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Breast Cancer Found Incidentally After Reduction Mammaplasty in Young Insured Women

  • Breast Oncology
  • Published:
Annals of Surgical Oncology Aims and scope Submit manuscript

Abstract

Background

Reduction mammaplasty is a common operation performed for healthy women. The estimated incidence of breast cancer diagnosed at the time of reduction mammaplasty varies from 0.06 to 4.5%, and information on the care of these patients is limited. This study aimed to determine the incidence of breast cancer identified incidentally during reduction mammaplasty and to characterize preoperative imaging.

Methods

Women 18 years of age or older who underwent reduction mammaplasty from 2013 to 2015 were identified from the Truven Health MarketScan® Research Databases. Patients with prior breast cancer were excluded. Descriptive statistics were calculated for patient characteristics, incidental breast cancer, preoperative breast imaging, and postoperative treatment.

Results

Reduction mammaplasty was performed for 18,969 women with a mean age of 42.5 years. Of these patients, 186 (0.98%) were incidentally found to have breast cancer, with 134 (0.71%) having invasive breast cancer and 52 (0.27%) having carcinoma in situ. The patients with incidentally found cancer were older than the patients without cancer (50.8 vs. 42.5 years; p < 0.001). Overall, 58.2% of the patients had undergone mammography before reduction mammoplasty. The rates were higher (> 80%) for the patients older than 40 years. Preoperative mammography was performed for 76.3% of those with a diagnosis of breast cancer at time of reduction mammoplasty.

Conclusions

Breast cancer diagnosed incidentally at the time of reduction mammaplasty is uncommon and often radiographically occult. The majority of women older than 50 years appropriately received preoperative mammography. These data can be used to manage patient expectations about the potential for the incidental diagnosis of breast cancer at reduction mammaplasty, even with a negative preoperative mammography.

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Acknowledgment

Drs. Walle, Stankowski-Drengler, and Livingston-Rosanoff are supported by NIH training grant T32 CA090217. Dr. Livingston-Rosanoff also is supported by the American College of Surgeons Resident Research Scholarship. Support for this project was provided by the Wisconsin Surgical Outcomes Research Program in the University of Wisconsin-Madison (UW-Madison) Department of Surgery, with additional support from the UW-Madison Institute for Clinical and Translational Research Community-Academic Partnership (ICTR-CAP) via NIH CTSA award UL1TR000427 and UW-Madison School of Medicine and Public Health’s Wisconsin Partnership Program WPP-ICTR grant #3086. MarketScan is a registered trademark of Truven Health Analytics Inc.

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Authors and Affiliations

  1. Department of Surgery, Clinical Science Center, University of Wisconsin–Madison, Madison, WI, USA

    Kara Vande Walle MD, Dou-Yan Y. Yang PhD, Trista J. Stankowski-Drengler MD, Devon Livingston-Rosanoff MD, PhD, Sara Fernandes-Taylor PhD, Jessica R. Schumacher PhD, Lee G. Wilke MD, Caprice C. Greenberg MD, MPH & Heather B. Neuman MD, MS

Authors
  1. Kara Vande Walle MD
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  2. Dou-Yan Y. Yang PhD
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  3. Trista J. Stankowski-Drengler MD
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  4. Devon Livingston-Rosanoff MD, PhD
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  5. Sara Fernandes-Taylor PhD
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  6. Jessica R. Schumacher PhD
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  7. Lee G. Wilke MD
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  8. Caprice C. Greenberg MD, MPH
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  9. Heather B. Neuman MD, MS
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Correspondence to Heather B. Neuman MD, MS.

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Appendix

Appendix

See Table 4.

Table 4 ICD-9 and CPT codes used for procedure, diagnosis, imaging, and treatment definitions
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Vande Walle, K., Yang, DY.Y., Stankowski-Drengler, T.J. et al. Breast Cancer Found Incidentally After Reduction Mammaplasty in Young Insured Women. Ann Surg Oncol 26, 4310–4316 (2019). https://doi.org/10.1245/s10434-019-07726-9

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  • DOI: https://doi.org/10.1245/s10434-019-07726-9

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