Pathology Evaluation of Reduction Mammaplasty Specimens and Subsequent Diagnosis of Malignant Breast Disease: A Claims-Based Analysis.
Pathology Evaluation of Reduction Mammaplasty Specimens and Subsequent Diagnosis of Malignant Breast Disease: A Claims-Based Analysis.
复制标题
缩小乳房整形术标本的病理学评估和恶性乳腺疾病的后续诊断：基于索赔的分析。
DOI：
10.1007/s00268-019-04931-1
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发表时间：
2019
影响因子：
2.6
通讯作者：
Chung,KevinC
中科院分区：
文献类型：
--
作者：
Sears,ErikaD;Lu,Yu-Ting;Chung,Ting-Ting;Momoh,AdeyizaO;Chung,KevinC
背景本研究旨在衡量接受乳房缩小整形术的患者乳房标本病理学评估的使用情况，并评估新诊断乳腺疾病的比率和相关费用。方法 我们分析了 2009 年至 2015 年的 Truven MarketScan 数据库，以确定因巨乳症而接受乳房缩小整形术的成年女性患者。我们记录了患者年龄、获得病理评估的比率、病理评估后新诊断的良性或恶性乳腺疾病以及手术的总费用。结果 17,738例接受乳房缩小整形术的巨乳症患者中，91.3%（n=16,193）接受了病理学评估。 < 70 岁年龄组的病理学评估率在临床上相似 (90.8–92.1%)，≥ 70 岁的患者略低 (85.0%)。在 6987 名接受病理学评估的 40 岁以下患者中，0.06%（n=4）随后在 3 个月内被诊断为恶性乳腺疾病，而整个队列中这一比例为 0.23%（n=37/16,193）。病理学索赔导致乳房缩小手术的平均发生率增加了 307 (SD251)。结论：乳房缩小整形术后的乳腺组织常规提交进行病理学评估，而不考虑基于年龄的乳腺癌风险。低风险群体（40 岁以下）患者的乳腺组织常规病理学评估需要额外的评估平均有 536,000 人检测出单一隐匿性乳腺癌，而在 40 岁及以上患者中检测出新恶性肿瘤的人数则增加了 85,600 人。临床医生和政策制定者应考虑是否应根据乳腺癌的危险因素对乳腺组织进行个体化常规病理学评估。
Background This study aimed to measure the use of pathology evaluation of breast specimens among patients undergoing reduction mammaplasty and assess rates of new diagnoses of breast disease and associated cost. Methods We analyzed the Truven MarketScan Databases from 2009 to 2015 to identify adult female patients undergoing reduction mammaplasty for macromastia. We recorded patient age, rates of obtaining pathology evaluation, new diagnoses of benign or malignant breast disease after pathology evaluation, and total cost for the surgery encounter. Results Among 17,738 macromastia patients undergoing reduction mammaplasty, 91.3%(n= 16,193) received pathology evaluation. Pathology evaluation rates were clinically similar across age groups< 70 years (90.8–92.1%) and slightly lower for patients≥ 70 (85.0%). Among 6987 patients less than 40 years who received pathology evaluation, 0.06%(n= 4) were subsequently diagnosed with malignant breast disease within 3 months, compared to 0.23% in the entire cohort (n= 37/16,193). Pathology claims resulted in an added 307(SD251)onaverageforthebreastreductionsurgeryencounters.ConclusionsBreasttissueafterreductionmammaplastyisroutinelysubmittedforpathologyevaluation,withoutconsiderationofage-basedriskforbreastcancer.Routinepathologyevaluationofbreasttissueinpatientsinlowerriskagegroups(lessthan40years)requiredanadditional 536,000 on average to detect a single occult breast cancer compared to an added 85,600todetectanewmalignancyinpatients40yearsandolder.Cliniciansandpolicymakersshouldconsiderwhetherroutinepathologyevaluationofbreasttissueshouldbeindividualizedbasedonriskfactorsforbreastcancer.