Fat necrosis in a TRAM flap

Case contributed by Dr Garth Kruger


A patient with a previous TRAM flap reconstruction of the left breast is sent for diagnostic mammography with palpable nodularity of the reconstructed breast.

Patient Data

Age: Adult
Gender: Female

This is the typical appearance of a TRAM flap reconstructed breast. In this case the surgery was performed almost 3 years previously. The appearance on the CC view with focal central parenchymal distortion is commonly found and should not alarm the reader. 


see below

Case Discussion

This case demonstrates focal fat necrosis in the reconstructed left breast. The reconstructed breast does not develop cysts and these lesions should not be labeled as such. The lesions in this case have not calcified, but the typical peripheral curvilinear calcifications can follow later.

Imaging of the reconstructed breast is accepted practice and in theory would pick up any new cancer in any residual breast tissue that may have been left behind after the previous mastectomy 2

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Case information

rID: 21653
Published: 8th Feb 2013
Last edited: 14th Aug 2019
System: Breast
Inclusion in quiz mode: Included

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