Hsieh Frank, Malata Charles M
Clinical School of Medicine, Cambridge University, Cambridge, UK.
Int J Surg. 2008 Dec;6(6):e83-5. doi: 10.1016/j.ijsu.2007.04.004. Epub 2007 Apr 14.
A 48-year-old woman was found to have histological recurrence of lobular breast carcinoma in a mastectomy scar excised routinely during delayed breast reconstruction 6 years after a mastectomy. Prior to the subsequent wide excision of the scar, she requested prophylactic contralateral mastectomy and immediate reconstruction. The scar excision revealed positive resection margins prompting further surgery while the contralateral mastectomy showed previously undetected widely infiltrative lobular carcinoma. It is extremely rare to detect lobular carcinoma in incidental histological specimens and even rarer to encounter it in asymptomatic contralateral breasts following prophylactic mastectomy. This unusual presentation and the implications for mastectomy scar management during delayed reconstruction are discussed.
一名48岁女性在乳房切除术后6年进行延迟乳房重建时，常规切除的乳房切除瘢痕组织学检查发现小叶型乳腺癌复发。在随后对瘢痕进行广泛切除之前，她要求进行预防性对侧乳房切除术并立即重建。瘢痕切除显示切缘阳性，需要进一步手术，而对侧乳房切除术显示出先前未检测到的广泛浸润性小叶癌。在偶然的组织学标本中检测到小叶癌极为罕见，在预防性乳房切除术后无症状的对侧乳房中发现更是罕见。本文讨论了这种不寻常的表现以及延迟重建期间乳房切除瘢痕处理的意义。
