title: Immediate chest wall reconstruction during pregnancy: surgical management after extended surgical resection due to primary sarcoma of the breast.
abstract: BACKGROUND
  Breast sarcoma during pregnancy is an extremely rare event and represents a complex problem because of a more advanced stage at presentation.
  
  
  METHODS
  This report presents the first case of a 24-year-old woman with a gestational age of 20 weeks with a fast growing tumour in her left breast (29 × 19 × 15 cm) and infiltrating the skin/pectoralis muscles. Radical mastectomy was performed with a gestational age of 22 weeks and a different design was planned for the latissimus dorsi musculocutaneous flap (LDMF) with primary closure in the V-Y pattern.
  
  
  RESULTS
  Satisfactory chest wall coverage and contour were achieved. Final histopathological findings allowed a diagnosis of undifferentiated sarcoma. With a gestational age of 37 weeks, a healthy infant was delivered by means of a caesarean section. The patient is currently in the second postoperative year and no recurrence has been observed.
  
  
  CONCLUSIONS
  Management of a large breast sarcoma in a pregnant patient presents unique challenges in consideration of the potential risks to the foetus and the possible maternal benefit. The results of this study demonstrate that the VY-LDMF is a reliable technique and should be considered in cases of immediate large thoracic wound reconstruction.
authors.affiliation: Cancer Institute of São Paulo, São Paulo, Brazil.
authors.forename: Eduardo Gustavo
authors.initials: EG
authors.lastname: Arruda
authors.affiliation: Hospital Sírio-Libanês, São Paulo, Brazil. Electronic address: munhozalex@uol.com.br.
authors.forename: Alexandre Mendonça
authors.initials: AM
authors.lastname: Munhoz
authors.affiliation: Cancer Institute of São Paulo, São Paulo, Brazil.
authors.forename: Eduardo
authors.initials: E
authors.lastname: Montag
authors.affiliation: Cancer Institute of São Paulo, São Paulo, Brazil.
authors.forename: José Roberto
authors.initials: JR
authors.lastname: Filassi
authors.affiliation: University of São Paulo, São Paulo, Brazil.
authors.forename: Rolf
authors.initials: R
authors.lastname: Gemperli
mesh_terms: D000328:Adult; D001943:Breast Neoplasms / Q000601:surgery*; D002585:Cesarean Section; D005260:Female; D006801:Humans; D015409:Mastectomy, Radical; D011247:Pregnancy; D011252:Pregnancy Complications, Neoplastic / Q000601:surgery*; D019651:Plastic Surgery Procedures; D012509:Sarcoma / Q000601:surgery*; D013524:Surgical Flaps; D047929:Term Birth; D035441:Thoracic Wall / Q000601:surgery*; D055815:Young Adult
keywords: Breast cancer; Breast reconstruction; Latissimus dorsi myocutaneous flap; Pregnancy; Sarcoma