CONTRALATERAL MASTOPLASTY FOR BREAST RECONSTRUCTION - A GOOD OPPORTUNITY FOR GLANDULAR EXPLORATION AND OCCULT CARCINOMAS DIAGNOSIS

Background: Exploration of the contralateral breast in case of breast cancer has been advocated by many investigators, based on the incidenc e of contralateral cancer expected to be around 10-15%. Method: From 1 978 to 1993, 813 contralateral mammaplasties were performed to obtain symmetry in the course of breast reconstruction, including 373 mastope xies and 440 reduction mammaplasties (RMs). All these operations were performed in patients treated for a cancer of the opposite breast. Cli nical and radiologic examination before the reduction mammaplasty show ed tissue to be free of evident tumor. Results: Twenty clinically and radiologically occult contralateral cancers were found in the reductio n specimen (4.6%). Most of them were located in the lower and central quadrants (70%). The macroscopic size of the tumors varied from 3 to 1 6 mm. Twelve carcinomas were in situ, and eight cases were infiltratin g. Conclusion: The symmetry procedure allows a good check-up of the gl andular tissue of the contralateral breast at the time of the breast r econstruction, especially when there is no evidence of tumor. The diff erent techniques of breast reduction provide specific possibilities fo r such exploration and should be chosen according to the preferential area that should be explored.