Shawna C. Willey

Delayed Recurrent and Bilateral Breast Cancer in Patients With Partial Poland's Anomaly: Report of 2 Rare Cases and Review of the Literature

Patients with Poland’s anomaly are at risk for developing cancer in the ipsilateral hypoplastic/normal, contralateral, and reconstructed breasts. To date, however, only 16 cases of concurrent breast cancer in patients with Poland’s anomaly have been described. We report the first cases of (1) recurrent ipsilateral and (2) bilateral breast cancer in 2 patients with mild variants of partial Poland’s sequence. In both cases, localized, hormone-sensitive, ductal-based carcinoma was identified and effectively treated with mastectomy, direct lymph node assessment, and autologous reconstruction with regional pedicled flaps. No adjuvant therapies were administered in either case, and both patients remained disease-free at long-term follow-up. Recommendations regarding diagnostic screening for breast cancer in patients with Poland’s anomaly should follow those of the general population. Underlying anatomical abnormalities in these patients require special consideration, as skeletal and/or soft tissue derangements may influence decisions regarding appropriate diagnostic imaging, surgical treatment planning, adjunct oncologic therapies, and strategies for breast/chest wall reconstruction.

Midclavicular to inframammary fold measurement, a method of evaluation for nipple sparing mastectomy

Background: Preoperative assessment is vital to properly select patients for nipple sparing mastectomies (NSM). The objective of this paper is to describe a novel method, measuring from mid-clavicle to inframammary fold (IMF), to determine tissue envelope characteristics when evaluating a patient for a single stage, IMF incision NSM. n Methods: The authors conducted a retrospective review of all IMF incision NSM between October 2010 to July 2016 that had IMF to mid-clavicle measurements. Patient characteristics, mastectomy weight, complications, and the association between measurement were analyzed. n Results: Of a total 36 patients, 67 breasts were included for analysis. Increasing IMF to midclavicular measurements were found to be significantly related to increasing breast weight (P Conclusions: The authors demonstrated that midclavicular to IMF measurement approaching 34 cm had significantly increased complication rates, thus making this a potential tool for assessing tissue envelope characteristics in the evaluation for NSM. We propose 34 cm being a relative cut-off for single staged NSM.