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Breast Reconstructions – Case Study 4
55 year old a screen detected right breast cancer.
⦁ Screening mammogram shows 32mm microcalcification at lower outer quadrant of right breast. Stereotactic core biopsy shows high grade DCIS.
⦁ Contrast-mammogram shows malignant area measures 40mm
⦁ Breast MRI showed extremely dense breast tissue –unable to measure size of tumour.
⦁ 32E bra size.
⦁ Patient opted for mastectomy + immediate reconstruction rather than breast conserving surgery (lumpectomy)
⦁ Right nipple sparing mastectomy via inframammary incision + sentinel node biopsy + immediate implant and Pre-pectoral Braxon ADM mesh reconstruction using pre-pectoral approach. Final histology showed 42mm area of high-grade DCIS with a single focus of 17mm grade 2 Invasive Ductal Ca with clear margins, ER-positive, PR-negative, HER2 positive. All sentinel nodes were normal.
⦁ Six months later underwent left breast implant augmentation.
⦁ Adjuvant chemotherapy due to presence of HER-2-positive invasive cancer, then tamoxifen.
⦁ No adjuvant radiotherapy required.
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