Background: Surgical intervention is the cornerstone in early-stage breast cancer treatment, with conventional breast conserving surgery and mastectomy historically being the main treatment modalities. In recent years “oncoplastic surgery,” or oncologic surgery in combination with immediate breast reconstruction, has been gaining more widespread adoption. To achieve improved cosmetic results, reconstructive surgeons use breast implants, acellular dermal matrix, autologous reconstruction, fat injections, and tissue rearrangement during, or after, lumpectomy or mastectomy. Familiarity with the imaging findings and expected progression of these post-operative changes is critical in avoiding unnecessary procedures as well as differentiating these changes from early recurrent tumor formation.
Learning Objectives: Discuss surgical methods employed in oncoplastic surgery Recognize expected benign imaging findings after oncoplastic lumpectomy and mastectomy Discern potential pitfalls and mimics of malignancy in the post-operative breast
Abstract Content/Results: This educational exhibit will be presented as a pictorial review with approximately 8-10 cases. These cases will be used to illustrate: 1. Tissue rearrangement following oncoplastic breast-conserving surgery 2. Fat necrosis following autologous fat grafting in oncoplastic breast reconstruction 3. Use of acellular dermal matrix presenting as a suspicious mass on ultrasound 4. Benign post-operative fluid collection following lumpectomy 5. Post-operative architectural distortion following lumpectomy 6. Benign post-surgical calcifications following lumpectomy 7. Expected imaging findings following mastectomy and TRAM and DIEP flap reconstruction 8. Imaging appearance of biopsy cavity markers for radiation therapy (e.g. Biozorb markers)
Conclusion: Surgery is a mainstay in the treatment of breast cancer and is commonly encountered in clinical practice. Identification of expected and benign changes after conventional lumpectomy, mastectomy, and oncoplastic breast surgery is essential in avoiding unnecessary invasive procedures as well as early detection of tumor recurrence.
