title: Impact of contra-lateral breast reshaping on mammographic surveillance in women undergoing breast reconstruction following mastectomy for breast cancer.
abstract: BACKGROUND
  The ultimate goal of breast reconstruction is to achieve symmetry with the contra-lateral breast. Contra-lateral procedures with wide parenchymal rearrangements are suspected to impair mammographic surveillance. This study aims to evaluate the impact on mammographic detection of mastopexies and breast reductions for contralateral adjustment in breast reconstruction.
  
  
  METHODS
  We retrospectively evaluated 105 women affected by uni-lateral breast cancer who underwent mastectomy and immediate two-stage reconstruction between 2002 and 2007. We considered three groups according to the contra-lateral reshaping technique: mastopexy or breast reduction with inferior dermoglandular flap (group 1); mastopexy or breast reduction without inferior dermoglandular flap (group 2); no contra-lateral reshaping (group 3). We assessed qualitative mammographic variations and breast density in the three groups.
  
  
  RESULTS
  Statistically significant differences have been found when comparing reshaped groups with non reshaped groups regarding parenchymal distortions, skin thickening and stromal edema, but these differences did not affect cancer surveillance. The surveillance mammography diagnostic accuracy in contra-lateral cancer detection was not significantly different between the three groups (p = 0.56), such as the need for MRI for equivocal findings at mammographic contra-lateral breast (p = 0.77) and the need for core-biopsies to confirm mammographic suspect of contra-lateral breast cancer (p = 0.90).
  
  
  CONCLUSIONS
  This study confirms previous reports regarding the safety of mastopexies and breast reductions when performed in the setting of contra-lateral breast reshaping after breast reconstruction. Mammographic accuracy, sensitivity and specificity are not affected by the glandular re-arrangement. These results provide a further validation of the safety of current reconstructive paradigms.
authors: Department of Surgery, Plastic and Reconstructive Surgery Unit, Fondazione IRCCS Istituto Nazionale Tumori Milano, Via Venezian 1, 20133 Milano, Italy.
authors: Maurizio B
authors: MB
authors: Nava
authors: Department of Clinical Medicine and Surgery, University of Naples "Federico II", Via S. Pansini 5, 80131 Naples, Italy. Electronic address: nicolarocco2003@gmail.com.
authors: Nicola
authors: N
authors: Rocco
authors: Multidisciplinary Breast Unit, Azienda Ospedaliera Cannizzaro, Via Messina 829, 95126 Catania, Italy.
authors: Giuseppe
authors: G
authors: Catanuto
authors: Breast Unit, IRCCS Arcispedale S.M.N, Via Risorgimento 80, 42120 Reggio Emilia, Italy.
authors: Giuseppe
authors: G
authors: Falco
authors: Department of Diagnostic Radiology, University of Milan, Italy.
authors: Emanuela
authors: E
authors: Capalbo
authors: 8th General and Gastrointestinal Surgery, Second University of Naples, Italy.
authors: Luigi
authors: L
authors: Marano
authors: Department of Senology Asur Marche Area Vasta 1, Santa Maria della Misericordia, Via Comandino, 70 Urbino, Italy.
authors: Daniele
authors: D
authors: Bordoni
authors: Department of Surgery, Plastic and Reconstructive Surgery Unit, Fondazione IRCCS Istituto Nazionale Tumori Milano, Via Venezian 1, 20133 Milano, Italy.
authors: Andrea
authors: A
authors: Spano
authors: Department of Diagnostic Radiology 1, Breast Imaging, Fondazione IRCCS Istituto Nazionale dei Tumori, Via G. Venezian 1, Milan, Italy.
authors: Gianfranco
authors: G
authors: Scaperrotta
mesh_terms: D000368:Aged; D001940:Breast / Q000473:pathology* / Q000601:surgery; D001943:Breast Neoplasms / Q000000981:diagnostic imaging* / Q000601:surgery*; D005260:Female; D006801:Humans; D016462:Mammaplasty / Q000009:adverse effects* / Q000379:methods; D008327:Mammography; D008408:Mastectomy; D008875:Middle Aged; D012189:Retrospective Studies; D013524:Surgical Flaps / Q000473:pathology
keywords: Breast cancer; Breast reconstruction; Breast symmetrization; Mammography