Will breast reduction surgery cause internal scar tissue that can be mistaken for breast cancer during mammograms?

There is no official recommendation against breast reduction just because of a family history of breast cancer.

Yes, they can. It is advised to get a baseline mammogram for comparision. Scar tissue and dense breasts can present a similar problem with obscuring early breast cancer, but scar tissue does not look like breast cancer.There are new imaging techniques,  such as the 3-D tomogram mammogram that is excellent at looking through dense breast tissue and around breast implants. If you are a candidate for a breast reduction, the concerns your doctor has raised should not prevent you from having the reduction. You can certainly have a consultation with a radiologist specializing in breast imaging and get this reassurance directly.

This is a really great question.  You should definitely get a baseline mammogram before and after your surgery- this will display the current "lay of the land" and be a baseline for any later concerns to be compared to.  In this way, if something comes up that you or your doctor has a concern about, you can compare the findings to the baseline to decide whether further testing or a biopsy is needed.Best wishes!Dr. L

Hi - this is a very good question I am asked all the time. For my reduction patients who have a higher than normal risk of breast cancer due to family history, I always make sure they have a baseline mammogram pretty soon before their surgery, then another new baseline mammogram around 3-4 months after their surgery. There is definitely a slightly higher risk of needing a biopsy, but typically radiologists can differentiate between scar tissue and a suspicious mass. If you have a very high genetic risk of breast cancer (such as any of the BRCA genes) and many people in your family have actually had breast cancer, you should have a serious discussion with your primary care physician and plastic surgeon before proceeding. 

The short answer is yes, there can be internal architectural changes, densities, and calcifications that can be confused with breast cancer both on exam and radiographic tests. You might want to discuss this with your local radiologists or imaging specialists where you might go for these tests. Most well-trained and experienced radiologists who deal with breast surgery and breast cancer patients can distinguished malignant lesions from benign. But remember that there are false positive and false negative readings on these tests even without breast reduction. Depending on your age, I will usually recommend a baseline post-op mammogram no sooner than 6 months after reduction so that you have a "clean" mammogram with which to compare future mammogram Often it is the change that a radiologist sees that tips off a lesion's significance. Finally, if you have an extremely strong family history of breast cancer as well as dense, "hard-to-read"  breasts, you might consider genetic counseling to see if genetic testing is appropriate.Robin T.W. Yuan, M.D.

Thanks for bringing up a very important topic. I have previously asked this of several of my friends who are radiologists and they assure me the breast reduction internal scarring can be differentiated from malignant changes.