Left NIPPLE-SPARING MASTECTOMY + IMMEDIATE BECKERS IMPLANT + prepectoral BRAXON MESH RECONSTRUCTION FOR A LARGE BC

52 year old with screen-detected microcalcification in left breast (Jan 2020)

• Mammogram + ultrasound and MRI shows 7 mm multricentric BC:
  ⦁ Left upper outer quadrant 10mm BC – biopsy shows Grade 1 Invasive Ductal Ca, ER-positive, PT-weakly negative, HER2- negative
  ⦁ Further left 4mm BC (3cm from index tumour)- intermediate grade DCIS.
  ⦁ MRI shows suspicious area span 67mm.
• 32B bra size.
• Left nipple sparing mastectomy via inframammary incision + sentinel node biopsy + immediate implant and Pre-pectoral Braxon ADM mesh reconstruction using pre-pectoral approach..Final histology shows 52mm multicentric grade 2 invasive ductal Ca, closest margin 2.3mm. 1 micrometastasis out of 2 sentinel nodes.
• Further Oncotype Dx test showed low benefit from chemotherapy and hence chemotherapy was not recommended.
• Adjuvant chest wall therapy and Letrazole.