ORIGINAL ARTICLE

Does histopathological examination of breast reduction specimens affect patient management and clinical follow up?

I S Cook and C E Fuller

Department of Histopathology, Salisbury District Hospital, Odstock, Salisbury, SP2 8BJ, UK

Correspondence to:
Correspondence to:
Dr I S Cook
Department of Histopathology, Southampton General Hospital, Tremona Road, Southampton, Hampshire, SO16 6YD, UK; iscook{at}doctors.org.uk

Aim: To assess the value of the histopathological examination of routine breast reduction specimens.

Methods: All patients who underwent breast reduction surgery over a 10 year period were identified. The histopathology report for each patient was analysed. For all cases with important microscopic abnormalities, the patient’s medical notes were examined to identify whether clinical follow up was arranged.

Results: Histopathology reports for specimens from 1289 patients were examined. One thousand, two hundred and fifty eight of these specimens (97.6%) were reported microscopically as showing normal breast tissue or benign breast disease, 26 cases (2.0%) showed lesions of uncertain malignant potential, four cases (0.3%) showed ductal carcinoma in situ (DCIS) or microinvasive malignancy, and there was one case (0.1%) of invasive malignancy. Important diagnoses were made in 2.1% of cases with no macroscopic abnormality. Clinical follow up was arranged for all patients with a diagnosis of DCIS, microinvasive carcinoma, or invasive malignancy. There were 26 patients diagnosed with lesions of uncertain malignant potential; 11 had follow up arrangements made and 13 patients were discharged. Follow up data was not available for two patients.

Conclusions: Histopathological examination of breast reduction specimens may reveal important pathological diagnoses. In some cases, patients were discharged from medical care despite histopathological examination revealing lesions associated with an increased risk of developing breast carcinoma.

Keywords: breast; reduction mammoplasty; histopathology; diagnosis; management

Abbreviations: ADH, atypical ductal hyperplasia; ALH, atypical lobular hyperplasia; DCIS, ductal carcinoma in situ; LCIS, lobular carcinoma in situ

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