title: The influence of reduction mammaplasty techniques in synchronous breast cancer diagnosis and metachronous breast cancer prevention.
abstract: BACKGROUND
  Although reduction mammaplasty (RM) is a well-described technique for cosmetic objectives, there are few reports regarding its bilateral application combined with oncologic breast surgery in patients with breast cancer. The purpose of this study is to analyze the role of RM in the contralateral breast (CB) synchronous cancer (SBC) incidence, the impact in risk reduction for metachronous breast cancer (MBC), the disease-free period, and overall survival
  
  
  METHODS
  Patients were divided into 2 groups; group I: 114 pts submitted to oncologic surgery associated with immediate CB RM. Group II: 135 pts without CB RM. Mean time of follow-up was 51.5 months for both groups. Data regarding age, tumor size, histologic type and grade, clinical stage, and adjuvant therapy were collected
  
  
  RESULTS
  Except for the CB RM, no differences were observed between the groups. In group I, the diagnosis of an occult, synchronic, and invasive carcinoma was noted in 1.8%, in situ in 2.6%, and MBC in 1.8%. In group II, MBC was observed in 6.7%. No difference was observed between the 2 groups (P = 0.062). The initiation of adjuvant therapy, the disease-free period, and overall survival were not influenced by the CB RM.
  
  
  CONCLUSIONS
  CB RM is a reliable technique providing an opportunity for diagnosis of an occult SBC. There is evidence of reduction of MBC; however, a larger number of patients are necessary for significant conclusions. The technique should be considered in combination with immediate breast reconstruction. Success depends on patient selection and careful intraoperative management.
authors.affiliation: Department of Gynecology and Division of Plastic Surgery, University of São Paulo School of Medicine, São Paulo, Brazil.
authors.forename: Marcos Desidério
authors.initials: MD
authors.lastname: Ricci
authors.forename: Alexandre Mendonça
authors.initials: AM
authors.lastname: Munhoz
authors.forename: Marianne
authors.initials: M
authors.lastname: Pinotti
authors.forename: Arícia Helena
authors.initials: AH
authors.lastname: Geribela
authors.forename: Luis Carlos
authors.initials: LC
authors.lastname: Teixeira
authors.forename: Claudia
authors.initials: C
authors.lastname: Aldrighi
authors.forename: Marcus Castro
authors.initials: MC
authors.lastname: Ferreira
authors.forename: José Roberto
authors.initials: JR
authors.lastname: Filassi
authors.forename: José Aristodemo
authors.initials: JA
authors.lastname: Pinotti
mesh_terms: D001943:Breast Neoplasms / Q000175:diagnosis* / Q000517:prevention & control*; D003949:Diagnostic Techniques, Surgical; D005260:Female; D006801:Humans; D016462:Mammaplasty / Q000379:methods*; D008875:Middle Aged