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Breast reconstruction following mastectomy in Indian women: a neglected entity
  1. Royson Dsouza1,
  2. Pranay Gaikwad2,
  3. Vasanth Mark Samuel2 and
  4. Cecil Thomas2
  1. 1General Surgery, ASHWINI Gudalur Adivasi Hospital, Vellore, India
  2. 2Department of General Surgery Unit 1, Christian Medical College Hospital, Vellore, India
  1. Correspondence to Dr Vasanth Mark Samuel; vasusanth{at}gmail.com

Abstract

Phyllodes tumour is a rapidly growing neoplasm with a propensity to involve the entire breast tissue. In large tumours, the treatment comprises a wide local excision or a mastectomy. A woman in her 20s from rural India presented with complaints of a recurrent left breast lump. The lump progressed to a large size, limiting her social activities and causing depression. On examination, she had a mass occupying almost the entire left breast, with stretched skin, dilated veins and pressure necrosis. There were no palpable axillary nodes. She was offered a wide local excision and reconstruction with a latissimus dorsi pedicled flap. After much discussion and clarification of some misconceptions around breast reconstruction, she underwent the planned surgery. This was followed by adjuvant radiation therapy as the histopathology was consistent with a complex phyllodes tumour with close margins. She was well at 1-year follow-up and led a good family and social life. Breast conservation and reconstruction are seldom offered as part of cancer treatment in India. All women should be offered surgical options that are oncologically safe while preserving body image, and hence healthcare providers must work towards breaking the barriers that prevent breast reconstruction.

  • Breast cancer
  • Breast surgery
  • Plastic and reconstructive surgery
  • Surgical oncology
  • Global Health

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Footnotes

  • Contributors VMS and RD were the clinicians involved in the diagnosis and management of the patient. RD did the write-up of the article and was proof-read and corrected by VMS, PG and CT.

  • 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.

  • Case reports provide a valuable learning resource for the scientific community and can indicate areas of interest for future research. They should not be used in isolation to guide treatment choices or public health policy.

  • Competing interests None declared.

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