Back to May 2007: Reconstruction Updates
Types of diagnostic testing after mastectomy?
- Question from Rosie: What type of diagnostic testing is available to detect recurrence of initially diagnosed cancer or new cancer in women who have undergone mastectomy with or without reconstructive surgery?
- Answer —Jennifer Sabol, M.D., F.A.C.S. : The most appropriate and most common tool to use is simply physical examination. You have to remember that the layer of breast tissue left is generally less than 1/4 of an inch thick. Your fingertips are going to detect a small nodule within that skin flap much faster than any imaging study. In addition, cancers that recur after a mastectomy tend to appear more like a rash on the surface of the skin than they do a mass deep within the reconstruction. Finally, the other places to evaluate for recurrence are under the arms and within the axillary lymph nodes. Again, this is not a place well imaged by any current imaging modality; it is best evaluated on physical examination. Having said that, if imaging of the reconstructed breast is warranted, a breast or chest wall MRI is probably the most useful tool we have to date.