Image: Many young women undergoing breast reduction surgery have unneeded mammography (Photo courtesy of Getty Images).
A new study reveals that nearly one-third of young women underwent mammography before cosmetic breast reduction surgery, despite the fact that no professional society recommends routine screening before age 40.
Researchers at Michigan Medicine (Ann Arbor, USA), the Veterans Affairs Center for Clinical Management Research (Ann Arbor, MI, USA), and other institutions searched the records of 52,486 women being evaluated for reduction mammoplasty between 2009 and 2015. The researchers excluded from the analysis women whose medical records indicated a personal or family history of breast cancer, genetic predisposition, or prior benign breast disease.
The results revealed that 30% of women 30-39 years of age had mammograms before breast reduction surgery, a rate five times higher than that of other women their age. Among these, 14% went on to have magnetic resonance imaging (MRI), ultrasonography, or a biopsy. Cancer was found in only 0.5% of the women. In addition, 4% of women 29 and younger received a mammogram before breast reduction, compared with just 0.2% of the population of millennial women. The study was published on December 26, 2018, in JAMA Surgery.
“Altering screening mammography for patients younger than 40 years in the setting of evaluation for breast surgery has a risk for subsequent tests and invasive procedures,” said lead author Erica Sears, MD, of Michigan Medicine. “I think that if there’s more awareness among patients, they may be motivated to have a conversation with their doctor about whether screening mammography is right for them. It’s also about education on the provider’s part about the downstream impact of future testing that women may experience.”
The American Society of Plastic Surgeons, among other organizations, recommended in 2014 that women undergoing elective breast surgery should not receive routine preoperative mammography beyond existing guidelines recommendations, considering risk factors and age, unless a specific concern exists based on their medical history or a physical finding.
Veterans Affairs Center for Clinical Management Research