The contralateral breast at reconstructive surgery after breast cancer operation — A histopathological study

Abstract

The present study concerns 73 patients with known unilateral breast carcinoma. Thirty of the patients had a primary invasive carcinoma removed and at a later operation contralateral subcutaneous mastectomy with implantation of a prosthesis. This was performed with or without ipsilateral breast reconstruction. Forty-three of the cases had an in situ carcinoma found by local excision, whereafter bilateral subcutaneous mastectomy was performed in 38 cases. Five cases had already had an ipsilateral mastectomy and contralateral subcutaneous mastectomy was performed. The histological examination of the subcutaneous mastectomy specimens was extensive with breasts cut into 3–5 mm slices, which were embedded and cut in large sections allowing us to map all lesions. 42.5 per cent of the contralateral breasts contained invasive orin situ carcinoma. In about 70 per cent of the cases other histological lesions, considered more or less precancerous, were found in the contralateral breast. Our results speak in favor of an active approach to the contralateral breast at reconstruction, especially in cases with a long life expectancy after the first carcinoma. It is psychologically comforting to the patient to know that most of the breast gland, which could be the future origin of a new carcinoma, has been removed.