XXXX in 866 reduction mammaplasties: preserving the choice of lumpectomy.

@entity1 @entity0 @entity5 @entity189 @entity21879
BACKGROUND: Occult @entity0 is occasionally found in reduction mammaplasty specimens. Historically, these @entity1 were treated with mastectomy because the exact location of the @entity5 was unknown. Currently, breast conservation is the treatment of choice in 50 to 85 percent of @entity0 . The authors present a technique of routine specimen marking that allows localization of the @entity5 and preservation of the choice of lumpectomy. METHODS: This is a retrospective review of 866 @entity1 who underwent reduction mammaplasty performed by a single surgeon between 1990 and 2009. Data were collected for @entity1 who had @entity5 found in their specimens, including age, @entity5 risk factors, abnormality, nodal status, selected treatment, and survival status. Specimens were marked and oriented and then sent in separate bags to the pathologist. RESULTS: There were 10 cases of @entity189 among the 866 @entity1 (1.15 percent) who underwent reduction mammaplasty. Six @entity5 were found in @entity1 undergoing reduction for symptomatic @entity21879 [n = 629 (0.95 percent)]. Four new @entity5 were found in the group of @entity1 with a personal history of @entity5 [n = 237 (1.69 percent)]. All 10 @entity1 had normal preoperative mammograms. Location, size, and margin status were easily identified and @entity1 were offered the choice of lumpectomy or mastectomy. CONCLUSIONS: This article demonstrates that careful marking of reduction specimens in high-risk @entity1 or in @entity1 older than 40 years allows the pathologist to orient, localize, and further section tissue for margin status. Communication among plastic surgeon, pathologist, oncologist, and radiation therapist preserves the choice of breast conserving therapy for early @entity5 .
