Breast MRI findings after modified radical mastectomy and transverse rectus abdominis myocutaneous flap in patients with breast cancer.
OBJECTIVE
To evaluate the MRI findings in breast cancer patients who had undergone a modified radical mastectomy (MRM) and a transverse rectus abdominis myocutaneous (TRAM) flap.


METHODS
MRI was performed on 20 patients who had been diagnosed with breast cancer and had undergone an MRM and TRAM flap. The results were examined in terms of MRI's ability to detect the flap and assess possible postoperative changes and recurrence. In addition, MRI images of the opposite breast were analyzed. Follow-up examinations were carried out on 11 patients, and all changes were assessed.


RESULTS
The flap was clearly visualized by MRI in all of the patients. The signal intensity of the flap was equivalent to that of fat. The contact zone between the TRAM flap and the mastectomy site was enhanced after contrast infusion. Postoperative changes, such as skin thickening (n=20), edema (n=2), fluid collection (n=3), hematoma (n=1), and fat necrosis (n=3), were detected. In two patients, artificially inserted fat tissue was identified. On the MRI of the opposite breast, enhancing lesions were detected in seven patients. In one patient with this finding, ductal carcinoma in situ was diagnosed. On the follow-up MRI, a decrease in skin thickening, fat necrosis, and hematoma was detected.


CONCLUSIONS
MRI is an effective method for lesion detection and evaluation of postoperative changes after MRM and TRAM flap, as well as for evaluation of the opposite breast.
Kang
Bong Joo
BJ
Department of Radiology, St. Mary's Hospital, Catholic University of Korea, Seoul, Korea.
Jung
Jung Im
JI
Park
Changsook
C
Park
Woo Chan
WC
Jeon
Hae Myung
HM
Hahn
Seong Tai
ST
Lee
Jae Mun
JM
D000328:Adult; D001943:Breast Neoplasms / Q000473:pathology / Q000601:surgery*; D003287:Contrast Media; D005260:Female; D019786:Gadolinium DTPA; D006801:Humans; D008279:Magnetic Resonance Imaging / Q000379:methods*; D016462:Mammaplasty / Q000379:methods*; D015411:Mastectomy, Modified Radical; D008875:Middle Aged; D009367:Neoplasm Staging; D011183:Postoperative Complications / Q000175:diagnosis; D017568:Rectus Abdominis / Q000637:transplantation; D013524:Surgical Flaps; D016896:Treatment Outcome
D003287:Contrast Media; D019786:Gadolinium DTPA