Multimodality Imaging of the Postmastectomy Breast

Targeted CE per ARRT’s Discipline, Category, and Subcategory classification for enrollments starting after February 10, 2026:
[Note: Discipline-specific Targeted CE credits may be less than the total Category A credits approved for this course.]

Breast Sonography: 2.75
Procedures: 2.75
Breast Interventions: 2.75

Computed Tomography: 0.75
Procedures: 0.75
Neck and Chest: 0.75

Mammography: 2.75
Procedures: 2.75
Mammographic Positioning, Special Needs, and Imaging Procedures: 2.75

Magnetic Resonance Imaging: 2.75
Procedures: 2.75
Body: 2.75

Registered Radiologist Assistant: 2.75
Procedures: 2.75
Thoracic Section: 2.75

Sonography: 2.75
Procedures: 2.75
Superficial Structures and Other Sonographic Procedures: 2.75

Outline

1. Introduction
2. Preoperative Planning and Imaging
3. Timing of Breast Reconstruction
4. Implant Reconstruction
5. Complications of Implant Reconstruction
   1. Postsurgical Fluid Collection
   2. Postsurgical Infection
   3. Foreign Body Granuloma
   4. Capsular Contracture
   5. Implant Rupture
   6. Implant Rupture Screening Recommendations
6. Autologous Tissue Flap Reconstruction
   1. Myocutaneous Latissimus Dorsi and Other Back Flaps
   2. Abdominal Flaps
      1. Transverse Rectus Abdominis Myocutaneous Flap
      2. Deep Inferior Epigrastric Perforator Flap
      3. Superficial Inferior Epigrastic Artery Flap
   3. Buttock Flaps
      1. Gluteal Artery Perforator Flap
   4. Thigh Flaps
      1. Transverse Upper Gracilis, Diagonal Upper Gracilis, Vertical Upper Gracilis, Lateral Thigh Perforator, and Profunda Artery Perforator Flaps
7. Complications of Tissue Flap Reconstruction
   1. Early Postoperative Complications
   2. Donor Site Complications
8. Benign and Abnormal Postoperative Imaging Findings in the Reconstructed Breast
   1. Expected Benign Postoperative Findings
   2. Abnormal Postoperative Findings
9. Benign Masses Associated with Reconstructed Breasts
10. Local Cancer Recurrence after Mastectomy
11. Postmastectomy Imaging Surveillance
12. Conclusion

Objectives

Upon completion of this course, students will:

1. list the beneficial factors of breast reconstruction
2. choose the year radical mastectomy was first described
3. describe how women who requested breast reconstruction during the time period of radical mastectomy treatment were labeled
4. detail what act mandated insurance coverage for breast reconstruction following mastectomy
5. indicate the percent of women undergo reconstruction following mastectomy
6. state the year in which more than 137,000 reconstructive breast procedures were performed
7. list the key determinants for selecting breast reconstruction types
8. choose the modalities utilized for preoperative free flap reconstruction imaging
9. state the location of the of the preferred perforator for free perforator-based flap transfer
10. list the advantages of immediate breast reconstruction
11. list the complications associated with applying radiation to a breast implant
12. state the most widely performed reconstruction procedure
13. list the options for implant protheses
14. explain the patient population of which the two-stage breast reconstruction approach has traditionally been the preferred method
15. discuss the advantages and disadvantages of prepectoral device placement
16. explain the use of acellular dermal matrix
17. describe the position of the outer capsule
18. list interventions for early complications of implant reconstruction
19. describe the characteristics of breast implant-associated anaplastic large cell lymphoma
20. explain the appearance of post-surgical breast implant infection at ultrasound
21. describe how cellulitis appears clinically
22. list the complications associated with abnormal contracture of the fibrous capsule that surrounds a breast implant
23. choose the modality that best evaluates silicone implant rupture
24. list and describe all the magnetic resonance imaging “signs” denoting intracapsular rupture
25. recall when the surgical technique of latissimus dorsi breast reconstruction was described and gained popularity
26. recall when the deep inferior epigastric perforator flap breast reconstruction method was first described by Allen and Treece
27. describe how the deep interior epigastric perforator flap can be identified at mammography
28. describe which breast reconstruction technique spares any incision to the rectus abdominis muscle or fascia
29. choose which breast reconstruction technique is an alternative for patients with insufficient abdominal tissue
30. list the known complications that occur early after flap reconstruction
31. name the most frequent cause of palpable and nonpalpable lesions in reconstructed breasts
32. name the most common abnormal imaging finding in a postmastectomy reconstructed breast