c l i n i c a l f o l i o s : n a r r a t i v e





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Synchronous Breast and Lung Cancer: 4

A D V E R T I S E M E N T

   
 

Chest CT done as part of the staging work-up showed a lesion in the right upper lobe. Trans-bronchial biopsy was unsuccessful in characterizing this lesion, and percutaneous biopsy was not attempted because of the central location. After negative right sentinel lymph biopsy (see breast cancer overview, frame 21) the patient underwent neoadjuvant chemotherapy with shrinkage of the breast lesion, but no change in the lung lesion.     

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Synchronous Breast and Lung Cancer: 5

A D V E R T I S E M E N T

   
 

The patient was taken to the operating room for combined video-assisted thoracoscopic surgery (VATS) and mastectomy. The resection lines to encompass the breast tumor are shown. Breast conservation was not an option because of the amount of resection necessary and the size of the breast.      

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Synchronous Breast and Lung Cancer: 6

A D V E R T I S E M E N T

   
 

The amount of skin resection necessary to include the nipple-areola complex and get clear margins raised the possibility that primary closure and coverage of the defect might not be possible. Plastic surgery was consulted and prepared for the possibility of a latissimus dorsi flap (see latissimus dorsi musculocutaneous pedicle flap breast reconstruction.) Two thoracoscopic port sites in the anterior axillary line and below the inferior angle of the scapula are marked.     

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This page was last modified on 1/19/2010.