Introduction: The standard of care for handling of breast reduction specimens is to submit the tissue for pathologic review. In the great majority of patients, there is a ‘benign' or ‘normal' tissue diagnosis assigned to these reduction mammoplasty tissue specimens. However, in a small portion of patients, a pre-malignant or even malignant lesion is discovered. The management of the reduction mammoplasty patient with a pre-malignant lesion is the focus of our review.

Methods: We performed a retrospective review of 206 patients treated with reduction mammoplasty in our university teaching hospital setting. The cases were collected from March 1992 to August 2006, and included cases performed by five faculty plastic surgeons. The resultant surgical specimen for each reduction mammoplasty was examined by the pathology department at Oregon Health Sciences University. We focused our attention on patients diagnosed with pre-malignant lesions for this review.

Results: Our review consisted of 206 patients and 402 reduction mammoplasty specimens. We found a pre-malignant tissue diagnoses in 3.8% of patients. Invasive cancer was noted in one patient (0.5%). A ‘benign' diagnosis was found in 51% of patients, while ‘normal' tissue was noted in 44.6% of patients. When patient groups with a benign or non-benign tissue diagnosis were compared, no statistically significant differences were noted in patient age, calculated body mass index (BMI), or specimen weight.

Conclusion: Routine reduction mammoplasty will uncover a premalignant breast lesion in 3.8% of patients. Appropriate recognition, patient counseling, surgical management with close clinical follow-up is mandatory for this group of plastic surgery patients with increased relative risk for invasive breast cancer.