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Recurrence in Autogenous Myocutaneous Flap Reconstruction after Mastectomy for Primary Breast Cancer: US Diagnosis¹

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).

PURPOSE: To assess the value of ultrasonography (US) and US-guided fine-needle aspiration biopsy (FNAB) in the detection and diagnosis of recurrent cancer in breasts reconstructed with autogenous myocutaneous flaps after mastectomy for primary breast cancer and to describe the US appearances of recurrence in the reconstructed breast.

MATERIALS AND METHODS: Between July 1994 and March 2001, US of the reconstructed breast was performed in 20 women with autogenous myocutaneous flap reconstruction. US findings were correlated with clinical and mammographic findings. US-guided FNAB of 25 (64%) of the 39 recurrent cancers depicted at US was performed.

RESULTS: Twenty-one (54%) of the 39 recurrent cancers depicted at US were clinically occult. Mammography performed in 12 of the 20 patients with reconstructed breasts depicted 14 (56%) of the 25 recurrent cancers that were detected at US in these patients. US-guided FNAB helped to establish a definitive diagnosis of recurrent breast carcinoma in 24 (96%) of the 25 tumor specimens sampled.

CONCLUSION: US and US-guided FNAB are valuable for the assessment of both palpable and clinically occult recurrent breast cancers in autogenous myocutaneous flap breast reconstructions.

© RSNA, 2003

Index terms: Breast, biopsy, 00.1261 • Breast, prostheses • Breast neoplasms, radiography, 00.11 • Breast neoplasms, US, 00.12983, 00.12985, 00.12989

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