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The Postoperative Breast

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Breast Cancer Screening and Diagnosis

Abstract

Surgical interventions in the breast include excisional biopsy, lumpectomy, mastectomy, reduction, and augmentation. There are expected benign postsurgical changes following these interventions. These benign imaging findings may overlap with radiographic features of malignancy or obscure tumor recurrence. Awareness of normal postoperative imaging changes correlated with prior procedural history and time that has elapsed since those procedures is important for increasing accurate early detection of breast cancer or tumor recurrence in patients with history of breast cancer.

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References

  1. Brenner RJ, Pfaff JM. Mammographic changes after excisional breast biopsy for benign disease. AJR Am J Roentgenol. 1996;167(4):1047–52.

    Article  PubMed  CAS  Google Scholar 

  2. Slanetz PJ, et al. Previous breast biopsy for benign disease rarely complicates or alters interpretation on screening mammography. AJR Am J Roentgenol. 1998;170(6):1539–41.

    Article  PubMed  CAS  Google Scholar 

  3. Frei KA, et al. MR imaging of the breast in patients with positive margins after lumpectomy: influence of the time interval between lumpectomy and MR imaging. AJR Am J Roentgenol. 2000;175(6):1577–84.

    Article  PubMed  CAS  Google Scholar 

  4. Lee CH, et al. Breast cancer screening with imaging: recommendations from the Society of Breast Imaging and the ACR on the use of mammography, breast MRI, breast ultrasound, and other technologies for the detection of clinically occult breast cancer. J Am Coll Radiol. 2010;7(1):18–27.

    Article  PubMed  Google Scholar 

  5. Orel SG, et al. Breast carcinoma: MR imaging before re-excisional biopsy. Radiology. 1997;205(2):429–36.

    Article  PubMed  CAS  Google Scholar 

  6. Fisher B, et al. Reanalysis and results after 12 years of follow-up in a randomized clinical trial comparing total mastectomy with lumpectomy with or without irradiation in the treatment of breast cancer. N Engl J Med. 1995;333(22):1456–61.

    Article  PubMed  CAS  Google Scholar 

  7. Veronesi U, et al. Breast conservation is a safe method in patients with small cancer of the breast. Long-term results of three randomised trials on 1,973 patients. Eur J Cancer. 1995;31A(10):1574–9.

    Article  PubMed  CAS  Google Scholar 

  8. Kriege M, et al. Efficacy of MRI and mammography for breast-cancer screening in women with a familial or genetic predisposition. N Engl J Med. 2004;351(5):427–37.

    Article  PubMed  CAS  Google Scholar 

  9. Lee SG, et al. MR imaging screening of the contralateral breast in patients with newly diagnosed breast cancer: preliminary results. Radiology. 2003;226(3):773–8.

    Article  PubMed  Google Scholar 

  10. Liberman L, et al. MR imaging of the ipsilateral breast in women with percutaneously proven breast cancer. AJR Am J Roentgenol. 2003;180(4):901–10.

    Article  PubMed  Google Scholar 

  11. Liberman L, et al. MR imaging findings in the contralateral breast of women with recently diagnosed breast cancer. AJR Am J Roentgenol. 2003;180(2):333–41.

    Article  PubMed  Google Scholar 

  12. Lehman CD, et al. MRI evaluation of the contralateral breast in women with recently diagnosed breast cancer. N Engl J Med. 2007;356(13):1295–303.

    Article  PubMed  CAS  Google Scholar 

  13. Fowble B, et al. Breast recurrence following conservative surgery and radiation: patterns of failure, prognosis, and pathologic findings from mastectomy specimens with implications for treatment. Int J Radiat Oncol Biol Phys. 1990;19(4):833–42.

    Article  PubMed  CAS  Google Scholar 

  14. Krishnamurthy R, et al. Mammographic findings after breast conservation therapy. Radiographics. 1999;19:S53–62; quiz S262–3.

    Article  PubMed  Google Scholar 

  15. Buckley JH, Roebuck EJ. Mammographic changes following radiotherapy. Br J Radiol. 1986;59(700):337–44.

    Article  PubMed  CAS  Google Scholar 

  16. Mitnick J, Roses DF, Harris MN. Differentiation of postsurgical changes from carcinoma of the breast. Surg Gynecol Obstet. 1988;166(6):549–50.

    PubMed  CAS  Google Scholar 

  17. Mendelson EB. Imaging the post-surgical breast. Semin Ultrasound CT MR. 1989;10(2):154–70.

    PubMed  CAS  Google Scholar 

  18. Mendelson EB. Evaluation of the postoperative breast. Radiol Clin North Am. 1992;30(1):107–38.

    PubMed  CAS  Google Scholar 

  19. Chansakul T, Lai KC, Slanetz J. The postconservation breast: part 1, Expected imaging findings. AJR Am J Roentgenol. 2012;198(2):321–30.

    Article  PubMed  Google Scholar 

  20. Libshitz HI, Montague ED, Paulus Jr DD. Skin thickness in the therapeutically irradiated breast. AJR Am J Roentgenol. 1978;130(2):345–7.

    Article  PubMed  CAS  Google Scholar 

  21. Paulus DD. Conservative treatment of breast cancer: mammography in patient selection and follow-up. AJR Am J Roentgenol. 1984;143(3):483–7.

    Article  PubMed  CAS  Google Scholar 

  22. Saslow D, et al. American Cancer Society guidelines for breast screening with MRI as an adjunct to mammography. CA Cancer J Clin. 2007;57(2):75–89.

    Article  PubMed  Google Scholar 

  23. Morris EA, et al. MRI of occult breast carcinoma in a high-risk population. AJR Am J Roentgenol. 2003;181(3):619–26.

    Article  PubMed  Google Scholar 

  24. Dershaw DD. Mammography in patients with breast cancer treated by breast conservation (lumpectomy with or without radiation). AJR Am J Roentgenol. 1995;164(2):309–16.

    Article  PubMed  CAS  Google Scholar 

  25. Early Breast Cancer Trialists’ Collaborative, Group. Effects of chemotherapy and hormonal therapy for early breast cancer on recurrence and 15-year survival: an overview of the randomised trials. Lancet. 2005;365(9472):1687–717.

    Article  Google Scholar 

  26. Wapnir IL, et al. Prognosis after ipsilateral breast tumor recurrence and locoregional recurrences in five National Surgical Adjuvant Breast and Bowel Project node-positive adjuvant breast cancer trials. J Clin Oncol. 2006;24(13):2028–37.

    Article  PubMed  Google Scholar 

  27. Komoike Y, et al. Ipsilateral breast tumor recurrence (IBTR) after breast-conserving treatment for early breast cancer: risk factors and impact on distant metastases. Cancer. 2006;106(1):35–41.

    Article  PubMed  Google Scholar 

  28. Horst KC, et al. Predictors of local recurrence after breast-conservation therapy. Clin Breast Cancer. 2005;5(6):425–38.

    Article  PubMed  Google Scholar 

  29. Samant RS, et al. Diagnosis of metachronous contralateral breast cancer. Breast J. 2001;7(6):405–10.

    Article  PubMed  CAS  Google Scholar 

  30. Broet P, et al. Contralateral breast cancer: annual incidence and risk parameters. J Clin Oncol. 1995;13(7):1578–83.

    PubMed  CAS  Google Scholar 

  31. Bernstein JL, et al. Risk factors predicting the incidence of second primary breast cancer among women diagnosed with a first primary breast cancer. Am J Epidemiol. 1992;136(8):925–36.

    PubMed  CAS  Google Scholar 

  32. Horn PL, Thompson WD. Risk of contralateral breast cancer: associations with factors related to initial breast cancer. Am J Epidemiol. 1988;128(2):309–23.

    PubMed  CAS  Google Scholar 

  33. Howell A, et al. Results of the ATAC (Arimidex, Tamoxifen, Alone or in Combination) trial after completion of 5 years’ adjuvant treatment for breast cancer. Lancet. 2005;365(9453):60–2.

    Article  PubMed  CAS  Google Scholar 

  34. Stomper PC, et al. Mammographic detection of recurrent cancer in the irradiated breast. AJR Am J Roentgenol. 1987;148(1):39–43.

    Article  PubMed  CAS  Google Scholar 

  35. Berg WA, et al. Combined screening with ultrasound and mammography vs mammography alone in women at elevated risk of breast cancer. JAMA. 2008;299(18):2151–63.

    Article  PubMed  CAS  PubMed Central  Google Scholar 

  36. Belli P, et al. Magnetic resonance imaging in breast cancer recurrence. Breast Cancer Res Treat. 2002;73(3):223–35.

    Article  PubMed  CAS  Google Scholar 

  37. Hartmann LC, et al. Efficacy of bilateral prophylactic mastectomy in women with a family history of breast cancer. N Engl J Med. 1999;340(2):77–84.

    Article  PubMed  CAS  Google Scholar 

  38. Taghian AG, Smith BL, Erban JK. Breast cancer: a multidisciplinary approach to diagnosis and management. Current multidisciplinary oncology. New York: Demos Medical Pub; 2010, xviii, 335 p.

    Google Scholar 

  39. Glaus SW, Carlson GW. Long-term role of external breast prostheses after total mastectomy. Breast J. 2009;15(4):385–93.

    Article  PubMed  Google Scholar 

  40. Helvie MA, et al. Mammographic screening of TRAM flap breast reconstructions for detection of nonpalpable recurrent cancer. Radiology. 2002;224(1):211–6.

    Article  PubMed  Google Scholar 

  41. Noone RB, et al. Recurrence of breast carcinoma following immediate reconstruction: a 13-year review. Plast Reconstr Surg. 1994;93(1):96–106; discussion 107–8.

    Article  PubMed  CAS  Google Scholar 

  42. Hartrampf CR, Scheflan M, Black PW. Breast reconstruction with a transverse abdominal island flap. Plast Reconstr Surg. 1982;69(2):216–25.

    Article  PubMed  CAS  Google Scholar 

  43. Devon RK, et al. Breast reconstruction with a transverse rectus abdominis myocutaneous flap: spectrum of normal and abnormal MR imaging findings. Radiographics. 2004;24(5):1287–99.

    Article  PubMed  Google Scholar 

  44. Antoniuk PM. Breast reconstruction. Obstet Gynecol Clin North Am. 2002;29(1):209–23, ix.

    Article  PubMed  Google Scholar 

  45. Grotting JC, Beckenstein MS, Arkoulakis NS. The art and science of autologous breast reconstruction. Breast J. 2003;9(5):350–60.

    Article  PubMed  Google Scholar 

  46. Berg WA. Diagnostic imaging. Breast. 1st ed. Salt Lake City: Amirsys; 2006.

    Google Scholar 

  47. Blondeel N, et al. The donor site morbidity of free DIEP flaps and free TRAM flaps for breast reconstruction. Br J Plast Surg. 1997;50(5):322–30.

    Article  PubMed  CAS  Google Scholar 

  48. Kroll SS, et al. Local recurrence risk after skin-sparing and conventional mastectomy: a 6-year follow-up. Plast Reconstr Surg. 1999;104(2):421–5.

    Article  PubMed  CAS  Google Scholar 

  49. Simmons RM, et al. Local and distant recurrence rates in skin-sparing mastectomies compared with non-skin-sparing mastectomies. Ann Surg Oncol. 1999;6(7):676–81.

    Article  PubMed  CAS  Google Scholar 

  50. Ho CM, et al. Skin involvement in invasive breast carcinoma: safety of skin-sparing mastectomy. Ann Surg Oncol. 2003;10(2):102–7.

    Article  PubMed  Google Scholar 

  51. Carlson GW, et al. Local recurrence after skin-sparing mastectomy: tumor biology or surgical conservatism? Ann Surg Oncol. 2003;10(2):108–12.

    Article  PubMed  Google Scholar 

  52. Gerber B, et al. Skin-sparing mastectomy with conservation of the nipple-areola complex and autologous reconstruction is an oncologically safe procedure. Ann Surg. 2003;238(1):120–7.

    PubMed  PubMed Central  Google Scholar 

  53. Greenway RM, Schlossberg L, Dooley WC. Fifteen-year series of skin-sparing mastectomy for stage 0 to 2 breast cancer. Am J Surg. 2005;190(6):918–22.

    Article  PubMed  Google Scholar 

  54. Kroll SS, et al. Risk of recurrence after treatment of early breast cancer with skin-sparing mastectomy. Ann Surg Oncol. 1997;4(3):193–7.

    Article  PubMed  CAS  Google Scholar 

  55. Lee JM, et al. Detecting nonpalpable recurrent breast cancer: the role of routine mammographic screening of transverse rectus abdominis myocutaneous flap reconstructions. Radiology. 2008;248(2):398–405.

    Article  PubMed  Google Scholar 

  56. Rieber A, et al. Breast-conserving surgery and autogenous tissue reconstruction in patients with breast cancer: efficacy of MRI of the breast in the detection of recurrent disease. Eur Radiol. 2003;13(4):780–7.

    PubMed  Google Scholar 

  57. Hogge JP, Zuurbier RA, de Paredes ES. Mammography of autologous myocutaneous flaps. Radiographics. 1999;19:S63–72.

    Article  PubMed  Google Scholar 

  58. Peng C, et al. MRI appearance of tumor recurrence in myocutaneous flap reconstruction after mastectomy. AJR Am J Roentgenol. 2011;196(4):W471–5.

    Article  PubMed  Google Scholar 

  59. Langstein HN, et al. Breast cancer recurrence after immediate reconstruction: patterns and significance. Plast Reconstr Surg. 2003;111(2):712–20; discussion 721–2.

    Article  PubMed  Google Scholar 

  60. Howard MA, et al. Breast cancer local recurrence after mastectomy and TRAM flap reconstruction: incidence and treatment options. Plast Reconstr Surg. 2006;117(5):1381–6.

    Article  PubMed  CAS  Google Scholar 

  61. Slavin SA, Love SM, Goldwyn RM. Recurrent breast cancer following immediate reconstruction with myocutaneous flaps. Plast Reconstr Surg. 1994;93(6):1191–204; discussion 1205–7.

    Article  PubMed  CAS  Google Scholar 

  62. Antoniuk PM. Breast augmentation and breast reduction. Obstet Gynecol Clin North Am. 2002;29(1):103–15.

    Article  PubMed  Google Scholar 

  63. Hammond DC, Loffredo M. Breast reduction. Plast Reconstr Surg. 2012;129(5):829e–39.

    Article  PubMed  Google Scholar 

  64. The American Society for Aesthetic Plastic Surgery. 15th Annual Cosmetic Surgery National Data Bank Statistics. 2011 [cited 2013 June 1]; Available from: http://www.surgery.org/sites/default/files/ASAPS-2011-Stats.pdf.

  65. Keleher AJ, et al. Breast cancer in reduction mammaplasty specimens: case reports and guidelines. Breast J. 2003;9(2):120–5.

    Article  PubMed  Google Scholar 

  66. Miller CL, Feig SA, Fox JW. Mammographic changes after reduction mammoplasty. AJR Am J Roentgenol. 1987;149(1):35–8.

    Article  PubMed  CAS  Google Scholar 

  67. Andrades P, Prado A. Understanding modern breast reduction techniques with a simplified approach. J Plast Reconstr Aesthet Surg. 2008;61(11):1284–93.

    Article  PubMed  Google Scholar 

  68. Spear SL, Howard MA. Evolution of the vertical reduction mammaplasty. Plast Reconstr Surg. 2003;112(3):855–68; quiz 869.

    Article  PubMed  Google Scholar 

  69. Danikas D, et al. Mammographic findings following reduction mammoplasty. Aesthetic Plast Surg. 2001;25(4):283–5.

    Article  PubMed  CAS  Google Scholar 

  70. Yalin CT, et al. Breast changes after reduction mammaplasty: a case report with mammographic and ultrasonographic findings and a literature review. Breast J. 2003;9(2):133–7.

    Article  PubMed  Google Scholar 

  71. Hogge JP, et al. The mammographic spectrum of fat necrosis of the breast. Radiographics. 1995;15(6):1347–56.

    Article  PubMed  CAS  Google Scholar 

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Correspondence to Karla Arabela Sepulveda MD .

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Sepulveda, K.A., Ebuoma, L.O. (2015). The Postoperative Breast. In: Shetty, M. (eds) Breast Cancer Screening and Diagnosis. Springer, New York, NY. https://doi.org/10.1007/978-1-4939-1267-4_16

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  • DOI: https://doi.org/10.1007/978-1-4939-1267-4_16

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