In recent years surgical options for breast cancer & cosmesis has developed dramatically.Various breast conservation surgeries have evolved for early breast malignancies. The main objective is : 1.To be familiar with thevarious types of surgeriesfor breast cancer like mastectomy, breast conservation surgery & augmentation techniques. 2.To knowvarying imaging appeararances of post surgical changes in breast and differentiating those post operative changes from complications like residual or recurrent tumors. 3.To know the indications foradvanced imaging techniques in appropriate post surgical circumstances and their pitfalls.

Treatment options for breast cancer have evolved from radical mastectomy to breast conservation procedures with radio-therapy and autologous reconstruction procedures. Post-surgical appearances in breast surgery are due to wound complications related to breast cancer surgery are relatively minor, self-limited, and managed on an outpatient basis.Commonest is seroma. Additional postsurgical complications include wound infection, hematoma, and chronic incisional pain. Post surgical imaging appearances are due to : Skin thickening Edema Scar/fibrosis - at native & flap junction - Dystrophic calcifications Surgical clips Fluid collections-Seroma,Haematoma Fat necrosis...

The various appearances in post-op breast in advanced techniques like Elastography,3D Tomo, help in studying the morphology of the lesion. MRI is of great value in conventional Birads IV lesions it is able give better clarity on elements of tissue composition especially in haematomas,fat necrosis & recurrance. Functional imaging MRI (diffusion & ADC) and PET CT & is used for response assessment & recurrance in the adjuvant & neo-adjuvant settings and detect local & distant disease effectively.However there are pitfalls & fallacies and timing and...

With early detection and devlopment of newer surgical techniques breast conservation with reconstruction has come to stay.However there can be complications like fat necrosis & scar which can mimic reurrance clinically and radiologically. Hence itis very important to have early detection protocols with advanced imaging techniques like Tomosynthesis, Elastography,MR mammography,PETCT so that we can differentiate normal postoperative changes from malignancy.Functional Imaging like Diffusion, Dynamic scanning & PET CT facilitate early detection besides helping us to target the correct site to biopsy. However it is very...

Dr. Bagyam Raghavan, Senior Consultant, Apoloo Cancer Institute, Tenampet, Chennai, India. email :[email protected]

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