Mammography after implant breast reconstruction

This report deals with the question of performing mammography routinely after implant breast reconstruction. Mammography cannot be performed on the mastectomy flaps unless reconstruction is done. Successful mammography in this situation does require special techniques. The most probable location for a local recurrence is anterior to, rather than behind, an implant. Since only 6 to 10 percent of mastectomy patients would be expected to develop a local recurrence and only a small proportion of these would be nonpalpable, the yield of routine mammography could not be expected to be high. Three patients are presented whose occult local recurrences were detected by routine surveillance mammography. The author's opinion is that mammography should be a part of the standard follow-up care of breast reconstruction patients, particularly those whose original tumor contained microcalcifications.