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Multistage surgical management of MBC. (a) Post conservative surgery appearance of the patient. (b) Four months after mastectomy and before NAC reconstruction. (c) Six months postoperative result.
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The patient underwent a nipple sparing upper outer quadrantectomy with excision of the retro-areolar tissue to the left breast at another institution. (Fig. 1) Pathology revealed a low-grade intraductal carcinoma, clinging and micropapillary type, ER/PR+.
(a) Left modified radical mastectomy: the breast tissue is detached from the pectoralis major muscle. (b) Sample of the mastectomy.
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A left modified radical mastectomy and sentinel lymph node biopsy were performed, and associated with a contralateral breast liposuction and adenectomy, as indicated in a grade II gynecomastia (Fig. 2).
Nipple-Areolar complex (NAC) reconstruction. Intraoperative view.
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Areolar reconstruction was performed using a full-thickness skin graft from the ipsilateral groin, while nipple reconstruction was achieved using a subdermal single pedicle local flap (Fig. 3).