Breast hypertrophy

a comparative study of histopathological and imaging findings

Abstract

Objective: To evaluate the sensitivity and specificity of mammography and ultrasonography in detecting breast changes in women with breast hypertrophy in its various degrees and to correlate the findings with the histopathological exam. Methods: Prospective study was conducted on 60 patients aged 16 to 72 years with breast hypertrophy, seen at the Plastic Surgery Service of the University Hospital of Federal University of Maranhão. Imaging exams were indicated according to age and the results were classified using the Breast Imaging Reporting and Data System. The imaging findings were correlated with the degree of hypertrophy (weight) and with the histopathological result of 120 surgical specimens obtained during reduction mammoplasty. Results: Histopathological analysis detected 47.5% of non-neoplastic benign lesions, 7.5% of them presenting a slightly elevated relative risk of malignancy. Ultrasonography showed 80.6% specificity and 40.5% sensitivity. Mammography presented 54.5% specificity and 49.0% sensitivity. Breast ultrasonography presented low sensitivity, whereas mammography showed both low sensitivity and specificity. Even in the case of patients of older age in whom a reduction in breast density would favor mammographic sensitivity, the result was similar to that obtained for dense breasts. Conclusion: These data suggest that breast hypertrophy should be taken into account when interpreting mammography and ultrasonography results for the screening of breast diseases.