SP46. Incidental Breast Carcinoma In Reduction Mammoplasty: A Systematic Review
Notice bibliographique
Résumé
Purpose: An estimated 534,284 breast reductions were performed worldwide in 2018. Occult histopathological findings of breast cancer in reduction mammoplasty specimens are rare but well documented in the literature. It has been a conventional practice for surgeons to obtain imaging studies prior to the reduction mammoplasty procedure. This practice aims to establish a radiological baseline of the breasts and detect occult pathological lesions before surgical intervention. Recent studies, however, have shown that preoperative imaging leads to an increasing number of false positive results and unnecessary diagnostic workups for the patient.The goal of this study was to conduct a systematic review to summarize the available literature on the incidence of occult breast carcinoma identified in patients undergoing non-oncologic reduction mammoplasty. Methods: A systematic review of all studies on the incidence of breast carcinoma in patients undergoing breast reduction was performed using PRISMA guidelines. Two databases were queried for randomized clinical trials, cohort studies, and retrospective studies. Two reviewers completed screening, data collection, and quality assessment. The Newcastle-Ottawa scale and JBI Critical Appraisal Checklist were used to assess methodological quality. Data extracted included the presence or absence of preoperative screening for breast cancer, sample size, age, pre-operative or intraoperative findings, and study recommendations. Results: A total of 328 articles were identified through a literature search. After the removal of duplicates, a total of 206 studies were screened. A final tally of 20 studies met our inclusion criteria, reporting on the incidence of breast carcinoma in reduction mammoplasty specimens. 18 studies were retrospective and 2 were prospective. All 20 studies used a routine intraoperative histopathologic examination of breast reduction specimens. 12 studies had patients undergo pre-operative imaging prior to reduction, 6 studies had only higher-risk patients undergo preoperative imaging (e.g. higher age, positive family history), and 2 studies had no pre-operative imaging. On histopathological evaluation, the incidence of breast carcinoma ranged from 0% to 1.6%. Most studies (19/20) found no correlation between preoperative imaging and histopathological diagnosis of breast carcinoma. One multicenter study of 5781 patients recommended preoperative imaging to be routinely performed in patients scheduled for non-oncologic reduction mammoplasty. They found a rate of 12.7% radiologically suspect findings, of which 1.3% were biopsy-confirmed malignancies. All studies recommended histopathological evaluation of breast reduction specimens. Conclusion: Our review demonstrates that histopathological evaluation of breast reduction specimens is widely recommended and used despite the small incidence of occult breast carcinoma findings. The current literature remains non-unanimous regarding routine preoperative imaging in patients undergoing reduction mammaplasty. Further studies are needed to confirm the role of preoperative imaging in patients undergoing reduction mammaplasty.
Récupéré en direct depuis OpenAlex et désinversé. Les résumés ne sont pas conservés dans cette base de données : les index inversés représentent 8,6 Go des 9,3 Go de texte de la base, et le serveur dispose de 13 Go libres.
Comment cette classification a été obtenuedéplier
Prédiction distillée sur la base complète
Imitation des enseignantsNi prévalence calibrée, ni vérité terrain. Validation humaine à venir. Apprise à partir de 10 348 étiquettes directes de Codex et de 10 348 étiquettes directes de Gemma. Le mode candidate est l'union des têtes enseignantes seuillées; le consensus est leur intersection. Ces sorties portent le statut machine_predicted_unvalidated et ne sont ni des étiquettes humaines ni des étiquettes directes de modèles de pointe.
Scores Codex et Gemma par catégorie
| Catégorie | Codex | Gemma |
|---|---|---|
| Métarecherche | 0,001 | 0,001 |
| Méta-épidémiologie (sens strict) | 0,001 | 0,001 |
| Méta-épidémiologie (sens large) | 0,004 | 0,001 |
| Bibliométrie | 0,000 | 0,001 |
| Études des sciences et des technologies | 0,000 | 0,000 |
| Communication savante | 0,000 | 0,000 |
| Science ouverte | 0,001 | 0,001 |
| Intégrité de la recherche | 0,000 | 0,000 |
| Charge utile insuffisante (le modèle a refusé de juger) | 0,000 | 0,000 |
Scores machine (provisoires)
Les deux têtes enseignantes du modèle étudiant, lues sur ce travail. Un score ordonne la base pour la relecture; il n'affirme jamais une catégorie, et le statut de validation accompagne chaque rangée tel quel.
Scores de référence d'un modèle non mature (critères de maturité non atteints, 7 itérations). Un score ordonne; il n'affirme jamais une catégorie.
score_only:v0-immature-baseline · tel quel depuis la passe de notation : score_only signifie que le nombre peut ordonner les travaux, et qu'aucune étiquette de catégorie n'en découleClassification
machine, non validéePrédiction automatique; un appel candidat d’une seule tête enseignante, pas un consensus.
Le détail, modèle par modèle et score par score, se trouve en fin de page sous « Comment cette classification a été obtenue ».