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.
Access this chapter
Tax calculation will be finalised at checkout
Purchases are for personal use only
Similar content being viewed by others
References
Brenner RJ, Pfaff JM. Mammographic changes after excisional breast biopsy for benign disease. AJR Am J Roentgenol. 1996;167(4):1047–52.
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.
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.
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.
Orel SG, et al. Breast carcinoma: MR imaging before re-excisional biopsy. Radiology. 1997;205(2):429–36.
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.
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.
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.
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.
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.
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.
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.
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.
Krishnamurthy R, et al. Mammographic findings after breast conservation therapy. Radiographics. 1999;19:S53–62; quiz S262–3.
Buckley JH, Roebuck EJ. Mammographic changes following radiotherapy. Br J Radiol. 1986;59(700):337–44.
Mitnick J, Roses DF, Harris MN. Differentiation of postsurgical changes from carcinoma of the breast. Surg Gynecol Obstet. 1988;166(6):549–50.
Mendelson EB. Imaging the post-surgical breast. Semin Ultrasound CT MR. 1989;10(2):154–70.
Mendelson EB. Evaluation of the postoperative breast. Radiol Clin North Am. 1992;30(1):107–38.
Chansakul T, Lai KC, Slanetz J. The postconservation breast: part 1, Expected imaging findings. AJR Am J Roentgenol. 2012;198(2):321–30.
Libshitz HI, Montague ED, Paulus Jr DD. Skin thickness in the therapeutically irradiated breast. AJR Am J Roentgenol. 1978;130(2):345–7.
Paulus DD. Conservative treatment of breast cancer: mammography in patient selection and follow-up. AJR Am J Roentgenol. 1984;143(3):483–7.
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.
Morris EA, et al. MRI of occult breast carcinoma in a high-risk population. AJR Am J Roentgenol. 2003;181(3):619–26.
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.
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.
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.
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.
Horst KC, et al. Predictors of local recurrence after breast-conservation therapy. Clin Breast Cancer. 2005;5(6):425–38.
Samant RS, et al. Diagnosis of metachronous contralateral breast cancer. Breast J. 2001;7(6):405–10.
Broet P, et al. Contralateral breast cancer: annual incidence and risk parameters. J Clin Oncol. 1995;13(7):1578–83.
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.
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.
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.
Stomper PC, et al. Mammographic detection of recurrent cancer in the irradiated breast. AJR Am J Roentgenol. 1987;148(1):39–43.
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.
Belli P, et al. Magnetic resonance imaging in breast cancer recurrence. Breast Cancer Res Treat. 2002;73(3):223–35.
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.
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.
Glaus SW, Carlson GW. Long-term role of external breast prostheses after total mastectomy. Breast J. 2009;15(4):385–93.
Helvie MA, et al. Mammographic screening of TRAM flap breast reconstructions for detection of nonpalpable recurrent cancer. Radiology. 2002;224(1):211–6.
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.
Hartrampf CR, Scheflan M, Black PW. Breast reconstruction with a transverse abdominal island flap. Plast Reconstr Surg. 1982;69(2):216–25.
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.
Antoniuk PM. Breast reconstruction. Obstet Gynecol Clin North Am. 2002;29(1):209–23, ix.
Grotting JC, Beckenstein MS, Arkoulakis NS. The art and science of autologous breast reconstruction. Breast J. 2003;9(5):350–60.
Berg WA. Diagnostic imaging. Breast. 1st ed. Salt Lake City: Amirsys; 2006.
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.
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.
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.
Ho CM, et al. Skin involvement in invasive breast carcinoma: safety of skin-sparing mastectomy. Ann Surg Oncol. 2003;10(2):102–7.
Carlson GW, et al. Local recurrence after skin-sparing mastectomy: tumor biology or surgical conservatism? Ann Surg Oncol. 2003;10(2):108–12.
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.
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.
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.
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.
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.
Hogge JP, Zuurbier RA, de Paredes ES. Mammography of autologous myocutaneous flaps. Radiographics. 1999;19:S63–72.
Peng C, et al. MRI appearance of tumor recurrence in myocutaneous flap reconstruction after mastectomy. AJR Am J Roentgenol. 2011;196(4):W471–5.
Langstein HN, et al. Breast cancer recurrence after immediate reconstruction: patterns and significance. Plast Reconstr Surg. 2003;111(2):712–20; discussion 721–2.
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.
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.
Antoniuk PM. Breast augmentation and breast reduction. Obstet Gynecol Clin North Am. 2002;29(1):103–15.
Hammond DC, Loffredo M. Breast reduction. Plast Reconstr Surg. 2012;129(5):829e–39.
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.
Keleher AJ, et al. Breast cancer in reduction mammaplasty specimens: case reports and guidelines. Breast J. 2003;9(2):120–5.
Miller CL, Feig SA, Fox JW. Mammographic changes after reduction mammoplasty. AJR Am J Roentgenol. 1987;149(1):35–8.
Andrades P, Prado A. Understanding modern breast reduction techniques with a simplified approach. J Plast Reconstr Aesthet Surg. 2008;61(11):1284–93.
Spear SL, Howard MA. Evolution of the vertical reduction mammaplasty. Plast Reconstr Surg. 2003;112(3):855–68; quiz 869.
Danikas D, et al. Mammographic findings following reduction mammoplasty. Aesthetic Plast Surg. 2001;25(4):283–5.
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.
Hogge JP, et al. The mammographic spectrum of fat necrosis of the breast. Radiographics. 1995;15(6):1347–56.
Author information
Authors and Affiliations
Corresponding author
Editor information
Editors and Affiliations
Rights and permissions
Copyright information
© 2015 Springer Science+Business Media New York
About this chapter
Cite this chapter
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
Download citation
DOI: https://doi.org/10.1007/978-1-4939-1267-4_16
Published:
Publisher Name: Springer, New York, NY
Print ISBN: 978-1-4939-1266-7
Online ISBN: 978-1-4939-1267-4
eBook Packages: MedicineMedicine (R0)