Types of diagnostic testing after mastectomy?

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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?
Answers - 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.

The Ask-the-Expert Online Conference called Reconstruction Updates featured Joseph Serletti, M.D. and moderator Jennifer Sabol, M.D. answering your questions about breast reconstruction.

Editor's Note: This conference took place in May 2007.

The materials presented in these conferences do not necessarily reflect the views of Breastcancer.org. A qualified healthcare professional should be consulted before using any therapeutic product or regimen discussed. All readers should verify all information and data before employing any therapies described here.

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