title: Simultaneous breast and axillary recurrence in a patient with a history of breast cancer and ipsilateral upper extremity melanoma: challenges in diagnosis and management.
abstract: BACKGROUND
  Nodal patterns of spread for breast cancer and melanoma have been extensively studied in the literature. The phenomenon of upper extremity melanoma and ipsilateral breast cancer has been previously reported. We describe a rare case of a simultaneous locoregional recurrence of both malignancies.
  
  
  METHODS
  A patient with a previous diagnosis of stage 1A melanoma of the left upper extremity at age 29 developed left breast invasive ductal carcinoma 1 year later. The patient underwent a wide local excision with negative margins for the melanoma and a partial mastectomy with axillary dissection followed by chemotherapy and radiation therapy for her breast cancer. Five years later she was diagnosed with a dual recurrence while 36 weeks pregnant.
  
  
  CONCLUSIONS
  Regular follow-up according to the NCCN guidelines is critical in diagnosing a recurrence of malignancy. Pathologic analysis is paramount in dictating management strategies in rare cases of dual recurrence.
authors.forename: Malcolm
authors.initials: M
authors.lastname: Ross
authors.forename: Lejla
authors.initials: L
authors.lastname: Hadzikadic Gusic
authors.forename: David J
authors.initials: DJ
authors.lastname: Dabbs
authors.forename: Joseph
authors.initials: J
authors.lastname: Kelley
authors.forename: Emilia
authors.initials: E
authors.lastname: Diego
mesh_terms: D000328:Adult; D061067:Antibodies, Monoclonal, Humanized / Q000008:administration & dosage; D000971:Antineoplastic Combined Chemotherapy Protocols / Q000627:therapeutic use*; D001132:Arm; D001365:Axilla; D001943:Breast Neoplasms / Q000175:diagnosis / Q000628:therapy*; D000069287:Capecitabine; D018270:Carcinoma, Ductal, Breast / Q000175:diagnosis* / Q000628:therapy*; D002285:Carcinoma, Intraductal, Noninfiltrating / Q000175:diagnosis / Q000628:therapy; D017024:Chemotherapy, Adjuvant; D003841:Deoxycytidine / Q000008:administration & dosage / Q000031:analogs & derivatives; D005260:Female; D005472:Fluorouracil / Q000008:administration & dosage / Q000031:analogs & derivatives; D006801:Humans; D007372:Interferons / Q000008:administration & dosage; D008197:Lymph Node Excision; D016462:Mammaplasty; D015412:Mastectomy, Segmental / Q000379:methods; D015413:Mastectomy, Simple; D008545:Melanoma / Q000556:secondary*; D060787:Neoplasm Grading; D009364:Neoplasm Recurrence, Local / Q000175:diagnosis* / Q000628:therapy*; D009378:Neoplasms, Multiple Primary / Q000175:diagnosis* / Q000473:pathology / Q000628:therapy*; D010348:Patient Care Team; D011247:Pregnancy; D011252:Pregnancy Complications, Neoplastic / Q000175:diagnosis* / Q000473:pathology / Q000628:therapy*; D012878:Skin Neoplasms / Q000473:pathology*; D000068878:Trastuzumab
chemical_list: D061067:Antibodies, Monoclonal, Humanized; D003841:Deoxycytidine; D000069287:Capecitabine; D007372:Interferons; D000068878:Trastuzumab; D005472:Fluorouracil