Screening for breast cancer post reduction mammoplasty

• Published in: Clinical radiology 2010-03, Vol.65 (3), p.198-205
• Main Authors: Muir, T.M, Tresham, J, Fritschi, L, Wylie, E
• Format: Article
• Language: English
• Subjects: Aged; Biological and medical sciences; Breast Cyst - diagnostic imaging; Breast Cyst - etiology; Breast Neoplasms - diagnostic imaging; Breast Neoplasms - epidemiology; Breast Neoplasms - pathology; Calcinosis - diagnostic imaging; Calcinosis - etiology; Cicatrix - etiology; Female; Genital system. Mammary gland; Gynecology. Andrology. Obstetrics; Humans; Investigative techniques, diagnostic techniques (general aspects); Mammaplasty - adverse effects; Mammaplasty - statistics & numerical data; Mammary gland diseases; Mammography; Mass Screening; Medical sciences; Middle Aged; Postoperative Period; Predictive Value of Tests; Radiodiagnosis. Nmr imagery. Nmr spectrometry; Radiology; Referral and Consultation; Surgery (general aspects). Transplantations, organ and tissue grafts. Graft diseases; Surgery of the genital tract and mammary gland; Tumors; Western Australia - epidemiology
• ISSN: 0009-9260; 1365-229X
• DOI: 10.1016/j.crad.2009.09.015

Aim To investigate whether remodelling of the breast after breast reduction surgery has an effect on mammographic cancer detection. Methods and materials For women who attended population-based screening between January 1998 to December 2007, data were extracted on their age, history of previous breast reduction, and the result of screening (recall for further assessment, cancer, or no cancer). The number of cancers detected, recalls per 1000 screens and the characteristics of the cancers detected in the two groups was compared. Results In total 244,147 women with 736,219 screening episodes were reviewed. In the 4743 women who had a breast reduction, 51 breast cancers were detected [age standardized rate (ASR) of 4.28 per 1000 screening episodes; 95% CI 3.11–5.46], compared with 4342 breast cancers in 239 404 women screened in the non-reduction group (ASR of 5.99 per 1000 screening episodes; 95% CI 5.81–6.16). There were fewer cancers in the breast reduction group with a relative risk of 0.71. There was no significant difference in the rate of recall between the two groups, with a crude recall rate of 46.1 per 1000 screening episodes post-breast reduction compared with 50.7 per 1000 screening episodes for women without breast reduction. There was no significant difference in the pathological type or location of the cancer between the two groups of women. Conclusion Postoperative breast changes following reduction mammoplasty do not significantly hinder analysis of the screening mammogram.