title: Breast reconstruction with a transverse rectus abdominis myocutaneous flap: spectrum of normal and abnormal MR imaging findings.
abstract: 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.
authors.affiliation: Department of Radiology, Hospital of the University of Pennsylvania, 3400 Spruce St, Philadelphia, PA 19104, USA.
authors.forename: Ronit Karpati
authors.initials: RK
authors.lastname: Devon
authors.forename: Mark A
authors.initials: MA
authors.lastname: Rosen
authors.forename: Carolyn
authors.initials: C
authors.lastname: Mies
authors.forename: Susan G
authors.initials: SG
authors.lastname: Orel
mesh_terms: 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