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KMID : 1114620110080020093
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Journal of the Korean Society for Breast Screening
2011 Volume.8 No. 2 p.93 ~ p.98
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Locoregional Recurence of Breast Cancer after Transverse Rectus Abdomins Myocutaneous Flap Reconstruction Following Modified Radical Mastectomy: Clinical and Radiologic Findings
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Yoo Hyun-kyung
Kim Bo-Hyun
Kim Hyun-Ji
Shin Hee-Jung
Cha Joo-Hee
Kim Hak-Hee
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Abstract
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Purpose: With wide implement of TRAM flap reconstruction after modified radical mastectomy for breast cancer, clinical and radiologic detection of cancer recurrence in reconstructed breast is becoming important. The purpose of our study is to identify radiologic findings of local or regional cancer recurrence the initial staging, and the role of radiologic findings in follow up studies.
Materials and Methods: From January 2000 to December 2009, patients who underwent TRAM flap reconstruction after modifed radical mastectomy of breast cancer was included in the study. This retrospective study was approved by IRB of our institution. The information regarding the population, past history, radiologic studies, clinical findings and prognosis was obtained through reviewing the EMR. Two breast radiologists retrospectively analyzed and compared imaging findings of follow up studies including ultrasonography, mammography and MRI stored in the PACS system.
Results: Of 29 patients, 13 (44.8%) patients had recurrence. The average age of 13 patients was 41.1 ± 9.0 years (ranges from 25-57 years), and the average period until the recurrence detection was 34.8 ± 27.0 months (ranges from 5-91 months). The most common sites of recurrence include remained skin or subcutaneous layer. In 9 (69.2%) patients, the recurrence was detected by additional studies performed after abnormal breast self-examination. In the other 4 (30.8%) patients, recurrence was found on routine follow-up examinations. In 8 (61.5%) recurred lesions, the radiologic manifestation was similar to that of benign mass, fat necrosis or postoperative parenchymal change, mimicking benign lesions. Only 5 (38.5%) lesions had suspicious malignant imaging findings.
Conclusion: The cancer recurrence after TRAM flap breast reconstruction following modified radiacal mastectomy is usually recognized by patients’ self-examinations, and in many times mimics imaging findings of benign lesions. Therefore, meticulous physical examination and history taking are important in detection of recurrence. Also, pathologic confirmation is worthwhile even in the benign looking lesion for the early detection of cancer recurrence.
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KEYWORD
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Breast cancer, Locoregional recurrence, TRAM flap reconstruction
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