Bilateral Breast Reconstruction Using Extended Latissimus Dorsi Musculocutaneous Flaps for Metachronous Bilateral Breast Cancer: A Case Report.

A 49-year-old woman had undergone radiofrequency ablation (RFA) therapy and sentinel lymph node biopsy (SNB), followed by radiation therapy for her right breast cancer at the age of 31. The patient had further undergone nipple-sparing mastectomy (NSM), SNB, and immediate breast reconstruction using an extended latissimus dorsi musculocutaneous flap (eLDMCF) for her left breast cancer at the age of 43. Follow-up mammography further revealed widespread linear calcifications in the right breast. Core needle biopsy pathologically showed atypical cells growing in trabecular and tubular fashions with connective tissue proliferation, leading to the diagnosis of invasive ductal carcinoma. Due to the patient's strong preference for not using silicone prosthesis on right breast reconstruction, the patient underwent NSM and SNB, followed by immediate breast reconstruction using the right eLDMCF after obtaining full informed consent about the unknown bilateral eLDMCF harvesting effect on respiratory function. The patient recovered uneventfully and showed respiratory function as follows: preoperative 2.69 L to postoperative 2.46 L in vital capacity and preoperative 2.1 L to postoperative 1.83 L in forced expiratory volume in one second. The patient reported no respiratory symptoms and has been fully satisfied with the cosmetic outcomes of the reconstructed right breast. These results suggest that bilateral breast reconstruction using eLDMCFs can be a good therapeutic option for metachronous bilateral breast cancer.