Intended for healthcare professionals


Tissue screening after breast reduction

BMJ 2009; 338 doi: (Published 11 March 2009) Cite this as: BMJ 2009;338:b630
  1. Mohammed Keshtgar, consultant breast surgeon1,
  2. Alireza Hamidian Jahromi, clinical fellow in breast surgery 1,
  3. Tim Davidson, consultant breast surgeon1,
  4. Paula Escobar, clinical fellow in breast surgery 1,
  5. Patrick Mallucci, consultant plastic surgeon 1,
  6. Afshin Mosahebi, consultant plastic surgeon 1,
  7. Michael Baum, emeritus professor of breast surgery 1
  1. 1University Department of Surgery, Royal Free Hampstead NHS Trust and Royal Free and University College Medical School, London NW3 2QG
  1. Correspondence to: M Keshtgarmo.keshtgar{at}
  • Accepted 19 November 2008

Patients who undergo breast reduction surgery have a low risk of being found to have breast cancer, but they need to be made aware of it—and doctors need to debate whether routine histological examination of tissue specimens is a good idea. We sought the views of Tom Treasure, a surgeon (doi:10.1136/bmj.b759), Jeremy Sugarman, an ethicist (doi:10.1136/bmj.b753), and Tessa Boase, a lay person (10.1136/bmj.b776)

Reduction mammoplasty is one of the most common procedures performed by plastic surgeons all around the world.1 For decades, it has been a common practice to send even normal looking surgical specimens for histopathological analysis because of the possibility of finding asymptomatic breast cancer. A postal questionnaire sent to consultant members of the British Association of Plastic Surgeons in 1994 found that 89% routinely sent breast reduction tissue for histopathology, and 42% of respondents had seen at least one case of breast cancer from these tissues.2

Pathological findings of breast cancer at the time of reduction mammoplasty have been …

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