Is there a need for preoperative imaging of the internal mammary recipient site for autologous breast reconstruction?

Warren M. Rozen, Alberto Alonso-Burgos, Alice C A Murray, Iain S. Whitaker

Research output: Contribution to journalReview ArticleResearchpeer-review

14 Citations (Scopus)

Abstract

Preoperative imaging of recipient-site vasculatur in autologous breast reconstruction may potentiate improved outcomes through the identification of individual variations in vascular architecture. There are a range of both normal and pathologic states which can substantially affect the internal mammary vessels in particular, and the identification of these preoperatively may significantly affect operative approach. There are a range of imaging modalities available, with ultrasound particularly useful, and computed tomography angiography (CTA) evolving as a useful option, albeit with radiation exposure. The benefits of CTA must be balanced against its risks, which include contrast nephrotoxicity and allergic reactions, and radiation exposure. The radiation risk with thoracic imaging is substantially higher than that for donor sites, such as the abdominal wall, with reasons including exposure of the contralateral breast to radiation (with a risk of contralateral breast cancer in this population 2 to 6 times higher than that of primary breast cancer, reaching a 20-year incidence of 15%), as well as proximity to the thyroid gland. Current evidence suggests that although many cases may not warrant such imaging because of risk, the benefits of preoperative CTA in selected patients may outweigh the risks of exposure, prompting an individualized approach.

Original languageEnglish
Pages (from-to)111-115
Number of pages5
JournalAnnals of Plastic Surgery
Volume70
Issue number1
DOIs
Publication statusPublished - Jan 2013
Externally publishedYes

Keywords

  • anatomy
  • Free flap
  • perforator flap
  • reconstructive surgery
  • variation

Cite this

Rozen, Warren M. ; Alonso-Burgos, Alberto ; Murray, Alice C A ; Whitaker, Iain S. / Is there a need for preoperative imaging of the internal mammary recipient site for autologous breast reconstruction?. In: Annals of Plastic Surgery. 2013 ; Vol. 70, No. 1. pp. 111-115.
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Is there a need for preoperative imaging of the internal mammary recipient site for autologous breast reconstruction? / Rozen, Warren M.; Alonso-Burgos, Alberto; Murray, Alice C A; Whitaker, Iain S.

In: Annals of Plastic Surgery, Vol. 70, No. 1, 01.2013, p. 111-115.

Research output: Contribution to journalReview ArticleResearchpeer-review

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