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Evaluating the Recommendation for Pre-operative Elective Non-Cancer Related Breast Surgery Mammography for Women between the Ages of 35 and 40: An Interim Analysis
Chika Agi, Russell Kling, William Tobler, M.D., Carolyn De La Cruz, M.D., J. Peter. Rubin, M.D., Jeffrey Gusenoff, M.D..
University of Pittsburgh School of Medicine, Pittsburgh, PA, USA.

Abstract
Introduction
Many surgeons order routine preoperative mammograms on patients undergoing plastic surgery. Currently, no professional organizations recommend initiating mammography under the age of 40 unless the patient is at high risk for breast cancer. The ASPS Choosing Wisely® Campaign recommends against routine pre-operative breast surgery mammography, however there is no primary plastic surgery literature supporting this claim. We aimed to determine the necessity of routine pre-operative mammography in women under age 40 undergoing aesthetic breast surgery.
Methods
All patients between 2002-2015 who underwent elective non cancer-related breast surgery by three plastic surgeons were evaluated. Patients were sorted in to groups based on age of screening mammography: Group 1 (age 35-40), Group 2 (under 35), Group 3 (41-45) and Group 4 (over 45).
Results
308 patients were initially reviewed. 39 (13%) were in Group 1, 112 patients (36%) were in Group 2, 28 (9%) were in Group 3, and 129 (42%) were in Group 4. 77% had a preoperative mammogram in Group 1 (8%, 64%, 60%, respectively). Group 1 had the lowest average Bi-Rads of 1.33 (1.44, 1.61, 1.80, respectively). 23% of Group 1 patients had additional testing and invasive procedures performed (33%, 17%, 22%, respectively).
Conclusion
In our study, women under the age of 40 who had preoperative mammograms prior to non-cancer related breast surgery were subjected to additional testing that was ultimately unnecessary. Our study confirms that preoperative mammograms in plastic surgery should be for patients over age 40 or high risk early breast cancer patients.


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