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The incidence of breast cancer and, therefore, the need for breast reconstruction are expected to increase. The many reconstructive options available and the changing aspects of the field make this a complex area of plastic surgery, requiring knowledge and expertise. Two major types of breast reconstruction can be distinguished: breast implants and autologous flaps. Both present advantages and disadvantages. Autologous fat grafting is also commonly used. MRI is the modality of choice for evaluating breast reconstruction. Knowledge of the type of reconstruction is preferable to provide the maximum amount of pertinent information and avoid false positives. Early complications include seroma, hematoma, and infection. Late complications depend on the type of reconstruction. Implant rupture and implant capsular contracture are frequently encountered. Depending on the implant type, specific MRI signs can be depicted. In the case of myocutaneous flap, fat necrosis, fibrosis, and vascular compromise represent the most common complications. Late cancer recurrence is much less common. Rarely reported late complications include breast-implant-associated large cell anaplastic lymphoma (BIA-ALCL) and, recently described and even rarer, breast-implant-associated squamous cell carcinoma (BIA-SCC). In this review article, the various types of breast reconstruction will be presented, with emphasis on pertinent imaging findings and complications. [ABSTRACT FROM AUTHOR]

Abstract: Purpose: To explore the correlation of morphological and kinetic DCE-MRI features with histopathological prognostic factors of invasive breast cancer. Material and methods: Fifty-one women with 57 cancerous lesions underwent DCE-MRI prior to surgery. DCE-MRI findings were interpreted with a multifactorial classification system that included morphological (shape, margins and pattern of enhancement) and kinetic characteristics (initial signal increase and post-initial behaviour of the time-signal intensity curve). Each morphological and kinetic parameter was scored with 0, 1 or 2 points and the total score was estimated. Finally each lesion was classified into one of the five categories that correspond to the five ACR BI-RADS categories. Statistical analysis was performed to correlate DCE-MR imaging parameters and histopathological findings using Fisher''s exact test and stepwise multiple regression analysis. Results: Increase of the signal intensity at the initial phase >100% was strongly correlated with positive lymph nodes (p =0.008, OR 0.054). Types I and II time-signal intensity curves at the post-initial phase were associated with a fourfold increase in the likelihood of progesterone receptors positivity (p =0.022, OR 4). Finally, high total score was positively correlated with affected lymph nodes (p =0.033, OR 0.29). There was a trend regarding ill-defined margins of the tumor (p =0.08) and vascular infiltration and also high score and neural infiltration (p =0.072). Conclusion: A multivariate interpretation model for DCE-MRI that includes morphological and kinetic characteristics has prognostic value for invasive breast cancer. Early initial contrast agent uptake and a high overall score are associated with poor prognostic factors. [Copyright &y& Elsevier]

The last decades, due to the systematic mammographic screening control, the incidence of DCIS has impressively increased and it consists almost 20% of breast carcinomas. A number of pathologic features have been identified which are useful for classification of ductal in situ carcinoma (DCIS) and better understanding of its pathogenesis and biological behavior. Recent advances in the diagnosis of DCIS include magnetic resonance imaging as an adjunct to mammography, which remains the gold standard for DCIS detection. The optimal management of DCIS remains an issue of controversy. Mastectomy that was practiced for long has been replaced in most cases by breast conserving-surgery with or without radiotherapy; radiotherapy significantly reduces local recurrence. Axillary lymph node dissection is generally not recommended. Tamoxifen appears to reduce the risk of local recurrence and should be considered in the management of selected patients with DCIS. [ABSTRACT FROM AUTHOR]