High Risk Patient with ADM Breast Reconstruction

Abstract

Breast reconstruction following mastectomy plays a vital role in many individuals’ recovery, symbolizing a shift from loss back to wholeness. Yet, this path can be complex, particularly in instances involving complicating factors such as radiotherapy and significant breast size. In such scenarios, often viewed as suboptimal for implant-based breast reconstruction, prioritizing the patient’s preferences is crucial. This article showcases the experience of a 50-year-old Caucasian woman who came to our department with a breast lump, later diagnosed as invasive mammary carcinoma of no specific type (NST) via percutaneous biopsy. Post a radical mastectomy of the left breast, left axillary lymphadenectomy and the placement of an expander beneath the pectoralis major muscle, she underwent radiotherapy following the tumor board’s advice due to positive lymph nodes. Patient opted not to have autologous breast reconstruction and we proceeded with the second phase, exchanging the expander for a breast implant and adding Acellular Dermal Matrix (ADM) in the infero-lateral pole of the breast for essential support and stability. Despite the challenges faced, our case successfully illustrates that with careful surgical planning and a patient diligently following postoperative care, implant-based breast reconstruction with ADM’s support can be effectively and safely achieved, even in less-than-ideal situations, fulfilling patient expectations.

Keywords

• acellular dermal matrix (adm)
• radiotherapy
• breast reconstruction
• breast implant
• expander