Prerequisites for histopathological evaluation of reduction mammoplasty specimens: Recommendations based on an audit in a tertiary care hospital

Objective: To recommend prerequisites for the histo-pathological evaluation of reduction mammoplasty [RM] specimens based on an audit in a tertiary care hospital

Methods: All reduction mammoplasty specimens received at department of pathology, in a tertiary care hospital over a 3 years period were re-evaluated retrospectively. Medical records were checked for age, family history of breast cancer, indication for surgery and radiological evaluation. Pathology reports were reviewed for number of blocks sampled and diagnosis. A prerequisites protocol was developed based upon deficiencies and impediments noted

Results: We received a total of 26 cases of reduction mammoplasty. Only 2 [7.69%] specimens were from males. The age of the patients ranged from 26 to 50 years. Indication for surgery was provided in all [100%] of cases, with macromastia being most prevalent indication. Family history of breast carcinoma and radiological evidence was absent or not provided in all cases. The number of blocks prepared were in range of <4 in 17 [73.91%], 5-8 blocks in 5 [19.23%] and 8-12 blocks in 4 cases [15.38%]. The main histopathological finding was fibrocystic change, [n = 12, 46.15%]. Specimen radiography was not conducted in any case

Conclusion: There is a need to stratify RM cases as high, moderate and low risk of breast cancer based on family history of breast carcinoma, clinical and radiological evaluation. The high risk cases should be oriented, with margins inked and extensive sampling done. Specimen radiography should be carried out in younger patients in which mammography is not recommended

The use of island radial forearm flap for local hand coverage

Extensive skin loss of the hand often necessitates creation of a flap for reconstruction and cover. At King Fahd Hospital of the University in Al-Khobar, we have treated 13 cases of hand injury with radial forearm flaps. We found it easy to reconstruct the tissue loss by a reliable flap of optimal thickness which has a good arc of rotation and provides a supple surface. The donor site morbidity is minimal in our hands. The procedure should be adopted for extensive and tedious hand injuries when the appearance and function are both important after reconstruction