MR imaging of the reconstructed breast: What the radiologist needs to know

OBJECTIVE: The objective is to review the different types of breast reconstruction following cancer surgery and describe expected imaging appearances and complications seen in the reconstructed breast. METHODS: Surgical management of breast cancer often entails lumpectomy or mastectomy. When mastectomy is performed, patients often opt for breast reconstruction. Most facilities do not routinely image the reconstructed breast with mammography. RESULTS: However, many of these women are imaged with screening breast MRI for evaluation of the contralateral breast, or they may develop a clinical problem that warrants a diagnostic evaluation with MRI. In this article, we will review the more commonly encountered types of breast reconstruction, which include implants, tranversus rectus abdomnis flap, latissimus dorsi flap, deep inferior epigastric perforator flap, and gluteal flaps. Each of these types of reconstruction has different appearances on MR. We will also discuss potential complications that can be seen in the reconstructed breasts, including fat necrosis and recurrence. CONCLUSION: Radiologists will better understand the different types of breast reconstruction after mastectomy and their normal imaging appearance on MRI. Radiologists will be more aware of how to recognize complications related to surgery as well as how to determine whether recurrence is present. MAIN MESSAGES: • The different surgical techniques used in breast reconstruction are discussed. • Describes the normal magnetic resonance imaging appearance of the breast after reconstruction. • Identify MR imaging features of benign sequelae and recurrence following breast reconstruction.