Cancer screening after breast reduction: an ethicist’s view
Cancer is sometimes found in patients who have breast reduction surgery
- By: Jeremy Sugarman
The current practice of sending reduction mammoplasty specimens for routine histological examination can result in a complicated set of circumstances that raise important ethical issues. As described by Keshtgar and colleagues, a small but measurable subset of these specimens show malignancy of uncertain clinical significance.1 Since patients undergoing this reconstructive procedure apparently are not informed about screening of the tissue removed during surgery, they may be understandably surprised that cancer was found and also face difficult questions about management. This situation is an opportunity for preventive ethics—which seeks to avoid vexing ethical issues by taking steps to avert them.
The authors wonder whether patients should be told explicitly about histological examination and the potential consequences if it turns out to be positive. It would be hard to imagine a justification for not including this sort of information in the consent process for reduction mammoplasty. Even though the likelihood of the