Breast Cancer Mass
A woman in her mid-thirties came to BMC with a large tumor of her left breast which she said had been growing for only 5 months. The mass was so large, in fact, that she wore a cloth like a sling to help manage its weight. There were no external wounds. The nipple and areola (the area around the nipple) were flattened and stretched out. She had enlarged lymph nodes in the axilla (armpit). She had no difficulty breathing and her lungs sounded clear with good air entry. She had no signs of distant metastatic disease.
I performed an ultrasound and found that inside were areas of solid mass and pockets of fluid. Clinically, the tumor appeared to be what is called a Phyllodes tumor or cystosarcoma phyllodes. These tumors can grow very rapidly. Some of these tumors are benign, some are malignant. Either way, the only treatment I could offer was a mastectomy.
After discussing the risks of surgery versus the benefit of a mastectomy, the patient agreed.
The mass was separate from the pectoral muscles of the chest and came off without much difficulty (except that my scrub technician, medical student and I all took turns holding the breast). Also due to its size, I was concerned that I may not be able to close the wound completely. I was prepared to do a skin graft if needed, however, I was able to make a large of enough skin flap on the upper part of the breast which allowed the wound to close very nicely.
The patient experienced pain for only a couple days. After that, she smiled and walked upright, free from the burden of the mass which had been weighing her down.
The pathology came back as a malignant form of cystosarcoma phyllodes.