Mammographic findings following reduction mammoplasty

Breast reduction mammoplasty is becoming an increasingly common procedure. A baseline mammogram is recommended after 35 years of age as the most effec tive method for detection of small breast cancers. A prospective study was conducted for the evaluation of the mammographic findings after reduction m ammoplasty. During the last 7 years, 113 patients over 35 years of age unde rwent bilateral reduction mammoplasty. All patients had a preoperative mamm ogram. A new mammogram was obtained at 6 and 18 months after the procedure. All films were reviewed by the same two radiologists. Breast reduction was performed with the vertical bipedicle flap technique (McKissock) and the i nferior pedicle technique. There were no apparent differences in the findin gs between the two methods. Most common findings were parenchymal redistrib ution in 102 (90.2%) and elevation of the nipple in 96 (84.9%), produced by a shift of the breast tissue to a lower position. Calcifications were seen in 29 (25.6%), and "oil cysts" in 22 (19.4%), caused by localized fat necr osis. A retroareolar fibrotic band was found in 23 (20.3%), from the transp osed flap. Areolar thickening was observed in six (5.3%), and skin thickeni ng in only two (1.7%), from scar tissue. Mammographic findings after reduct ion mammoplasty are predictable, thus preventing unnecessary biopsies and m aking the diagnosis of lesions unrelated to the procedure easier. All patie nts over 35 years of age should have a preoperative and a postoperative mam mogram for future reference.