title: Breast Cancer Detection by Preoperative Imaging in Reduction Mammaplasty Patients: A Single Center Study of 918 Patients.
abstract: The role of preoperative imaging and the usability of different imaging modalities is highly variable and controversial in reduction mammaplasty patients. Our study describes the imaging process in a single center in regard to modality selection, age and timing, and of the association between imaging and histopathological findings in reduction mammaplasty specimens.
  
  
  
  Nine hundred eighteen women, who underwent reduction mammaplasty during 1.1.2007-31.12.2011, were retrospectively reviewed for demographics, preoperative imaging, further preoperative examinations, and pathology reports.
  
  
  
  Preoperative imaging had been conducted for 89.2% (n = 819) of the patients. In 49 (6.0%) patients, suspicious preoperative imaging led to further examinations revealing 2 high-risk lesions (atypical ductal hyperplasia (ADH), lobular carcinoma in situ (LCIS)), and 2 cancers preoperatively. Postoperatively abnormal histopathology specimens were revealed in 88 (10.4%) patients. The incidence of high-risk lesions was 5.5% (n = 47), and the incidence of cancer was 1.2% (n = 10). Preoperative imaging was normal (BI-RADS 1 and BI-RADS 2) in 80.8% of these patients. The sensitivity of the preoperative imaging for cancer detection was 20.0%, and the specificity was 100.0%.
  
  
  
  Preoperative imaging and further examinations do not sufficiently detect malignant or cancer risk-increasing findings. Therefore, histopathological analysis of reduction mammaplasty specimens seems mandatory.
authors.affiliation: Department of Plastic and Reconstructive Surgery, University of Helsinki and Helsinki University Hospital, P.O. Box 266, 00029, Helsinki, Finland. paivi.merkkola-vonschantz@hus.fi.
authors.forename: Päivi A
authors.initials: PA
authors.lastname: Merkkola-von Schantz
authors.affiliation: Department of Plastic and Reconstructive Surgery, University of Helsinki and Helsinki University Hospital, P.O. Box 266, 00029, Helsinki, Finland.
authors.forename: Susanna M C
authors.initials: SMC
authors.lastname: Kauhanen
authors.affiliation: Department of Plastic and Reconstructive Surgery, University of Helsinki and Helsinki University Hospital, P.O. Box 266, 00029, Helsinki, Finland.
authors.forename: Tiina A
authors.initials: TA
authors.lastname: Jahkola
authors.affiliation: Department of Pathology, University of Helsinki and Helsinki University Hospital, P.O. Box 800, 00029, Helsinki, Finland.
authors.forename: Leena A
authors.initials: LA
authors.lastname: Krogerus
authors.affiliation: Department of Radiology, University of Helsinki and Helsinki University Hospital, P.O. Box 263, 00029, Helsinki, Finland.
authors.forename: Katja S
authors.initials: KS
authors.lastname: Hukkinen
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D001940:Breast / Q000473:pathology; D001943:Breast Neoplasms / Q000000981:diagnostic imaging* / Q000453:epidemiology / Q000473:pathology; D005260:Female; D006801:Humans; D016462:Mammaplasty; D008327:Mammography; D008875:Middle Aged; D011300:Preoperative Care; D012189:Retrospective Studies; D016217:Ultrasonography, Mammary; D055815:Young Adult