Brown F E, Sargent S K, Cohen S R, Morain W D
Department of Surgery, Dartmouth-Hitchcock Medical Center, Hanover, N.H.
Plast Reconstr Surg. 1987 Nov;80(5):691-8. doi: 10.1097/00006534-198711000-00006.
Mammographic findings after reduction mammaplasty may be similar to those seen with carcinoma. A knowledge of the expected mammographic alterations would be helpful in differentiating postoperative changes from those seen with carcinoma of the breast. Accordingly, the clinical records and mammograms of patients who underwent reduction mammaplasty at the Dartmouth-Hitchcock Medical Center between March of 1977 and July of 1985 were analyzed. Forty-two patients had at least one mammographic examination following reduction mammaplasty. Periareolar soft-tissue changes and inferior pole alterations were present in almost all examinations of patients during the first 6 months after operation, but they decreased during the next few years. Asymmetrical densities were present in approximately half the patients throughout the follow-up period but decreased in degree. Parenchymal calcifications occurred later; few x-rays showed these calcifications during the first year, but 50 percent were apparent after 2 years. Evidence of fat necrosis occurred in approximately 10 percent. Four patients had biopsies for suspicious densities. Chronic inflammation and inclusion cyst were reported. We believe that changes after reduction mammaplasty are predictable and can usually be differentiated from those associated with cancer.
乳房缩小成形术后的乳腺X线摄影表现可能与癌的表现相似。了解预期的乳腺X线摄影改变有助于鉴别术后改变与乳腺癌的表现。因此，对1977年3月至1985年7月在达特茅斯-希区柯克医疗中心接受乳房缩小成形术的患者的临床记录和乳腺X线照片进行了分析。42例患者在乳房缩小成形术后至少接受了一次乳腺X线检查。乳晕周围软组织改变和下极改变几乎在术后头6个月的所有患者检查中均存在，但在接下来的几年中减少。在整个随访期间，约一半的患者存在不对称密度，但程度有所降低。实质钙化出现较晚；第一年很少有X线片显示这些钙化，但2年后50%的钙化明显可见。约10%的患者有脂肪坏死的证据。4例患者因可疑密度进行了活检。报告有慢性炎症和包涵囊肿。我们认为，乳房缩小成形术后的改变是可预测的，通常可以与癌症相关的改变相鉴别。
