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Routine Screening of Excised Breast Tissue Can Backfire

-- Jane Parry

Wednesday, March 11, 2009

WEDNESDAY, Mar. 11 (HealthDay News) -- Most plastic surgeons routinely send breast reduction tissue for routine histological testing, effectively screening women under the age of 50 for breast cancer without their consent, according to an article published online Mar. 10 in BMJ. Three related editorials discuss the surgical management problems, ethical dilemmas and implications for patients of such a practice.

Mohammed Keshtgar, M.D., Ph.D., and colleagues at the Royal Free and University College Medical School and Royal Free Hampstead NHS Trust in London, U.K., describe the case of a 37-year-old woman who underwent breast reduction surgery and whose tissue was subsequently sent for histological testing, which revealed signs of small cell type ductal cancer.

The patient underwent annual follow-up mammograms, the results of which led to further surgery to excise the cancer cells, and additional cosmetic surgery to mitigate the esthetic impact of the cancer excision, the researchers explain. The authors note that women who had breast reduction and who were subsequently diagnosed with breast cancer were more likely to have mastectomy than conservative surgery.

"Part of the clinical difficulty arises because specimens are not oriented during surgery and therefore it is not possible to identify the exact area affected," the authors write. "Either the routine practice of screening the excised breast tissue should be abandoned completely, or women should be given the opportunity of informed consent for an unproved and potentially harmful screening practice."

Abstract
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Editorial - Treasure
Editorial - Sugarman
Editorial - Boase

Specialties Cardiology
Diabetes & Endocrinology
Internal Medicine
Family Practice

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