title: Reconstruction with cutaneous flap after resection for breast cancer's skin metastases in a chemoresistant patient.
abstract: We reported a case of a breast cancer's skin metastases in a patient that had sustained 3 lines of chemotherapy. At first she received surgical treatment with Madden's mastectomy with dissection of axillary limphnodes and positioning of an expander. After that she underwent to chemo- and radiotherapy. The schedules we performed were: FEC, TC,Vinorelbine and Capecitabine. Only after the FEC there was a clinical remission just for 1 year. After that she underwent to surgery for the removal of a lozenge of skin on the right hemithorax, including also the subcutaneous tissue, a strip of muscular tissue, and a residue of the breast implant. The histology showed a multiple-nodules infiltration involving the dermis, the hypodermis, and the muscle. This pattern was valuated as a G3 breast cancer recurrence with ER 70%, PgR<5%, Ki67 50% Her2neu-. During the second line chemotherapy with TC she developed an high grade LCIS with lymphovascular infiltration on the left breast; on the right hemithorax there were cutaneous metastases with dermis' infiltration. Surgery with local excision was performed, and a cutaneous flap was realized.
authors.affiliation: A O U Federico II, Napoli, Italy. an.varr89@hotmail.it
authors.forename: Antonio
authors.initials: A
authors.lastname: Varricchio
authors.forename: Lorenzo
authors.initials: L
authors.lastname: Di Libero
authors.forename: Carlo
authors.initials: C
authors.lastname: Iannace
mesh_terms: D001943:Breast Neoplasms / Q000188:drug therapy / Q000473:pathology*; D019008:Drug Resistance, Neoplasm; D005260:Female; D006801:Humans; D008875:Middle Aged; D019651:Plastic Surgery Procedures / Q000379:methods*; D012878:Skin Neoplasms / Q000188:drug therapy / Q000556:secondary* / Q000601:surgery*; D013524:Surgical Flaps