Abstract
Breast cancer is the second most common cause of cancer death in women in India in spite of advances in the adjuvant treatment of breast cancer. Locally advanced breast cancer (LABC) still represents the major presenting picture in many urban and rural institutions in our country. Skin Sparing Mastectomy (SSM) and primary reconstruction is a popular option for patients with breast cancer. There are similar local and distant recurrences in SSM compared to the traditional non-skin sparing mastectomy. A 57-year-old lady presented with a locally advanced left breast cancer. After undergoing neoadjuvant chemotherapy and a PET-CT to accurately detect residual disease in breast and axilla, she underwent skin sparing mastectomy with nipple-areola complex preservation and primary reconstruction with silicon prosthesis implant over a latissimus dorsi myocutaneous flap for primary reconstruction. SSM in LABC has not been reported in the literature so far. This patient is disease free for the past 24 months.
Highlights
The incidence of breast cancer is rising in India, with an estimated 80,000 new cases diagnosed annually
Standard treatment would include a metastatic work up followed by neoadjuvant chemotherapy and a traditional mastectomy with or without reconstruction followed by adjuvant treatment protocols [3]
Patients who present with Locally advanced breast cancer (LABC) or multi focal disease require a mastectomy
Summary
The incidence of breast cancer is rising in India, with an estimated 80,000 new cases diagnosed annually. The incidence of breast cancer increased by approximately 50% between 1965 and 1985 and age adjusted rate of breast cancer during 1998-2002 in Bangalore Cancer Registry increased from 18.2 to 25.2 [1]. Toth and Lappert (1991) were the first to describe Skin sparing mastectomy (SSM) which includes resection of the nipple-areola complex (NAC), any existing biopsy scars and removal of the breast parenchyma (with or without an axillary dissection), and this has gained acceptance as an oncologic alternative combined with breast reconstruction [6]. The current report discusses a patient who presented with left sided LABC and received neoadjuvant chemotherapy followed by FDG-PET assessment to determine the extent of residual disease and underwent SSM with NAC preservation and primary breast reconstruction using silicon prosthesis over Latissimus dorsi flap. SSM and NAC preservation in LABC has not been reported so far
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