[Mammography of the reconstructed breast--a comparison of different methods of reconstruction].

The choice of a breast reconstruction technique is considerably influenced by the possibility of detecting recurrence. Mammography is the most important diagnostic aid in detecting a tumor. We have compared the mammographic evaluation of different reconstruction methods. 41 patients were investigated and divided into three subgroups: Group I (n = 10): Reconstruction with autologous tissue (TRAM-flap); group II (n = 22): Reconstruction with silicone gel-filled implants, muscle and soft tissue replacement (latissimus flap or submuscular expander technique and silicone gel prostheses); group III (n = 9): Reconstruction with silicone gel-filled implants. Evaluation was performed employing a scoring system. The mammographic appearance of autologous breast reconstructions consisting of skin, subcutaneous fat and muscle is comparable to involuted breasts. One mammography in this group was of poor, one of acceptable, and eight of good quality. Autologous reconstruction is associated with the highest chance of recurrence detection. Within group II and III, parts of the reconstructed breast are covered by the X-ray absorbing silicone gel prosthesis. In group II, seven mammographies were considered poor, 14 acceptable, and one good; in group III it was two, four und three respectively. The interpretation depended on the implant soft tissue ratio. If thin soft tissue layers cover the prosthesis, inspection and palpation become increasingly important, nevertheless it is not possible to achieve comparable data as with mammography.