title: Cosmetic surgery prior to diagnosis of breast cancer.
abstract: BACKGROUND
  Cosmetic breast surgery is amongst the top five most commonly performed cosmetic surgical procedures. With breast cancer being the most common non-skin malignancy in women, the likelihood that a woman undergoing cosmetic breast surgery may have an occult breast cancer needs to be considered. Most of the available data pertaining to breast cancer diagnosis in the setting of cosmetic surgery are from studies of cosmetic breast surgery populations. We report on the prevalence of breast cancer as an incidental finding during cosmetic breast surgery in the context of women subsequently diagnosed with invasive breast cancer.
  
  
  METHODS
  The Bupa Health Foundation Health and Wellbeing after Breast Cancer Study is a prospective cohort study of 1684 women recruited within 12 months of their first diagnosis with invasive breast cancer. Participants completed an enrolment questionnaire and annual follow-up questionnaires for 5 years.
  
  
  RESULTS
  At the second follow-up, 1.5% of women reported having undergone cosmetic breast surgery prior to being diagnosed with breast cancer, 16 had undergone breast reduction and seven had augmentations. Invasive breast cancer was diagnosed at the time of a cosmetic breast procedure in two women, in both an augmentation and a reduction procedure, which is 8.7% (95% confidence interval 23.5% to +20.9%) of the women in our study reporting a cosmetic breast procedure prior to diagnosis.
  
  
  CONCLUSIONS
  Although prior cosmetic breast surgery was reported by few women, breast cancer was diagnosed in two women during the procedure. Surgeons performing elective breast surgery need to understand and apply consistent, reliable breast cancer screening practices.
authors.affiliation: Women's Health Research Program, School of Public Health and Preventive Medicine, Department of Epidemiology and Preventive Medicine, Monash University, 99 Commercial Road, Melbourne, Australia.
authors.forename: M
authors.initials: M
authors.lastname: Panjari
authors.forename: R J
authors.initials: RJ
authors.lastname: Bell
authors.forename: P
authors.initials: P
authors.lastname: Fradkin
authors.forename: S R
authors.initials: SR
authors.lastname: Davis
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D019928:Breast Implantation; D001943:Breast Neoplasms / Q000175:diagnosis* / Q000453:epidemiology*; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D033162:Incidental Findings; D016462:Mammaplasty; D008875:Middle Aged; D015995:Prevalence; D011446:Prospective Studies; D011795:Surveys and Questionnaires; D014739:Victoria / Q000453:epidemiology