Atypical Hyperplasia Found Incidentally during Routine Breast Reduction Mammoplasty: Incidence and Management

Autor: Seth Noorbakhsh, BA, Zachary A. Koenig, BA, BS, Noah Hewitt, BS, Mihail Climov, MD, Hannah Hazard-Jenkins, MD, Melina Flanagan, MD, Kerri Woodberry, MD
Jazyk: angličtina
Rok vydání: 2022
Předmět:
Zdroj: Plastic and Reconstructive Surgery, Global Open, Vol 10, Iss 2, p e4141 (2022)
Druh dokumentu: article
ISSN: 2169-7574
00000000
DOI: 10.1097/GOX.0000000000004141
Popis: Background:. Atypical ductal hyperplasia (ADH) and atypical lobular hyperplasia (ALH) of the breast are premalignant lesions. Although the literature on ADH and ALH as a whole is well-developed, research on ADH and ALH incidentally discovered during breast reduction is less robust. Methods:. In this study, 355 patients undergoing bilateral reduction mammoplasty at West Virginia University were retrospectively reviewed. A variety of demographic and clinicopathologic variables were collected for each patient, and the incidence of atypical hyperplasia was calculated. Four patients (1.13%) were found to have atypical hyperplasia, three ALH, and one ADH, which is within the range reported in the literature. For patients incidentally found to have atypical hyperplasia, an in-depth analysis of postoperative management was performed. Results:. Of the four patients with atypical hyperplasia, three were referred to a cancer center, and one patient followed only with plastic surgery. The three patients who were referred to a cancer center saw a breast surgeon, whereas the patient followed only by plastic surgery did not. None of the four patients received anti-estrogen therapy, but each patient who followed with a cancer center was offered treatment and declined. Conclusions:. As a relatively uncommon finding with complex management guidelines, atypical hyperplasia discovered on breast reduction should be referred to a cancer center for long-term follow-up and management when possible. Further research is needed to assess if the management of atypical hyperplasia discovered incidentally after routine reduction should mimic treatment of atypical hyperplasia found after biopsy for suspicion of malignancy.
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