A Comparison of the Mammographic Findings Between Oncoplastic Reduction Mammoplasty Patients and Lumpectomy Patients
Merisa Piper, MD, Anne W. Peled, MD, Elissa R. Price, MD, Robert D. Foster, MD, Laura J. Esserman, MD, MBA, Hani Sbitany, MD.
University of California, San Francisco, San Francisco, CA, USA.
Purpose: Reconstruction of partial mastectomy defects with reduction mammoplasty techniques can improve aesthetic outcomes and patient satisfaction. However, concerns exist that significant tissue rearrangement increases biopsy rates and complicates following patients mammographically. We report on the post-operative mammographic findings and subsequent recommendations for biopsy in oncoplastic reduction mammoplasty patients compared with lumpectomy alone.
Methods: We performed a retrospective review of 98 patients from 2001 to 2009 who underwent partial mastectomy with oncoplastic reduction mammoplasty (49 patients) compared to an age-matched cohort of lumpectomy alone (49 patients). Mammography reports over a five year period were reviewed for BI-RADS scores, predominant findings, and recommendations for subsequent imaging or biopsy.
Results: There was no significant difference in abnormal mammographic findings between the oncoplastic reduction and lumpectomy cohorts at 6 months, 1, 2 and 5 years (p>0.05). Biopsy rates did not differ significantly between the two cohorts [11 (22%) in lumpectomy cohort, 15 (31%) in oncoplastic cohort, p=0.25]. Two patients in the lumpectomy cohort and five in the oncoplastic cohort had disease recurrence within five years. Thus, the overall cancer-to-biopsy ratio was 18% (2 of 11) in the lumpectomy cohort and 33% (5 of 15) in the oncoplastic cohort (p=0.65).
Conclusions: Our results demonstrate no increased incidence of post-operative mammographic abnormalities and recommendation for biopsy in oncoplastic reduction mammoplasty patients compared with lumpectomy alone. These results support the incorporation of this technique as a way to optimize outcomes for breast conservation.
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