Breast Reduction Surgery Guidelines

Patient Selection and Indications

For patients with BRCA1/2 mutations or strong family history of breast cancer, risk-reduction mastectomy rather than simple reduction should be considered, as this provides 90% reduction in breast cancer risk, according to the National Comprehensive Cancer Network 1
The Society of Surgical Oncology and other organizations emphasize the importance of proper breast cancer screening before proceeding with breast reduction surgery, highlighting the need to exclude malignancy in age-appropriate patients or those with suspicious findings 1, 2

Patients with breast cancer requiring treatment can undergo therapeutic mammoplasty (oncoplastic breast reduction) to achieve both oncologic and aesthetic goals simultaneously, as recommended by the Society of Surgical Oncology and European Society of Surgical Oncology, although specific guidelines are not provided in the article, the general principle is supported by 1, 2

Active breast cancer or suspicious breast lesions requiring workup first, as stated by the American College of Surgeons, is an absolute contraindication for breast reduction surgery 3

Breast reduction techniques can be combined with cancer surgery (therapeutic mammoplasty) to achieve better cosmetic outcomes in patients with large breasts undergoing breast-conserving surgery for cancer, according to the Society of Surgical Oncology 4, 5, 3
This represents a newer oncoplastic procedure that addresses both cancer treatment and breast size simultaneously, as reported by the European Society of Surgical Oncology 5, 3