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Case report
Multidisciplinary approach to chest wall reconstruction in primary breast angiosarcoma resection
  1. John Phineas O'Donnell1,2,
  2. Ryan Sugrue1,2,
  3. Ray McLaughlin1,3 and
  4. Niall M McInerney1,2
  1. 1Department of Surgery, Galway University Hospitals, Galway, Ireland
  2. 2Plastic & Reconstructive Surgery, National University of Ireland Galway, Galway, Ireland
  3. 3Breast & General Surgery, National University of Ireland Galway, Galway, Ireland
  1. Correspondence to Dr John Phineas O'Donnell; johnp.odonnell{at}hse.ie

Abstract

Angiosarcomas account for less than 1% of primary breast cancers. Typically, they occur in young women with a low-risk personal or family history. Diagnosis, resection and reconstruction require a multidisciplinary team of breast surgeons, oncologists and plastic reconstructive surgeons. Cross-disciplinary awareness among these specialities enables dimensional patient treatment. We report a case of primary angiosarcoma of the breast in a 33-year-old woman, with no previous radiotherapy exposure, treated with a radical mastectomy and chest wall reconstruction with a deep inferior epigastric perforator (DIEP) Flap. There is a general consensus in current literature regarding the difficulty for curative treatment in angiosarcomas. There is a requirement for surgical intervention to be aggressive to ensure oncological clearance. Subsequently, the extensive reconstructive task proves a major procedure for any plastic surgeon. DIEP autologous flap chest wall reconstruction accompanying radical mastectomy can be used in efforts to eradicate risks of deep margin incomplete excision in breast angiosarcomas. This case report and review of the current literature aim to provide guidance for colleagues managing angiosarcomas and also highlight the versatility of the DIEP flap.

  • breast cancer
  • plastic and reconstructive surgery
  • surgical oncology
  • transplantation
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Footnotes

  • Contributors JPO: main author of the text within the case report and its contents. RS: contributed to surgical procedural write-up and draft revision. RM: breast surgeon and critical review of mastectomy side of the write-up and preoperative aspects from a mastectomy point of view. As well he provided key information in follow-up of patient. NMM: reconstructive surgeon and supervisor of the case report. He provided crucial insight into the preoperative assessment and planning from a reconstructive point of view. He provided details on the DIEP procedure. He contributed a final draft review also and helped prepare the case for the hospitals grand rounds presentation.

  • Funding The authors have not declared a specific grant for this research from any funding agency in the public, commercial or not-for-profit sectors.

  • Competing interests None declared.

  • Patient consent for publication Obtained.

  • Provenance and peer review Not commissioned; externally peer reviewed.

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