Multimodality Imaging of the Reconstructed Breast

Adrada, Beatriz E.; Whitman, Gary J.; Crosby, Melissa A.; Çarkaci, Selin; Dryden, Mark J.; Dogan, Basak E.

doi:10.1067/j.cpradiol.2015.04.006

Cited by 15 publications

(4 citation statements)

References 43 publications

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“…Additionally, mammography can be helpful in the work-up of masses with worrisome features on ultrasound to exclude fat necrosis, as mammography will depict typical features of fat necrosis. [22] e mammographic features of breast recurrences in the reconstructed breast in our study were oval masses in 50% (3/6) and irregular masses in 50% (3/6). ese findings are similar to the results reported by Yoo et al, where 50% of the masses had a benign appearance.…”

Section: Discussionmentioning

confidence: 46%

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Imaging Surveillance of the Reconstructed Breast in a Subset of Patients May Aid in Early Detection of Breast Cancer Recurrence

Adrada

Karbasian

Huang

et al. 2021

JCIS

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Objectives: The purpose of this study is to determine the biological markers more frequently associated with recurrence in the reconstructed breast, to evaluate the detection method, and to correlate recurrent breast cancers with the detection method. Material and Methods: An institutional review board-approved retrospective study was conducted at a single institution on 131 patients treated with mastectomy for primary breast cancer followed by breast reconstruction between 2005 and 2012. Imaging features were correlated with clinical and pathologic findings. Results: Of the 131 patients who met our inclusion criteria, 40 patients presented with breast cancer recurrence. The most common histopathologic type of primary breast cancer was invasive ductal carcinoma in 82.5% (33/40) of patients. Triple-negative breast cancer was the most common biological marker with 42.1% (16/38) of cases. Clinically, 70% (28/40) of the recurrences presented as palpable abnormalities. Of nine patients who underwent mammography, a mass was seen in eight patients. Of the 35 patients who underwent ultrasound evaluation, an irregular mass was found in 48.6% (17/35) of patients. Nine patients with recurrent breast cancer underwent breast MRI, and MRI showed an irregular enhancing mass in four patients, an oval mass in four patients, and skin and trabecular thickening in one patient. About 55% of patients with recurrent breast cancer were found to have distant metastases. Conclusion: Patients at higher risk for locoregional recurrence may benefit from imaging surveillance in order to detect early local recurrences.

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Section: Discussionmentioning

confidence: 46%

Section: Discussionmentioning

confidence: 99%

Imaging Surveillance of the Reconstructed Breast in a Subset of Patients May Aid in Early Detection of Breast Cancer Recurrence

Adrada

Karbasian

Huang

et al. 2021

JCIS

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“…The majority of recurrences in the reconstructed breast will be found in the skin and the subcutaneous tissues followed by recurrences deep to the pectoralis muscle [7]. Recurrence rates are reported to be approximately 1% to 2% annually for both mastectomy and mastectomy with reconstruction, and overall recurrence has been reported at between 2% to 15% and has been noted to vary based on the initial cancer type and stage as well as follow-up period of the study [5,[7][8][9][10][11][12][13]. Clinical evaluation has been a mainstay of evaluation of the postmastectomy breast [4], and the appropriate surveillance imaging strategy for patients with a history of mastectomy with or without reconstruction is an evolving topic, with evidence predominantly drawn from small retrospective studies.…”

Section: 2 Ormentioning

confidence: 99%

“…Finally, women who have undergone mastectomy with or without reconstruction may present with symptomatic concerns, both in the immediate postoperative period and later. Sequalae of the surgery, such as hematomas, infections, and most commonly in the early postoperative period, fat necrosis [7], may present as palpable findings. Recurrent disease may also present as a palpable lump [7,14].…”

Section: 2 Ormentioning

confidence: 99%

ACR Appropriateness Criteria® Imaging After Mastectomy and Breast Reconstruction

Heller

Lourenço

Niell

et al. 2020

Journal of the American College of Radiology

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Mastectomy may be performed to treat breast cancer or as a prophylactic approach in women with a high risk of developing breast cancer. In addition, mastectomies may be performed with or without reconstruction. Reconstruction approaches differ and may be autologous, involving a transfer of tissue (skin, subcutaneous fat, and muscle) from other parts of the body to the chest wall. Reconstruction may also involve implants. Implant reconstruction may occur as a single procedure or as multistep procedures with initial use of an adjustable tissue expander allowing the mastectomy tissues to be stretched without compromising blood supply. Ultimately, a full-volume implant will be placed. Reconstructions with a combination of autologous and implant reconstruction may also be performed. Other techniques such as autologous fat grafting may be used to refine both implant and flap-based reconstruction. This review of imaging in the setting of mastectomy with or without reconstruction summarizes the literature and makes recommendations based on available evidence. The American College of Radiology Appropriateness Criteria are evidence-based guidelines for specific clinical conditions that are reviewed annually by a multidisciplinary expert panel. The guideline development and revision include an extensive analysis of current medical literature from peer reviewed journals and the application of well-established methodologies (RAND/UCLA Appropriateness Disclaimer: The ACR Committee on Appropriateness Criteria and its expert panels have developed criteria for determining appropriate imaging examinations for diagnosis and treatment of specified medical condition(s). These criteria are intended to guide radiologists, radiation oncologists and referring physicians in making decisions regarding radiologic imaging and treatment. Generally, the complexity and severity of a patient's clinical condition should dictate the selection of appropriate imaging procedures or treatments. Only those examinations generally used for evaluation of the patient's condition are ranked. Other imaging studies necessary to evaluate other co-existent diseases or other medical consequences of this condition are not considered in this document. The availability of equipment or personnel may influence the selection of appropriate imaging procedures or treatments. Imaging techniques classified as investigational by the FDA have not been considered in developing these criteria; however, study of new equipment and applications should be encouraged. The ultimate decision regarding the appropriateness of any specific radiologic examination or treatment must be made by the referring physician and radiologist in light of all the circumstances presented in an individual examination.

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