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Breast Imaging

E3142. Partial Reconstruction

Patel M,  Santiago L,  Candelaria R,  Arribas E,  Adrada B. University of Texas MD Anderson Cancer Center , Houston, TX

Address correspondence to B. Adrada (beatrizad@yahoo.com)

Background Information: Breast conservation therapy (BCT) is an increasingly popular treatment option for patients with breast cancer, with survival rates equivalent to mastectomy. Improvements in breast imaging and neoadjuvant therapies have allowed downstaging of tumors, thus increasing the number of patients who are candidates for BCT. Therefore, different partial breast reconstruction techniques have been developed to improve aesthetic outcome and enable breast conservation in patients with larger tumors. However, interpretation of imaging findings in breasts with partial breast reconstruction can be challenging, and knowledge of the different types of breast reconstruction surgery is necessary for radiologists and clinicians to detect early recurrences and prevent unnecessary biopsies of typical benign findings. The purpose of this exhibit is to review the surgical techniques and expected imaging features in partial breast reconstruction, and to discuss the imaging appearances of benign and malignant findings in these types of breasts.

Educational Goals/Teaching Points: We will review the definition of partial breast reconstruction and types of breast reconstruction. We will describe techniques for volume displacement (i.e., local tissue rearrangement, mastopexy, or reduction) and replacement (i.e., local fasciocutaneous flaps and latissimus dorsi flaps). Finally, we will review multimodality imaging features of normal and abnormal findings in patients with partial breast reconstruction.

Key Anatomic/Physiologic Issues and Imaging Findings/Techniques: We will cover normal, benign, and malignant mammographic, ultrasound, and MRI findings in patients with partial breast reconstruction.

Conclusion: Imaging surveillance for patients who have undergone partial breast reconstruction can be challenging due to overlap in the appearance of benign findings and recurrent disease. Knowledge of common findings in the partially reconstructed breast can allow earlier diagnosis of recurrence and prevent unnecessary biopsies.