A 56-year-old woman underwent right mastectomy and sentinel node biopsy for stage I (T1 N0 M0)(see breast cancer staging) infiltrating ductal carcinoma. Tumor board recommendation for adjuvant therapy was Tamoxifen (TAM, see hormonal therapy of breast cancer). The patient had had prior biopsy of the left breast that contained lobular neoplasia and atypical ductal hyperplasia. There was no strong family history (see breast cancer genetics) of breast cancer. Initiation of TAM was deferred until after prophylactic left total mastectomy and bilateral reconstruction.
Six weeks after the right mastectomy, the patient was returned to the operating room for left total mastectomy and bilateral saline tissue expander placement. The skin-sparing mastectomy incision was marked by the plastic surgeon in the holding area.
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