Imaging of Breast Cancer–Related Changes After Surgical Therapy

Abstract

Many breast cancer patients undergo cross-sectional imaging at some point during or after treatment. Thoracic CT is an important modality performed for staging and surveillance. Thoracic CT examinations often show findings related to patients' surgical or adjuvant treatment. The postsurgical changes visible on thoracic CT may include those related to lumpectomy, mastectomy, breast reconstruction, and axillary surgery. Postsurgical complications may also be seen, including fluid collections, infection, fat necrosis, and lymphedema. Recognition and appropriate interpretation of the posttherapeutic spectrum of findings are important to avoid unnecessary diagnostic imaging and minimize patient anxiety.

How should we manage women with fat necrosis following autologous breast reconstruction: An algorithmic approach

“…None of the reviewed studies used CT as a FN diagnostic tool. The difficulty distinguishing FN from malignancy recurrence on CT has been reported . Surprisingly, MRI was also not utilized in any reviewed study despite a negative predictive value of FN in patients with a history of breast surgery approaching 100% .…”

Digital Mammographic Features of Breast Cancer Recurrences and Benign Lesions Mimicking Malignancy Following Breast-Conserving Surgery and Radiation Therapy

“…SEROMA Seroma is a serous fluid collection within the breast parenchyma after BCS [38] seen in the early period. The etiology is suggested to be multifactorial, including surgically-created dead spaces, extended axillary surgery, disorder of lymphatic and vascular flows, and delayed wound healing [39,40]. Seroma occurs in 9-15% of patients after BCS with RT [41,42].…”

“…US is a helpful tool to diagnose seroma (Fig. 5e) [40,43]. It shows a complex cystic mass with a solid mass in an anechoic cyst, which represents resolving postoperative hematomas [18,44].…”

Intramammary Findings on CT of the Chest – a Review of Normal Anatomy and Possible Findings

“…On the other hand, as discussed above, the resolution of a standard CT may be too low to show discrete irregularities of the margins. Therefore morphological features on CT are not pathognomonic and every enhancing mass without clearly depicted calcifications suggestive of fibroadenoma should undergo further work- up (Figures 9, 10) [15]. …”

“…Nowadays most cancers are operated with breast-conserving surgery [15]. Common findings after breast-conserving surgery include volume loss, architectural distortion, scar tissue and skin thickening (Figures 7, 12).…”