Magnetic Resonance Imaging of Immediate Breast Reconstruction with Silicone Implant and Latissimus Dorsi Flap

Aleksandra Pirjavec Mahić, Damir Grebić, Barbara Čandrlić, Ivan Sebaher and Harry Grbas

1Department of Plastic and Reconstructive Surgery, Clinical Hospital Center Rijeka, Croatia
Department of General and Oncological Surgery, Clinical Hospital Center Rijeka, Croatia
Department of Radiology, Clinical Hospital Center Rijeka, Croatia
Department of Digestive Surgery, Clinical Hospital Center Rijeka, Croatia

^*Correspondance to: Damir Grebi? 

 PDF  Full Text DOI: 10.25107/2474-1647.1907

Abstract

Purpose: Skin-sparing mastectomy followed by immediate breast reconstruction is one of the latest revolutions of surgical treatment for breast cancer. Purpose was to analyse implants using magnetic resonance imaging after immediate breast reconstruction with a combined silicone implant and latissimus dorsi muscle flap technique and to compare the results with clinical findings using the Baker scale.Methods: From May 2011 to May 2015, 22 patients with breast cancer (T1 and T2N0M0) underwent skin-sparing mastectomy and immediate breast reconstruction procedures using the latissimus dorsi muscle flap in combination with anatomical silicone breast implants. Magnetic resonance imaging was used to detect signs of capsular contracture, intracapsular or extracapsular rupture.
Results: Analysing magnetic resonance, 9 patients (41%) (6 of which underwent radiotherapy) presented signs of capsular contracture, manifested with an anteroposterior to mediolateral ratio of less than 2. This correlates with 6 patients who presented clinical findings of Baker grades II and III contracture. The mean fibrous capsule thickness in patients with radiotherapy was 1.6 mm and without radiotherapy 0.9 mm. The mean value of maximum length of free fluid around the implant was 3.8 mm in patients with radiotherapy versus 2.9 mm in patients without radiotherapy. The mean value of reconstructed muscle thickness was 5 mm in patients with radiotherapy and 5.8 mm in patients without radiotherapy.Conclusion: We consider immediate breast reconstruction to have better results if the operation is performed without additional radiotherapy. Magnetic resonance imaging can be used to analyse reconstructed breasts, especially for the detection of postoperative complications.

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Cite the article

Mahi? AP, Grebi? D, ?andrli? D, Sebaher I, Grbas H. Magnetic Resonance Imaging of Immediate Breast Reconstruction with Silicone Implant and Latissimus Dorsi Flap. Clin Surg. 2018; 3: 1907.