Priority Health: Breast reduction and breast cancer

Some women are wondering if undergoing a breast reduction lowers their risk of breast cancer. Unfortunately, this is not a percentage disease, but a cellular disease.

Breast cancer starts as a single cell, and mutates into a continuously growing mass. It's uncontrolled growth is the abnormality. Therefore simply removing breast tissue will decrease the number of cells that could turn into cancer, but it does not remove the risk of breast cancer. The risks are related to genetics and lifestyle.

Some risk factors for breast cancer include:

• Age
• Gender
• Race
• Early menses/late menopause
• Family history/genetics 
• No children or later child birth
• Hormone exposure
• Alcohol Diet
• Obesity

There have been multiple studies to compare breast cancer rates after having breast reduction surgery. The outcomes vary slightly, but the statistics do show a decrease in breast cancer incidence in the breast reduction group compared to the average female. But this was calculated, not actually measured. Further, they found some interesting statistics related to when the breast reduction was done.

Some statistics of breast reduction surgery and cancer include:

• Reduction in breast cancer occurrence if 600 grams or more of breast tissue was removed
• This was age related; the decrease in occurrence (40%) was only in the group older than 40 at the time of breast reduction surgery. The numbers actually improved if the patient was older (50 or 60), but if the patient was under forty at the time of surgery, there was actually an increase in the occurrence of breast cancer. In the patient that was 20 years old at surgery, there was actually an increase of breast cancers found (twice as many as expected).
• The average time of diagnosis from surgery for breast cancer was 6.2 years after surgery.

Complications that may have affected the studies include:

• Infections after surgery
• Scarring of the tissue after surgery
• Difficulty with self breast exams due to decrease sensitivity
• Decreased sensitivity to mammograms due to thicker tissue, and scarring after surgery
• Increased repeat mammograms due to abnormalities for surgeries

It is important to note that these statistics only include breast reduction surgery. This means that only a portion of the breast is removed. There is actually a treatment for women that are gene positive (BRCA) that involves electively removing both breasts. This is called bilateral mastectomies, and is not related to this.

Mastectomies have been proven to reduce the risk of breast cancer occurrence by 90%. Why only 90%? It's because it is not possible to remove 100% of the breast without significant side effects.

Breast cancer starts as a microscopic disease, so if there is any breast tissue in the body, and you have any of the risk factors, or lifestyle problems, you can still get breast cancer. No study so far has proven a link between the size of the breast and the risk of cancer.