NCIDENTAL FINDING OF ATYPICAL PROLIFERATIVE LESIONS IN PATIENTS UNDERGOING CONTRALATERAL MAMMOPLASTY FOR SYMMETRIZATION AFTER ONCOLOGICAL SURGERY AT WOMEN’S HOSPITAL CAISM ?UNICAMP

The contralateral breast reduction is an increasingly performed procedure to achieve symmetry and harmony between the treated breast and the healthy breast. The incidental finding of proliferative lesions with atypia in reducing mammaplasties ranges from 0.06% to 4.6% according to the literature, and in patients with a personal history of breast cancer this figure may reach around 9.7% to 12, 8% of cases. Objective: To evaluate the presence of atypical proliferative lesions (APL), ductal carcinoma in situ (DCIS) and invasive carcinoma in pathological report of reductive mammoplasty specimens of the contralateral breast conducted between January 2010 and February 2015 at Women´s Hospital – CAISM- UNICAMP. Methods: atypical proliferative lesions were considered: atypical ductal hyperplasia, atypical lobular hyperplasia, flat epithelial atypia and lobular carcinoma in situ. Results: 129 symmetrization surgeries were realized during this period, pathology analyses were available in 108 cases. In 14 of 108 patients (12.9%), at least one APL finding was found. DCIS was incidental diagnosis in 2 patients (1.8%). The most frequent findings were atypical ductal hyperplasia (7.4%), flat epithelial atypia (7.4%) and LCIS (2.8%). No cases of invasive carcinoma was found. Of all the incidental findings, only in 2 cases of DCIS, an additional adjuvant therapy was necessary. The first case was found in a 52 years patient, grade 2/3 with 2 mm in a late symmetrization. The second, grade 1/2 measuring 3 mm in an immediate symmetrization of patient of 52 years. For both, radiotherapy was indicated to complete the treatment. Conclusion: The findings of this study are in agreement with previous data from other publications; atypical incidental lesions in patients with cancer history, although frequent (12.9%), rarely changes the management. By contrast, the findings of DCIS, considered precursor lesions of breast cancer, additional treatment should be considered.