Multimodality Imaging of the Treated Breast

Breast cancer recurrence remains a clinical challenge despite advances in early detection and treatment. In particular, using imaging to distinguish normal posttreatment changes from early signs of recurrence can be difficult. This Pictorial Essay reviews the expected evolution of imaging findings after breast-conserving therapy and mastectomy and highlights the key imaging features of expected postoperative findings and cancer recurrence across multiple modalities. We illustrate how recurrence might present in different clinical contexts and locations, including after lumpectomy, mastectomy, and breast reconstruction and in regional lymph nodes. By emphasizing multimodal imaging patterns and longitudinal comparison, this review aims to improve diagnostic confidence in identifying early recurrences of cancer and distinguishing them from expected posttreatment findings.