Ipsilateral breast cancer recurrence after Deep Inferior Epigastric Perforator (DIEP) flap reconstruction: Incidence and radiological presentation.
OBJECTIVE
To assess the incidence and presentation of ipsilateral cancer recurrences (ICR) after deep inferior epigastric perforator (DIEP) flap reconstruction for breast cancer.


METHODS
Data of 247 consecutive women with DIEP flap reconstruction after breast cancer in our institution between 1997 and 2009 were retrospectively reviewed.


RESULTS
Mean follow-up time was 4.1years±3.2 (SD) (median: 3years; range: 1month - 14years). Thirty-one patients (12.5%, 95%CI: =8.7-17.3) presented 34 relapses, in average 4.1years±2.6 after mastectomy: 14 (41%) were ipsilateral, 6 (18%) contralateral and 14 (41%) metastatic. ICRs occurred earlier (3.9 vs. 5.8years; P<0.05) than non-ICRs. Most ICRs (10/14, 71%) involved the periphery of the flap and presented as palpable nodules. The remaining (4/14, 29%) involved the axilla and 3/4 (75%) were palpable. Imaging procedures detected infra-clinical ICRs in 3 of 10 imaged patients (30%).


CONCLUSIONS
ICRs after DIEP flap reconstruction are more frequent than contralateral recurrences suggesting the need for imaging follow-up of the reconstructed breast.
Service d'imagerie médicale, groupe Henri-Mondor-Albert-Chenevier, centre sein Henri-Mondor, AP-HP, 51, avenue du Maréchal-de-Lattre-de-Tassigny, 94010 Créteil cedex, France.
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Farras Roca
Service d'imagerie médicale, groupe Henri-Mondor-Albert-Chenevier, centre sein Henri-Mondor, AP-HP, 51, avenue du Maréchal-de-Lattre-de-Tassigny, 94010 Créteil cedex, France.
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Dao
Service de chirurgie plastique et reconstructrice, hôpital européen Georges-Pompidou, AP-HP, 20, rue Leblanc, 75015 Paris, France.
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Lantieri
Service de chirurgie plastique et reconstructrice, hôpital européen Georges-Pompidou, AP-HP, 20, rue Leblanc, 75015 Paris, France.
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Lepage
Service de chirurgie plastique et reconstructrice, groupe Henri-Mondor-Albert-Chenevier, centre sein Henri-Mondor, AP-HP, 51, avenue du Maréchal-de-Lattre-de-Tassigny, 94010 Créteil cedex, France.
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Bosc
Service d'imagerie médicale, groupe Henri-Mondor-Albert-Chenevier, centre sein Henri-Mondor, AP-HP, 51, avenue du Maréchal-de-Lattre-de-Tassigny, 94010 Créteil cedex, France.
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Meyblum
Service d'imagerie médicale, groupe Henri-Mondor-Albert-Chenevier, centre sein Henri-Mondor, AP-HP, 51, avenue du Maréchal-de-Lattre-de-Tassigny, 94010 Créteil cedex, France.
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Pigneur
Service d'imagerie médicale, groupe Henri-Mondor-Albert-Chenevier, centre sein Henri-Mondor, AP-HP, 51, avenue du Maréchal-de-Lattre-de-Tassigny, 94010 Créteil cedex, France.
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Beaussart
Service d'oncologie médicale, groupe Henri-Mondor-Albert-Chenevier, centre sein Henri-Mondor, AP-HP, 51, avenue du Maréchal-de-Lattre-de-Tassigny, 94010 Créteil cedex, France.
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Assaf
Service d'anatomo-pathologie, groupe Henri-Mondor-Albert-Chenevier, centre sein Henri-Mondor, AP-HP, 51, avenue du Maréchal-de-Lattre-de-Tassigny, 94010 Créteil cedex, France.
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Totobenazara
Service de radiothérapie, groupe Henri-Mondor-Albert-Chenevier, centre sein Henri-Mondor, AP-HP, 51, avenue du Maréchal-de-Lattre-de-Tassigny, 94010 Créteil cedex, France.
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Calitchi
Service de radiothérapie, groupe Henri-Mondor-Albert-Chenevier, centre sein Henri-Mondor, AP-HP, 51, avenue du Maréchal-de-Lattre-de-Tassigny, 94010 Créteil cedex, France; Faculté de médecine, université Paris Est, Créteil, France.
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Belkacemi
Service d'imagerie médicale, groupe Henri-Mondor-Albert-Chenevier, centre sein Henri-Mondor, AP-HP, 51, avenue du Maréchal-de-Lattre-de-Tassigny, 94010 Créteil cedex, France; Faculté de médecine, université Paris Est, Créteil, France.
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Rahmouni
Service d'imagerie médicale, groupe Henri-Mondor-Albert-Chenevier, centre sein Henri-Mondor, AP-HP, 51, avenue du Maréchal-de-Lattre-de-Tassigny, 94010 Créteil cedex, France; Faculté de médecine, université Paris Est, Créteil, France. Electronic address: alain.luciani@hmn.aphp.fr.
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Luciani
D000328:Adult; D000368:Aged; D001943:Breast Neoplasms / Q000000981:diagnostic imaging* / Q000453:epidemiology* / Q000601:surgery; D005260:Female; D006801:Humans; D015994:Incidence; D016462:Mammaplasty / Q000379:methods*; D008327:Mammography; D008875:Middle Aged; D016609:Neoplasms, Second Primary / Q000000981:diagnostic imaging* / Q000453:epidemiology*; D061525:Perforator Flap; D012189:Retrospective Studies
Breast cancer recurrence; Breast imaging; Breast reconstruction; Deep inferior epigastric perforator (DIEP) flap; Follow-up