Faculty Collaboration Database

Surgical Management of Breast Amyloidosis. Clin Breast Cancer 2023 Aug;23(6):e359-e367

Date

06/26/2023

Pubmed ID

37357131

DOI

10.1016/j.clbc.2023.06.001

Scopus ID

2-s2.0-85162854034 (requires institutional sign-in at Scopus site)

Abstract

Amyloidosis is characterized by extracellular deposition of insoluble misfolded beta-pleated proteins. Amyloid disease involving the breast is rare and there is a paucity of literature guiding surgical management in caring for these patients. In this article we review medical and surgical management with an emphasis on post mastectomy breast reconstruction. We propose an algorithm for breast reconstructive options based on unique considerations in this patient population. An institutional database at the Medical College of Wisconsin was used to identify patients diagnosed with breast amyloidosis from 2011 to 2021. We utilized the electronic medical record to present patient demographics, diagnostic and treatment data regarding the medical and surgical management of these patients. Five women were identified with a median age of 70 years and a median follow up of 19 months (range, 9-80 months). All patients were diagnosed with light chain (AL) type of amyloidosis. Systemic amyloidosis was identified in 3 patients and localized disease was identified in 2 patients. Concurrent breast malignancy was identified in 2 patients who underwent skin-sparing mastectomies followed by breast reconstruction with both prosthetic and autologous techniques. Both prosthetic and autologous reconstructive techniques are safe in patients with amyloidosis, however careful consideration and preoperative work-up are warranted to avoid complications in this vulnerable population. Further studies are warranted to improve surgical outcomes in patients with amyloidosis involving the breast.

Author List

Bacos JT, Doren E, D'Souza A, Jorns J, Kong A

Authors

Anita D'Souza MD Associate Professor in the Medicine department at Medical College of Wisconsin
Julie M. Jorns MD Professor in the Pathology department at Medical College of Wisconsin
Amanda L. Kong MD, MS Professor in the Surgery department at Medical College of Wisconsin

MESH terms used to index this publication - Major topics in bold

Amyloidosis
Breast
Breast Implants
Breast Neoplasms
Child
Child, Preschool
Female
Humans
Infant
Mammaplasty
Mastectomy
Retrospective Studies