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Breast Imaging

E2515. Pitfalls and Pearls in Postoperative Breast Imaging

Gabe M,  Chang G,  Eghtedari M,  Ojeda-Fournier H. University of California San Diego, San Diego, CA

Address correspondence to M. Gabe (mjg989@gmail.com)

Background Information: Surgical findings are common in breast imaging and include breast conservation therapy, reduction mammoplasty, autologous reconstruction, and mastectomy. Familiarity with the changes seen in mammography, ultrasound (US), and MRI are important to decrease false-positives, call back rates, and unnecessary biopsies. Postoperative changes can also overlap with imaging features of malignancy, and missed cancer recurrence can also be decreased by familiarity with imaging features of the postoperative breast. This exhibit reviews the common postoperative changes in multimodality breast imaging, benign and malignant imaging findings associated with the postoperative breast, pearls from our institution, and an opportunity for self-assessment.

Educational Goals/Teaching Points: After reviewing this exhibit, the radiologist will be familiar with the expected imaging findings of common surgical procedures of the breast, be able to recognize suspicious imaging findings in postoperative patients concerning for breast cancer recurrence, and have an opportunity for self-assessment.

Key Anatomic/Physiologic Issues and Imaging Findings/Techniques: We will review descriptions of common procedures including breast conservation therapy, reduction mammoplasty, autologous reconstruction, and mastectomy. We will also review benign and malignant mammographic, US, and MRI features in the postoperative breast and discuss common patterns of disease recurrence according to surgery type. Finally, we will summarize the temporal changes seen in breast imaging.

Conclusion: Given the frequency of surgical breast intervention, an understanding of common imaging manifestations is an important responsibility of the radiologist. The ability to distinguish benign from suspicious imaging findings can assist in the early detection and management of breast cancer and avoid false-positives and prevent unnecessary call-backs and biopsies.