MedWire News: Postoperative breast changes following reduction mammoplasty do not hinder analysis of the screening mammogram, Australian researchers report.

“It has been previously theorized that the presence of scar tissue may make the analysis of screening mammography more difficult, and subsequently, may lead to a poorer cancer detection rate,” say Tracey Muir (Royal Perth Hospital, Western Australia) and colleagues.

To investigate whether remodeling of the breast after breast reduction surgery has an effect on mammographic cancer detection, Muir and team compared the number of cancers detected, recalls per 1000 screens, and the characteristics of the cancers detected, between women with a history of breast reduction and those with no reduction.

In total, 244,147 women with 736,219 screening episodes in the Western Australia population screening program between 1998 and 2007 were eligible for the study. Of these, 4743 (1.9%) women had breast reduction mammoplasty prior to screening.

The researchers report that 4393 breast cancers were detected, of which 51 (1.2%) were in women who had a breast reduction. The age-standardized rates of screen-detected cancers were lower in the reduction group, at 4.28 per 1000 screens, than the non-reduction group, at 5.99 per 1000 screens. This equates to a 29% reduced risk for cancer in the breast reduction group.

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 also no significant difference in the pathological type or location of the cancer between the two groups of women.

“Women undergoing breast reduction for cosmetic or symptomatic reasons may be reassured that this procedure will not interfere with the early detection and intervention of screening mammography,” conclude Muir and co-authors in the journal Clinical Radiology.

They add: “The reasons why breast reduction women have a lower rate of breast cancer are not understood as they have similar breast densities and the majority of detected breast cancers are in the upper outer quadrant remote to the surgical resection site in both groups.”

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