Presentation
A patient with a previous TRAM flap reconstruction of the left breast is sent for diagnostic mammography with palpable nodularity of the reconstructed breast.
Patient Data
Focal central parenchymal distortion on the CC view.
This is the typical appearance of a TRAM flap reconstructed breast. In this case, the surgery was performed almost 3 years previously. The appearance on the CC view with focal central parenchymal distortion is commonly found and should not alarm the reader.
Ultrasound of the left breast shows multiple small focal well-defined areas of hypoechoic nodularity some of which the patient could feel. None of the lesions shows calcification.
Case Discussion
This case demonstrates focal fat necrosis in the reconstructed left breast. The reconstructed breast does not develop cysts and these lesions should not be labeled as such. The lesions, in this case, have not calcified, but the typical peripheral curvilinear calcifications can follow later.
Imaging of the reconstructed breast is accepted practice and in theory, would pick up any new cancer in any residual breast tissue that may have been left behind after the previous mastectomy 2.