乳房减小术病理标本可偶然发现增生病变。然而，缺乏数据调查其比较发生率和危险因素。在都市大型医疗机构内，由两位整形外科医生在两年的时期内进行了所有连续进行的乳房减小术的回顾性评估。所有的乳房减小术，对称减小术和肿瘤整形减小术都纳入了研究，没有排除标准。共分析了632个乳房：342位患者进行了502次乳房减小术、85次对称减小术和45次肿瘤整形减小术。平均年龄为43.9±15.9岁，平均体重指数为29.2±5.7，平均减小重量为610.0±313.1克。接受乳房减小术治疗的良性巨乳症患者中，偶然发现乳腺癌和增生病变的发生率（3.6%）明显低于接受肿瘤整形减小术（13.3%）和对称减小术（17.6%）的患者（p<0.001）。在单变量分析中，个人患乳腺癌的病史（p<0.001）、一级亲属患乳腺癌的病史（p=0.008）、年龄（p<0.001）和使用烟草（p=0.033）均是显著的危险因素。使用后向淘汰法的逐步多元逻辑回归模型分析发现，年龄（p<0.001）是唯一的显著危险因素。乳房减小术病理标本中发现的增生病变和乳腺癌的发生率可能比以前报道的更常见。良性巨乳症患者中新的增生病变的发生率明显低于肿瘤整形减小术和对称减小术的发生率。版权所有 ©2023年美国整形外科医师协会。

Reduction mammoplasty pathologic specimens can reveal incidentally found proliferative lesions. Yet, there is a lack of data investigating the comparative incidences and risk factors for such lesions.A retrospective review was conducted of all consecutively performed reduction mammoplasty cases at a single large academic medical institution in a metropolitan city by two plastic surgeons over a two-year period. All reduction mammoplasties, symmetrizing reductions, and oncoplastic reductions performed were included. There were no exclusion criteria.Six hundred thirty-two total breasts were analyzed: 502 reduction mammoplasties, 85 symmetrizing reductions, and 45 oncoplastic reductions in 342 patients. Mean age was 43.9±15.9 years, mean BMI 29.2±5.7, and mean reduction weight 610.0±313.1 grams. Patients who underwent reduction mammoplasty for benign macromastia had a significantly lower incidence (3.6%) of incidentally found breast cancers and proliferative lesions compared to patients with oncoplastic reductions (13.3%) and symmetrizing reductions (17.6%) (p<0.001). In univariate analysis, personal history of breast cancer (p<0.001), first degree family history of breast cancer (p = 0.008), age (p<0.001), and tobacco use (p = 0.033) were all statistically significant risk factors. Using a backwards elimination stepwise reduced multivariable logistic regression model for risk factors associated with breast cancer or proliferative lesions, age (p<0.001) was the only retained significant risk factor.Proliferative lesions and carcinomas of the breast found in reduction mammoplasty pathologic specimens may be more common than previously reported. The incidence of newly found proliferative lesions was significantly lower in cases of benign macromastia compared to oncoplastic and symmetrizing reductions.Copyright © 2023 by the American Society of Plastic Surgeons.