhD Paul J. van Diest, MD, PhD Time Trends in Histopathological Findings in Mammaplasty Specimens in a Dutch Academic Pathology Laboratory Plastic and Reconstructive Surgery, Global Open |
| title | Time Trends in Histopathological Findings in Mammaplasty Specimens in a Dutch Academic Pathology Laboratory |
| title_full | Time Trends in Histopathological Findings in Mammaplasty Specimens in a Dutch Academic Pathology Laboratory |
| title_fullStr | Time Trends in Histopathological Findings in Mammaplasty Specimens in a Dutch Academic Pathology Laboratory |
| title_full_unstemmed | Time Trends in Histopathological Findings in Mammaplasty Specimens in a Dutch Academic Pathology Laboratory |
| title_short | Time Trends in Histopathological Findings in Mammaplasty Specimens in a Dutch Academic Pathology Laboratory |
| title_sort | time trends in histopathological findings in mammaplasty specimens in a dutch academic pathology laboratory |
| url | http://journals.lww.com/prsgo/fulltext/10.1097/GOX.0000000000004966 |
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