Surgery and Imaging of Breast Reconstruction

Following mastectomy, breast reconstruction methods and image appearance are reviewed.

Course ID: Q00383 Category:
Modalities: , ,


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Targeted CE per ARRT’s Discipline, Category, and Subcategory classification:
[Note: Discipline-specific Targeted CE credits may be less than the total Category A credits approved for this course.]

Breast Sonography: 3.25
Procedures: 3.25
Pathology: 1.00
Breast Interventions: 2.25

Mammography: 3.25
Patient Care: 1.00
Patient Interactions and Management: 1.00
Procedures: 2.25
Anatomy, Physiology, and Pathology: 2.25

Magnetic Resonance Imaging: 2.25
Procedures: 2.25
Body: 2.25

Registered Radiologist Assistant: 3.25
Patient Care: 1.00
Patient Management: 1.00
Procedures: 2.25
Thoracic Section: 2.25

Sonography: 2.25
Procedures: 2.25
Superficial Structures and Other Sonographic Procedures: 2.25

Radiation Therapy: 3.25
Patient Care: 2.25
Patient and Medical Record Management: 2.25
Procedures: 1.00
Treatments: 1.00


  1. Introduction
  2. Breast Reconstruction Techniques
    1. Reconstruction with Prosthetic Implants
    2. Reconstruction with Autologous Tissue Flaps
      1. Latissimus Dorsi Mycutaneous Flap
      2. TRAM Flaps
        1. Pedicled TRAM Flap
        2. Free TRAM Flap
        3. Free Muscle-sparing TRAM Flap
      3. DIEP Flap
      4. SIEA Flap
  3. Preoperative Imaging Studies
  4. Breast Imaging Appearances after Autologous Reconstruction
    1. Normal Finding and Benign Changes
      1. Seromas and Hematomas
      2. Fat Necrosis
      3. Fibrosis
    2. Breast Cancer Recurrence
  5. Analysis of Patient Records at Our Breast Imaging Center


Upon completion of this course, students will:

  1. discuss why breast reconstruction is performed following mastectomy
  2. describe the solutions utilized for prosthetic breast implants
  3. differentiate between silicon and saline breast implants
  4. explain the advantage of prosthetic breast reconstruction
  5. organize the grades of breast capsular contracture
  6. specify the preferred tissue donor site for autologous tissue flaps
  7. describe the advantage of the latissimus dorsi myocutaneous flap technique
  8. know what pedicled means
  9. describe how pedicled TRAM flaps are tunneled to the mastectomy site
  10. communicate the disadvantages of the pedicled TRAM flap procedure
  11. understand the advantages of the free TRAM flap technique
  12. list success factors for free TRAM flap procedures
  13. specify vessels used for free TRAM flap procedures
  14. identify components of the free muscle-sparing TRAM flap procedure
  15. describe components of the DIEP flap procedure
  16. list advantages of the DIEP flap procedure
  17. explain the use of the rectus abdominis muscle for SIEA flap procedures
  18. describe the veins utilized for SIEA flap procedures
  19. differentiate between pre-operative vascular mapping studies
  20. describe the appearance of reconstructed breasts on mammography and breast MRI
  21. list common benign changes in breasts reconstructed with autologous tissue flaps
  22. specify the time frame following radiation therapy when skin and trabeculae thickening of the reconstructed breast may occur
  23. explain the composition of seromas
  24. be familiar with the appearance of tissues on T2-weighted MR images
  25. describe factors causing seromas
  26. explain the cause of fat necrosis
  27. discuss the presentation of fat necrosis at physical examination
  28. describe the appearance of fibrosis on mammograms
  29. be familiar with the enhancement patterns of fibrosis and recurrent tumors following the injection of a gadolinimum-based MR contrast agent
  30. understand by how much breast cancer is reduced following mastectomy
  31. compare T1 and T2 tumor classifications
  32. describe where recurrent breast cancer occurs post-reconstruction
  33. list the factors influencing risk of local breast cancer recurrence
  34. be familiar with the features of MR subtraction imaging
  35. explain the relevance of additional imaging procedures when MR demonstrates abnormalities