title: Occult breast cancer during reduction mammoplasty: case report.
abstract: OBJECTIVE
  Breast carcinoma occurring in routine reduction mammaplasty is rare.
  
  
  METHODS
  In our Breast Unit each patient eligible for any breast surgery is routinely evaluated by preoperative breast imaging. We reported the clinical case of a woman with an infiltrating lobular breast cancer detected during surgical reduction mammaplasty despite a negative preoperative bilateral mammography.
  
  
  RESULTS
  The clinical case was discussed at multidisciplinary breast cancer meeting in order to evaluate the different therapeutic options. In conjunction with general surgeons, oncologists, radiologists and radiotherapists, and upon patient's ultimate decision, a conservative tumor approach was chosen: first-level axillary node dissection followed by adjuvant chemotherapy and hormonotherapy.
  
  
  CONCLUSIONS
  The mean frequency of breast cancer detection during reduction mammaplasty ranges from 0.06% up to 4%. There are many possible treatment choices for these patients ranging from radical mastectomy to more conservative approaches dealing with lumpectomy followed by radiation therapy or chemotherapy and radiation therapy alone. The therapeutical plan must be discussed by a multidisciplinary team and many tumors and patients characteristics should be evaluated in the decision making process.
  
  
  CONCLUSIONS
  All patients selected for breast aesthetical surgery must be screened, during preoperative workup, for breast cancer. Combination of three diagnostic modalities increases sensitivity and reaches the diagnostic accuracy of 93.2%. The reported case stresses the importance of an oncological approach to breast surgery even in case of planned aesthetical procedures.
authors.forename: Nicola
authors.initials: N
authors.lastname: Panizzo
authors.forename: Chiara
authors.initials: C
authors.lastname: D'Aloja
authors.forename: Serena
authors.initials: S
authors.lastname: Scomersi
authors.forename: Giovanni
authors.initials: G
authors.lastname: Papa
authors.forename: Marina
authors.initials: M
authors.lastname: Bortul
authors.forename: Zoran Marij
authors.initials: ZM
authors.lastname: Arnez
mesh_terms: D000368:Aged; D001943:Breast Neoplasms / Q000175:diagnosis*; D018270:Carcinoma, Ductal, Breast / Q000175:diagnosis*; D005260:Female; D006801:Humans; D033162:Incidental Findings; D016462:Mammaplasty
keywords: Breast cancer, Infiltrating lobular carcinoma, Reduction Mammopasty, Mammography, Macromastia, Occult breast carcinoma.