title: Poor adherence to clinical guidelines for women undergoing breast reduction.
abstract: BACKGROUND
  Indication for breast reduction in a publically funded or an insurance-funded setting depends on the severity of the subjective symptoms and on the clinical evaluation. The purpose of this study was to evaluate whether Danish surgeons follow a clinical practice recommending a minimum tissue resection weight of 400-500 g per breast.
  
  
  METHODS
  Included in the study were a total of 366 female patients with breast hypertrophy who underwent bilateral breast reduction surgery at three large university hospitals in Denmark in the period from August 2008 to November 2013. The patients' height, weight and standard breast measurement were registered as was the weight of breast tissue resection. The preoperative breast volume was measured using transparent plastic cups designed for this purpose.
  
  
  RESULTS
  Among the 366 female participants, the median age was 40 years, the median BMI was 24 kg/m2, and the median breast volume was 1,050 cc on each side. Only 201 (55%) cases met the resection criterion of a minimum of 400 g tissue per breast, and 130 (36%) had 500 g or more resected. We found a highly significant correlation between the amount of resected breast tissue and the preoperative breast volume (p < 0.001, n = 366).
  
  
  CONCLUSIONS
  Many surgeons did not follow the clinical practice of resecting 400-500 g of breast tissue in women who underwent breast reduction surgery at three large hospitals in Denmark in the 2008-2013 period. Our findings are surprising and beg the question if the guidelines should be revised to reflect the current practice or vice versa.
  
  
  BACKGROUND
  none.
  
  
  BACKGROUND
  not relevant.
authors.affiliation: lisbet.rosenkrantz.hoelmich@regionh.dk.
authors.forename: Dogu
authors.initials: D
authors.lastname: Aydin
authors.forename: Lone Bak
authors.initials: LB
authors.lastname: Hansen
authors.forename: Peder
authors.initials: P
authors.lastname: Ikander
authors.forename: Jennifer Berg
authors.initials: JB
authors.lastname: Drejøe
authors.forename: Susanne
authors.initials: S
authors.lastname: Lambaa
authors.forename: Lisbet Rosenkrantz
authors.initials: LR
authors.lastname: Hölmich
mesh_terms: D000328:Adult; D001837:Body Weights and Measures / Q000379:methods; D001940:Breast / Q000473:pathology / Q000601:surgery; D005260:Female; D019983:Guideline Adherence; D006801:Humans; D006984:Hypertrophy / Q000175:diagnosis / Q000601:surgery; D016462:Mammaplasty / Q000379:methods / Q000592:standards; D009929:Organ Size; D017063:Outcome Assessment, Health Care; D017410:Practice Guidelines as Topic