Mammography of autologous myocutaneous flaps

Autologous myocutaneous flaps (AMFs) are used increasingly as a method of breast reconstruction after mastectomy for breast cancer. Autogenous breast reconstruction may be performed with a rectus abdominis, latissimus dorsi, or gluteus maximus myocutaneous flap. Mammographic imaging of AMFs is controversial but has been recommended by some authors because mammographic detection of nonpalpable local recurrences in AMFs continues to be reported. At mammography, AMFs have a predominantly fatty appearance with variable density due to the muscle component and postoperative scarring. Normal mammographic findings include the vascular pedicle, surgical clips, and surgical scars, which produce radiopaque lines in predictable locations. Abnormal mammographic findings include fat necrosis appearing as a spiculated mass, noncalcified or calcified lipid cysts, calcifications, lymph nodes, epidermal inclusion cysts, and locally recurrent carcinoma.