Left Breast Necrosis Following Cardiac Bypass Surgery

Rosato, Francis E.; Schaner, Patrick J.; Chojnacki, Karen A.; Rosato, Ernest L.

doi:10.1111/j.1075-122x.2006.00308.x

Cited by 11 publications

(11 citation statements)

References 6 publications

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“…There was no need for any further plastic surgical reconstructions, as opposed to the works of and Rashid et al and Morris et al [5, 13] (post-mastectomy skin-graft), or Harish et al [11] (vertical rectus abdominis myocutaneous flap). Post-mastectomy healing is undoubtedly influenced by the extent of necrosis—if necrotic tissue is completely included in the resected mass, healing by first intention may be expected, as what occurred in our case and some other published works [7, 10]. …”

Section: Discussionsupporting

confidence: 71%

“…In the three cases described by Wong et al, the construction of the pectoralis major myocutaneous flap, which was used for surgical treatment of dehisced sternotomy, may had contributed to the breast necrosis [9]. In another case, described by Rosato, blood perfusion of the mammary gland was damaged by the previous treatment of breast cancer, which included partial mastectomy, axillary dissection, and radiotherapy [7]. The most patients with breast necrosis following IMA harvest also suffered from diabetes mellitus and hypertension.…”

Section: Discussionmentioning

confidence: 99%

“…As for the treatment, debridement, antibiotic therapy, and healing by conservative ways through granulation were sufficient in the two of the so far described cases [4, 8]. In other cases, the condition was handled by more extensive resections, through partial or total mastectomy [5, 7, 10, 11, 13], sometimes with resection of thoracic or abdominal walls [5, 7, 10]. Subsequent surgical reconstructions with skin grafts or more complex fasciocutaneous or musculocutaneous flaps occasionally had to be used [5, 6, 9, 11].…”

Section: Discussionmentioning

confidence: 99%

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Focal necrosis mimicking breast cancer following coronary bypass grafting

et al. 2017

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BackgroundBreast cancer can be diagnosed easily in most cases. However, occasionally, we are faced with some conditions that can mimic it. These may include inflammations, benign tumors, cysts, hematomas, or, more rarely, focal necrosis.Case presentationThis report presents a case of focal breast necrosis following myocardial revascularization with the left internal mammary artery, which is a very rare condition, with only few cases described in the literature. The necrosis becomes usually apparent a few days or weeks after the surgery and is often coincidental with the dehiscence of sternotomy with necrosis of wound edges. As it mostly affects the skin, it can be easily recognized. Also, our patient developed a dehisced sternotomy shortly after the surgery but there were no obvious objective changes on the breast. The condition was first dominated only by non-specific subjective symptom—pain. Later, a lump in the breast occurred, when the sternotomy had already healed. Moreover, an enlarged lymph node was palpable in the axilla. Because of non-typical symptoms, the condition was suggestive of breast cancer for a relatively long time. The patient had suffered from a very strong pain until she was treated by mastectomy with a good clinical result.ConclusionsMammary necrosis following the coronary artery bypass is rare. In most cases, it manifests on the skin shortly after the surgery concurrently with dehisced sternotomy, so it can be easily diagnosed. However, in sporadic cases, the symptoms may occur later and may mimic breast cancer. Our objective is to raise awareness of this rare condition.

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Section: Discussionsupporting

confidence: 71%

Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

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Focal necrosis mimicking breast cancer following coronary bypass grafting

et al. 2017

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“…3 The association of cardiac surgery with partial or total breast necrosis is extremely rare, even in the presence of complex cardiac procedures, because the breast is a highly vascular organ. 2,[4][5][6][7][8] The IMA, also known as internal thoracic artery, is the major source (almost 60%) of breast vascularization, but the breast is also irrigated by the external mammary artery and intercostals branches.…”

Section: Introductionmentioning

confidence: 99%

“…5 In other reports, there was an unusual combination of calciphylaxis, which decreased vascular breast capacity and loss of IMA. 4,6,8 One author reported a partial breast necrosis after an abscess of the sternal wound. 2 After reviewing these cases, it is not clear whether the necrosis is directly related to breast vascular insufficiency.…”

Section: Introductionmentioning

confidence: 99%