Background: Routine histologic examination of secondarily excised mastectomy scars is considered good practice, even though the microscopic detection of a metastasis in clinically unsuspected mastectomy scars is rare. Because cost-effective use of histologic services is required, the occurrence rate of metastases in such scars needs to be established to assess the possible benefit of such routine examination.
Methods: The histologic observations on 728 clinically unsuspected scars from prophylactic (n = 151) or curative (n = 395) mastectomy or breast-conservation treatment in 424 patients were traced and correlated to the indication of initial breast surgery, possible adjuvant therapy, and time lapse between initial surgery and scar examination.
Results: In none of the 728 scars was a scar metastasis or de novo tumor found.
Conclusions: Routine histologic examination of clinically unsuspected scars excised at the time of breast reconstruction or scar correction after prophylactic or curative breast surgery did not benefit the authors' patients.