Women undergo unnecessary mammograms before breast reduction surgery

Countless women with no known risk of breast cancer get mammograms before having breast reduction surgery—a practice doctors have been doing without question for years.  

Although relatively new recommendations—such as those released in 2014 from the American Society of Plastic Surgeons—say routine mammograms should be completely avoided before surgery unless breast cancer risks exist, new research published in JAMA Surgery found that one-third of women younger than 40 undergo mammography exams before breast reduction surgery.  

Unnecessary preoperative mammograms can expose patients to needless amounts of radiation and increase patient costs or anxiety, the study's authors wrote.

“Altering screening mammography for patients younger than 40 years in the setting of evaluation for breast surgery has a risk for subsequent tests and invasive procedures,” lead author Erika D. Sears, MD, MS, a plastic surgeon at the University of Michigan Medicine in Ann Arbor, Michigan, said in a prepared statement.  

For the study, the multi-institutional team of researchers analyzed patient records of 52,486 women with no known breast cancer risk from the American Board of Plastic Surgery Maintenance of Certification data. The women were of all ages and were evaluated for breast reduction between 2009 and 2015.  

Women whose records indicated a personal or family history of breast cancer, genetic predisposition or prior benign breast disease were excluded, according to the researchers.  

Sears and colleagues found that 30 percent of women ages 30 to 39 had screening mammograms before breast reduction surgery. Of these women, 14 percent went on to have an MRI, ultrasound or a breast biopsy. However, breast cancer was found in only 50 percent of the women.  

Additionally, roughly four percent of women ages 29 and younger received mammograms before surgery.  

“I think that if there’s more awareness among patients, they may be motivated to have a conversation with their doctor about whether screening mammography is right for them,” Sears said. “It’s also about education on the provider’s part about the downstream impact of future testing that women may experience.”