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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 46-year-old woman with implant reconstruction. Axial a unenhanced T2W fat-saturated, b enhanced T1W, and c sagittal T1 silicone suppressed images show a circumscribed mass adjacent to the silicone implant in the inferior breast. The mass is bright on bright on T2W images and shows postcontrast enhancement. Biopsy proved this to be a spindle cell tumor
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Fig12: A 46-year-old woman with implant reconstruction. Axial a unenhanced T2W fat-saturated, b enhanced T1W, and c sagittal T1 silicone suppressed images show a circumscribed mass adjacent to the silicone implant in the inferior breast. The mass is bright on bright on T2W images and shows postcontrast enhancement. Biopsy proved this to be a spindle cell tumor

Mentions: Despite adequate surgical technique, residual glandular breast tissue can remain following mastectomy and breast reconstruction. An extremely extended time period between mastectomy and tumor appearance may indicate that a de novo cancer has formed. The distinction is important clinically, as a de novo ipsilateral breast cancer may be amenable to cure after local treatment, whereas local tumor recurrence following complete surgical excision is almost inevitably followed by the appearance of distant metastases. Other cancers may occur secondary to implant placement, such as mesenchymal tumors and sarcomas [19] (Fig. 12).Fig. 12


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

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

A 46-year-old woman with implant reconstruction. Axial a unenhanced T2W fat-saturated, b enhanced T1W, and c sagittal T1 silicone suppressed images show a circumscribed mass adjacent to the silicone implant in the inferior breast. The mass is bright on bright on T2W images and shows postcontrast enhancement. Biopsy proved this to be a spindle cell tumor
© Copyright Policy
Related In: Results  -  Collection

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

Fig12: A 46-year-old woman with implant reconstruction. Axial a unenhanced T2W fat-saturated, b enhanced T1W, and c sagittal T1 silicone suppressed images show a circumscribed mass adjacent to the silicone implant in the inferior breast. The mass is bright on bright on T2W images and shows postcontrast enhancement. Biopsy proved this to be a spindle cell tumor
Mentions: Despite adequate surgical technique, residual glandular breast tissue can remain following mastectomy and breast reconstruction. An extremely extended time period between mastectomy and tumor appearance may indicate that a de novo cancer has formed. The distinction is important clinically, as a de novo ipsilateral breast cancer may be amenable to cure after local treatment, whereas local tumor recurrence following complete surgical excision is almost inevitably followed by the appearance of distant metastases. Other cancers may occur secondary to implant placement, such as mesenchymal tumors and sarcomas [19] (Fig. 12).Fig. 12

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