Comparison of breast pathology in bilateral breast reduction and unilateral breast symmetrisation: A case series of 371 cases
EK Tan, J Chen, WL Wong, T Creagh
Department of Plastic Surgery, Christchurch Hospital, New Zealand
: J Regen Med
Abstract
Aim:To investigate if breast pathology from non-oncological bilateral breast reduction (BBR) differs from unilateral breast symmetrisation (UBS) post contralateral oncological surgery Introduction: Recent research from Australia and the United Kingdom shows a 1 in 9 lifetime risk of a woman being diagnosed with breast cancer. There is an observed increased demand for non BRCA and genetic breast cancer patients requesting for prophylactic contralateral mastectomy. There are numerous publication of ‘abnormal’ incidental pathology found in routine bilateral reduction. The American College of Surgeons (ACS) in 2016 discouraged patients in this group from contralateral surgery in view that the extent of disfigurement outweighs the benefits (Level V evidence). We would like to share our experience in this. Method: All bilateral and unilateral breast symmetrisation surgery (UBS) recorded in Christchurch Hospital from 2003-2017 were included in this study. Demographic and surgical details of individual patients were recorded where available. The pathology of individual cases were recorded and statistical tests were used to test the significance of difference in both groups. Results: Please refer to table 1 Conclusion: Our case series supports ACS’ recommendations and should serve as reassurance to non BRCA/genetic breast cancer patients that in our experience contralateral mastectomy is not indicated; thus symmetrisation is the only indication for contralateral surgery.
Biography
Eric Tan is a senior fellow / clinical lecturer in Plastic Surgery in University of Otago/Christchurch Hospital, New Zealand. He graduated in United Kingdom in 2002 with MBCHB and completed MRCS, CCBST and FRCSPlast during his plastic surgery training. He has been awarded for multiple awards like Henessy Prize in Surgery and 2010 Wessex Education Award (commendation) as well as nominated for various awards for innovation, service improvement and medical education. He reviews articles for British Medical Journal and write for e-BAPRAS as well as previously acted as international committee member in Plastic Surgery Education Network in USA for Microsurgery subdivision. ryantan8@hotmail.co.uk
