Breast reconstruction with a transverse rectus abdominis myocutaneous flap: spectrum of normal and abnormal MR imaging findings.
The authors retrospectively reviewed their clinical database for cases of breast magnetic resonance (MR) imaging performed in women who had undergone breast reconstruction with a transverse rectus abdominis myocutaneous (TRAM) flap. Patient histories, MR imaging results, and, when available, biopsy results were reviewed. During a 4-year period, 24 neobreasts were imaged in 22 women who had undergone TRAM flap reconstruction after mastectomy. In most of the cases (64%), the indication for MR imaging was a palpable abnormality or pain. In four of 24 cases (17%), recurrent breast cancer was detected. These cases consisted of a local chest wall tumor (n = 2), an infiltrating chest wall tumor (n = 1), and axillary nodal recurrence (n = 1). In all four cases, MR imaging demonstrated a suspicious lesion or abnormality. In 11 of 24 cases (46%), benign findings only were demonstrated. These consisted of localized or diffuse skin thickening, fibrosis, fat necrosis, and seroma. In nine of 24 cases (38%), no pathologic abnormality was identified. MR imaging is useful in detection of locally recurrent tumor in patients who have undergone breast reconstruction with a TRAM flap. MR imaging allows differentiation between benign and malignant findings in patients with palpable abnormalities or pain after TRAM flap reconstruction.
Devon
Ronit Karpati
RK
Department of Radiology, Hospital of the University of Pennsylvania, 3400 Spruce St, Philadelphia, PA 19104, USA.
Rosen
Mark A
MA
Mies
Carolyn
C
Orel
Susan G
SG
D000328:Adult; D016477:Artifacts; D001943:Breast Neoplasms / Q000532:radiotherapy / Q000601:surgery; D018270:Carcinoma, Ductal, Breast / Q000000981:diagnostic imaging / Q000532:radiotherapy / Q000556:secondary / Q000601:surgery; D002921:Cicatrix / Q000000981:diagnostic imaging; D003131:Combined Modality Therapy; D005218:Fat Necrosis / Q000000981:diagnostic imaging; D005260:Female; D005355:Fibrosis; D006801:Humans; D008207:Lymphatic Metastasis / Q000000981:diagnostic imaging; D008279:Magnetic Resonance Imaging / Q000379:methods; D016462:Mammaplasty / Q000379:methods*; D008327:Mammography; D008875:Middle Aged; D009364:Neoplasm Recurrence, Local / Q000000981:diagnostic imaging; D016609:Neoplasms, Second Primary / Q000000981:diagnostic imaging; D011832:Radiation Injuries / Q000000981:diagnostic imaging; D011878:Radiotherapy / Q000009:adverse effects; D017568:Rectus Abdominis / Q000637:transplantation*; D012189:Retrospective Studies; D049291:Seroma / Q000000981:diagnostic imaging; D013524:Surgical Flaps; D013899:Thoracic Neoplasms / Q000000981:diagnostic imaging / Q000556:secondary; D035441:Thoracic Wall / Q000000981:diagnostic imaging