Histologic profiles of reduction mammaplasty specimens among jordanian females

Reduction mammaplasty is a common surgical procedure that yields a variable amount of tissue for pathologic examination. The purpose of this study was to evaluate the histological diagnoses of the reduction mammaplasty specimens and to determine the incidence of breast lesions in otherwise asymptomatic and healthy Jordanian females. All reduction mammaplasty specimens of 73 patients over a 10-year period [September 1999-September 2009] at Jordan University Hospital were retrospectively examined. The average number of blocks submitted per breast was 4 [range 3-5]. Variables such as age and preoperative mammograms were examined. A total of 143 specimens were evaluated. Normal mammary tissue was present in 36 patients [49%]. The most common benign lesion was fibrocystic disease [21%] Precancerous breast lesions were identified in 7 patients [9.6%]. No case of carcinoma in situ or invasive carcinoma was encountered in our study. Most of the histopathological lesions were found in patients younger than 35 years of age. Preoperative mammograms were done for 26 patients and all were normal. This study demonstrates the importance of systemic analysis of breast reduction specimens to help identify and guide the management of patients with increased risk of breast cancer following reduction mammaplasty. Consequently, thorough sampling and handling of breast reduction specimens should be emphasized

Risk factors for hematoma development post reduction mammaplasty: novel associations and implications

The aim of this retrospective study was to analyze various preoperative and intraoperative factors that may contribute to the development of wound hematoma after reduction mammaplasty. This will help us to estimate a prospective patient's individualized risk based on selected identifiable factors, facilitating patient selection and preoperative counseling. Sixty six patients, who underwent Wise-pattern, Inferior pedicle reduction mammaplasty over a 10- year period [1999-2008] performed by a single surgeon were studied. The following factors were addressed: age, medical history, medications, smoking habits, Body Mass Index [BMI], phase of menstrual cycle, mass of resection, prophylactic heparin, operation time, intraoperative blood loss, preoperative and postoperative Hemoglobin [Hb] and Hematocrit [Hct] levels, various blood pressure measurements and hematoma formation. The operative time was divided into two periods and in our experience, hemostasis was achieved in the second period. In our series, six patients developed a postoperative wound hematoma; only two patients required operative evacuation [3%]. Body Mass Index [BMI], mass of resection and subcutaneous prophylactic heparin significantly affected the likelihood of wound hematoma [P values: 0.018, 0.002 and 0.031, respectively]. Smoking, age, medical illnesses and phase of menstrual cycle had no statistical significance on the development of wound hematoma. Logistic regression analysis showed that the peak systolic blood pressure during the period of hemostasis was significantly lower in patients who developed hematoma [P=0.019]. Our data indicate that there was a significant correlation between post-operative hematoma and Body Mass Index [BMI], mass of resection, prophylactic heparin and intraoperative hypotention during the period of hemostasis