Breast tissue removed during cosmetic surgery could be screened for cancer, surgeons proposed today.
The idea was put forward after British surgeons found cancer following a routine breast operation on a woman of 37.
On the website of the British Medical Journal, surgeon Mr Mohammed Keshtgar of the Royal Free Hampstead NHS Trust, UK, and colleagues say doctors need to debate whether examination of these specimens is a good idea, as it is routinely carried out without informed consent.
In the UK, breast cancer screening is not recommended for women under the age of 50, “but young women throughout the world are in effect undergoing a ‘screening’ procedure after cosmetic reduction surgery,” they write.
“Either the routine practice of screening the excised breast tissue should be abandoned completely, or women should be given the opportunity of informed consent for an unproved and potentially harmful screening practice,” they conclude.
Also in the journal, surgeon Professor Tom Treasure from University College London, UK, writes that there is a lack of evidence for the benefit of screening this tissue.
Discarding breast tissue may spare patients unnecessary investigations, but routinely screening would mean taking the time to gain informed consent.
“The big question remains unanswered,” he concludes.
Ethicist Jeremy Sugarman of Johns Hopkins University, Baltimore, USA, believes that patients should be told explicitly about tests 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,” he writes.
“Even though the likelihood of the specimens being malignant is small, discussing this issue in advance should help to prepare patients to receive the news and to face the complex decisions that follow.”
Treasure, T. The big question remains unanswered. The British Medical Journal, 2009;338:b759.
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