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MR imaging of the reconstructed breast: What the radiologist needs to know.

Dialani V, Lai KC, Slanetz PJ - Insights Imaging (2012)

Bottom Line: Surgical management of breast cancer often entails lumpectomy or mastectomy.In this article, we will review the more commonly encountered types of breast reconstruction, which include implants, tranversus rectus abdomnis flap, latissimus dorsi flap, deep inferior epigastric perforator flap, and gluteal flaps.Radiologists will better understand the different types of breast reconstruction after mastectomy and their normal imaging appearance on MRI.

View Article: PubMed Central - PubMed

Affiliation: Department of Radiology, Beth Israel Deaconess Medical Center, C/o Dr. Vandana Dialani, 330 Brookline Avenue, Boston, MA, 02215, USA, vdialani@bidmc.harvard.edu.

ABSTRACT

Objective: The objective is to review the different types of breast reconstruction following cancer surgery and describe expected imaging appearances and complications seen in the reconstructed breast.

Methods: Surgical management of breast cancer often entails lumpectomy or mastectomy. When mastectomy is performed, patients often opt for breast reconstruction. Most facilities do not routinely image the reconstructed breast with mammography.

Results: However, many of these women are imaged with screening breast MRI for evaluation of the contralateral breast, or they may develop a clinical problem that warrants a diagnostic evaluation with MRI. In this article, we will review the more commonly encountered types of breast reconstruction, which include implants, tranversus rectus abdomnis flap, latissimus dorsi flap, deep inferior epigastric perforator flap, and gluteal flaps. Each of these types of reconstruction has different appearances on MR. We will also discuss potential complications that can be seen in the reconstructed breasts, including fat necrosis and recurrence.

Conclusion: Radiologists will better understand the different types of breast reconstruction after mastectomy and their normal imaging appearance on MRI. Radiologists will be more aware of how to recognize complications related to surgery as well as how to determine whether recurrence is present.

Main messages: • The different surgical techniques used in breast reconstruction are discussed. • Describes the normal magnetic resonance imaging appearance of the breast after reconstruction. • Identify MR imaging features of benign sequelae and recurrence following breast reconstruction.

No MeSH data available.


Related in: MedlinePlus

A 66-year-old women with a history of left breast cancer treated with mastectomy in 1990, with saline implant reconstruction. Axial T2W images demonstrate the intracapsular rupture of this saline implant. The valve of the deflated implant is seen on the image (white arrow)
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Fig10: A 66-year-old women with a history of left breast cancer treated with mastectomy in 1990, with saline implant reconstruction. Axial T2W images demonstrate the intracapsular rupture of this saline implant. The valve of the deflated implant is seen on the image (white arrow)

Mentions: If a saline breast implant ruptures, the implant deflates, causing the affected breast to change in shape and size (Fig. 10). The leaking saline is absorbed without complications. Patients usually undergo surgery and replacement of the implant. If silicone breast implants rupture, patients may remain asymptomatic or present with symptoms of breast pain, nodularity, or deformity. As we know, MRI is the most sensitive method for detection of intracapsular silicone implant rupture, and the linguine (collapsed and folded elastomer shell that is floating in gel) and keyhole (presence of silicone on both the inside and outside a radial fold) signs have been well documented in the literature. Macroscopic extrusion of silicone through the fibrous capsule into the surrounding parenchyma, pectoralis muscle, or lymph nodes may be seen as signs of extracapsular rupture.Fig. 10


MR imaging of the reconstructed breast: What the radiologist needs to know.

Dialani V, Lai KC, Slanetz PJ - Insights Imaging (2012)

A 66-year-old women with a history of left breast cancer treated with mastectomy in 1990, with saline implant reconstruction. Axial T2W images demonstrate the intracapsular rupture of this saline implant. The valve of the deflated implant is seen on the image (white arrow)
© Copyright Policy
Related In: Results  -  Collection

Show All Figures
getmorefigures.php?uid=PMC3369124&req=5

Fig10: A 66-year-old women with a history of left breast cancer treated with mastectomy in 1990, with saline implant reconstruction. Axial T2W images demonstrate the intracapsular rupture of this saline implant. The valve of the deflated implant is seen on the image (white arrow)
Mentions: If a saline breast implant ruptures, the implant deflates, causing the affected breast to change in shape and size (Fig. 10). The leaking saline is absorbed without complications. Patients usually undergo surgery and replacement of the implant. If silicone breast implants rupture, patients may remain asymptomatic or present with symptoms of breast pain, nodularity, or deformity. As we know, MRI is the most sensitive method for detection of intracapsular silicone implant rupture, and the linguine (collapsed and folded elastomer shell that is floating in gel) and keyhole (presence of silicone on both the inside and outside a radial fold) signs have been well documented in the literature. Macroscopic extrusion of silicone through the fibrous capsule into the surrounding parenchyma, pectoralis muscle, or lymph nodes may be seen as signs of extracapsular rupture.Fig. 10

Bottom Line: Surgical management of breast cancer often entails lumpectomy or mastectomy.In this article, we will review the more commonly encountered types of breast reconstruction, which include implants, tranversus rectus abdomnis flap, latissimus dorsi flap, deep inferior epigastric perforator flap, and gluteal flaps.Radiologists will better understand the different types of breast reconstruction after mastectomy and their normal imaging appearance on MRI.

View Article: PubMed Central - PubMed

Affiliation: Department of Radiology, Beth Israel Deaconess Medical Center, C/o Dr. Vandana Dialani, 330 Brookline Avenue, Boston, MA, 02215, USA, vdialani@bidmc.harvard.edu.

ABSTRACT

Objective: The objective is to review the different types of breast reconstruction following cancer surgery and describe expected imaging appearances and complications seen in the reconstructed breast.

Methods: Surgical management of breast cancer often entails lumpectomy or mastectomy. When mastectomy is performed, patients often opt for breast reconstruction. Most facilities do not routinely image the reconstructed breast with mammography.

Results: However, many of these women are imaged with screening breast MRI for evaluation of the contralateral breast, or they may develop a clinical problem that warrants a diagnostic evaluation with MRI. In this article, we will review the more commonly encountered types of breast reconstruction, which include implants, tranversus rectus abdomnis flap, latissimus dorsi flap, deep inferior epigastric perforator flap, and gluteal flaps. Each of these types of reconstruction has different appearances on MR. We will also discuss potential complications that can be seen in the reconstructed breasts, including fat necrosis and recurrence.

Conclusion: Radiologists will better understand the different types of breast reconstruction after mastectomy and their normal imaging appearance on MRI. Radiologists will be more aware of how to recognize complications related to surgery as well as how to determine whether recurrence is present.

Main messages: • The different surgical techniques used in breast reconstruction are discussed. • Describes the normal magnetic resonance imaging appearance of the breast after reconstruction. • Identify MR imaging features of benign sequelae and recurrence following breast reconstruction.

No MeSH data available.


Related in: MedlinePlus