AB223. SOH26AB_0313. Radical resection and reconstruction of recurrence: a case report of multidisciplinary surgical management of a locally invasive breast cancer recurrence
General Posters II

AB223. SOH26AB_0313. Radical resection and reconstruction of recurrence: a case report of multidisciplinary surgical management of a locally invasive breast cancer recurrence

Ailbhe Kenny1, Darragh Rice2, Katie Nolan3, Gerard Kelly3, Alan Hussey3, Alan Soo2, Carmel Malone1,4

1Department of General Surgery, University Hospital Galway, Galway, Ireland; 2Department of Cardiothoracic Surgery, University Hospital Galway, Galway, Ireland; 3Department of Plastic and Reconstructive Surgery, University Hospital Galway, Galway, Ireland; 4Department of Breast Surgery, University Hospital Galway, Galway, Ireland

Background: Locally advanced breast tumours invading the chest wall pose significant surgical and perioperative challenges. Achieving complete oncological clearance often requires en bloc resection of the breast, chest wall structures, and immediate reconstruction, which necessitates thorough preoperative optimisation and multidisciplinary alignment.

Case Description: We report a case of a 67-year-old female who developed a left breast mass involving the anterior chest wall, at the site of previous wide local excision and radiotherapy for left breast ductal carcinoma in situ (DCIS), as well as a new contralateral invasive lobular carcinoma. She was started on neoadjuvant therapy, with the aim of reducing the tumour burden. At 8 months, there was minimal tumour regression. Multidisciplinary team re-evaluation confirmed the need for bilateral mastectomy with en bloc resection of involved ribs and diaphragm, followed by immediate chest wall reconstruction using bovine pericardium, a methyl methacrylate plate, and a pedicled latissimus dorsi flap, with a skin graft taken from her left thigh. Preoperative coordinated decision making and intraoperative communication with anticipation of physiological challenges were integral to the success of the procedure.

Conclusions: Although prognosis after chest wall recurrence is guarded, this case illustrates that radical chest wall resection with immediate reconstruction can be safely undertaken when supported by comprehensive perioperative planning. We highlight the importance of perioperative multidisciplinary planning in advanced breast malignancies to achieve both oncological safety and acceptable functional outcomes. It also demonstrates that while neoadjuvant therapy is the preferred initial approach in disease that appears unresectable, failure of response should prompt reconsideration of surgical resection.

Keywords: Chest wall reconstruction; en bloc resection; locally advanced breast cancer; multidisciplinary approach; case report

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Footnote

Funding: None.

Conflicts of Interest: The authors have no conflicts of interest to declare.

Ethical Statement: The authors are accountable for all aspects of the work in ensuring that questions related to the accuracy or integrity of any part of the work are appropriately investigated and resolved.

Open Access Statement: This is an Open Access article distributed in accordance with the Creative Commons Attribution-NonCommercial-NoDerivs 4.0 International License (CC BY-NC-ND 4.0), which permits the non-commercial replication and distribution of the article with the strict proviso that no changes or edits are made and the original work is properly cited (including links to both the formal publication through the relevant DOI and the license). See: https://creativecommons.org/licenses/by-nc-nd/4.0/.

doi: 10.21037/map-26-ab223
Cite this abstract as: Kenny A, Rice D, Nolan K, Kelly G, Hussey A, Soo A, Malone C. AB223. SOH26AB_0313. Radical resection and reconstruction of recurrence: a case report of multidisciplinary surgical management of a locally invasive breast cancer recurrence. Mesentery Peritoneum 2026;10:AB223.

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