ABPS Breast Surgery & Oncoplastic Reconstruction Flashcards

Which implant characteristic is most predictive of implant rupture detection on physical examination?

Answer: Saline implant deflation causing visible size asymmetry

Saline implant rupture causes immediate, visible deflation, making it clinically detectable, whereas silicone gel rupture often requires MRI for diagnosis.

The FDA recommends periodic MRI screening for asymptomatic silicone gel breast implant rupture starting at what interval after implantation?

Answer: 3 years post-op, then every 2 years

The FDA recommends the first MRI screening at 3 years post-implantation, followed by every 2 years thereafter, to detect silent silicone rupture.

A patient presents with axillary mass and breast implant-associated anaplastic large cell lymphoma (BIA-ALCL) is suspected. What is the first diagnostic step?

Answer: Ultrasound-guided aspiration of peri-implant fluid

Ultrasound-guided aspiration of peri-implant fluid for cytology and CD30 immunostaining is the recommended first diagnostic step for suspected BIA-ALCL.

In tissue expander-based breast reconstruction, what is the primary purpose of the acellular dermal matrix (ADM)?

Answer: To provide inferolateral coverage and define the pocket

ADM is used to extend inferolateral coverage of the tissue expander, creating a defined lower pole pocket and reducing implant visibility.

Which reconstructive option is preferred for a thin patient undergoing post-mastectomy radiation who requires autologous breast reconstruction?

Answer: DIEP flap reconstruction

The DIEP flap is preferred in irradiated fields because autologous tissue is more resilient to radiation-induced complications than implant-based reconstruction.

Postmastectomy radiation therapy most commonly leads to which implant-based reconstruction complication?

Answer: Capsular contracture

Radiation significantly increases the rate of capsular contracture, often progressing to Baker Grade III–IV, with implant-based reconstruction.