Imaging post therapeutic mammaplasty

Katherine Gale, Eleanor Cornford, Douglas Macmillan

Nottingham City Hospital, Nottingham, UK

Background

Bilateral Therapeutic Mammaplasty (BTM) is an effective technique in breast conservation surgery, which combines tumour wide local excision (WLE) with breast reduction. Large adjustments in parenchymal architecture with BTM can potentially alter the imaging appearances of both breasts. This study aimed to evaluate the mammographic appearances after BTM and the frequency of additional imaging and biopsies compared to matched controls of woman who had a WLE only.

Methods

A retrospective analysis and film review was undertaken for 210 cancer patients who underwent BTM or WLE at the Nottingham Breast Institute from Jan 2001 to June 2008. Observations were recorded for both the ipsilateral (cancer) and contralateral breasts and on the operated side for the WLE group.

Results

Mammographic calcification at the post-operative site was present in 45% (47/105) of the ipsilateral BTM group, 9.5% (10/105) of the contralateral BTM group, and 37% (39/105) of the WLE group. In total, further imaging occurred in 51% (54/105) of the BTM group and 40% (42/105) of the WLE group, but the number of individual imaging episodes per patient was similar (1.59 TM vs 1.56 WLE respectively). The biopsy rate was 23% (24/105) for the ipsilateral BTM breast, 10% (10/105) for contralateral BTM breast and 21% (22/105) in the WLE breast.

Conclusions

Therapeutic mammaplasty does not significantly increase the rate of post-operative imaging or intervention when compared to standard WLE.

Abstract from publication as appears in European Journal of Surgical Oncology. View file here.