Mammograms After Breast Reconstruction

If your breast has been reconstructed using your own tissues, you're probably not a good candidate for mammography. That's because, essentially, no breast tissue is present. Under some circumstances, however, doctors will recommend mammography after this kind of breast reconstruction:

• if you're at high risk for local recurrence
• if physical examination of the breast is difficult
• if there is a questionable abnormality

Recurrent breast cancers can sometimes be detected this way in women who have had TRAM reconstruction.

Usually, lumps and calcifications in reconstructed tissue that can be felt and are visible with mammography are benign fat necrosis. This is the result of fat cells dying after the reconstruction procedure. These cells calcify and form lumps soon after the surgery, and unlike cancer, they usually stay the same size or get smaller over time.

Interpreting your mammogram can also be tricky if you've had a very large lumpectomy followed by reconstruction with your own tissue. But if you have a baseline mammogram after treatment effects have "cooled," your later mammograms may become easier to interpret.

If you've had saline or silicone implants after mastectomy, you won't need mammograms of the affected side. No breast tissue remains, and the implant blocks the view of surrounding tissues. With an implant, however, you and your doctor can still do a careful physical examination of the breast area.