DOI: 10.1148/radiol.2272011175
Recurrence in Autogenous Myocutaneous Flap Reconstruction after Mastectomy for Primary Breast Cancer: US Diagnosis1
Beth S. Edeiken, MD,
Bruno D. Fornage, MD,
Deepak G. Bedi, MD,
Nour Sneige, MD,
Suhas G. Parulekar, MD and
Joshua Pleasure, MD
1 From the Departments of Diagnostic Radiology (B.S.E., B.D.F., D.G.B., S.G.P., J.P.) and Pathology (N.S.), University of Texas M.D. Anderson Cancer Center, 1515 Holcombe Blvd, Box 57, Houston, TX 77030. Received July 10, 2001; revision requested August 20; revision received August 22, 2002; accepted September 26. Address correspondence to B.S.E. (e-mail: bedeiken@di.mdacc.tmc.edu).
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Figure 1. Recurrence (invasive ductal carcinoma) in the TRAM-reconstructed right (RT) breast of a 54-year-old woman. Extended field-of-view sonogram facilitates measurement of the distance (8.4 cm) between the recurrent tumor (caliper at top right) at the 2-o’clock position and the reconstructed nipple (RECON NIP, caliper at left).
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Figure 2. Multiple recurrences (invasive ductal carcinoma) in the TRAM-reconstructed breast of a 59-year-old woman. Sonogram shows two nonpalpable lesions (arrows and calipers) smaller than 0.5 cm in diameter separated by a distance of 1.2 cm. The 1 marks the satellite (ie, nondominant) recurrence (black arrow), which is in proximity to the dominant recurrence (white arrow).
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Figure 3. Small calcified recurrence (invasive ductal carcinoma) in the TRAM-reconstructed breast of a 59-year-old woman. Sonogram shows a very small (0.4 cm) ill-defined hypoechoic mass (straight arrow) that contains echogenic foci (curved arrow).
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Figure 4. Subcutaneous recurrence (invasive ductal carcinoma) in the TRAM-reconstructed breast of a 47-year-old woman. Sonogram shows a spiculated hypoechoic mass (arrows) infiltrating into the overlying dermis.
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Figure 5. Recurrence (invasive ductal carcinoma) in the TRAM-reconstructed breast of a 37-year-old woman. Longitudinal sonogram shows a typical malignant-appearing lesion (arrows) with irregular margins and a taller-than-wider shape.
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Figure 6. Power Doppler US image of a recurrence (invasive ductal carcinoma) (arrows) in the TRAM-reconstructed breast of a 47-year-old woman shows intratumoral vascularity (red areas).
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Figure 7. Recurrence (invasive ductal carcinoma) in the TRAM-reconstructed breast of a 33-year-old woman has a US appearance suggestive of a benign lesion. Sonogram shows an oval hypoechoic solid mass (arrows) with predominantly smooth margins and no acoustic shadowing.
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Figure 8. Recurrence (invasive ductal carcinoma) in the TRAM-reconstructed breast of a 44-year-old woman has a US appearance characteristic of a benign lesion. Longitudinal sonogram shows the recurrence to be an oval subcutaneous echogenic nodule (calipers).
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Figure 9. Recurrence (invasive ductal carcinoma) in the TRAM-reconstructed breast of a 53-year-old woman who initially received an incorrect diagnosis of organizing hematoma. Findings on the subsequently obtained spectral Doppler US image confirmed vascularity in a septum within a fluid collection. These findings led to the diagnosis of cystic recurrent cancer.
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Figure 10. Recurrence (invasive ductal carcinoma) in the TRAM-reconstructed breast of a 36-year-old woman. Sonogram obtained during US-guided FNAB shows the tip (curved arrow) of the needle, which is echogenic, has been placed within the hypoechoic suspicious mass (straight arrows).
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Copyright © 2003 by the Radiological Society of North America.
