Thoracic approach for suspected internal mammary lymph node recurrence following mastectomy and implant-based reconstruction: a case report

The use of video-assisted thoracic surgery (VATS) has increased in recent years. We herein report a case wherein suspected intramammary lymph node (IM) recurrence of breast cancer was treated using the thoracic approach (VATS). A 53-year-old woman had undergone right total mastectomy, axillary lymph node dissection, and implant-based reconstruction for right breast cancer 19 years ago. Hormone therapy was commenced postoperatively. Positron emission tomography as health check up performed at another hospital 1 year prior to presentation revealed enlargement of the right IMs, suggesting recurrence of breast cancer. IM biopsy was performed using VATS to preserve the artificial breast implant. The operative time and blood loss were 157 min and 20 ml, respectively. The postoperative course was favourable. IM biopsy revealed reactive enlargement owing to inflammation. In conclusion, VATS is a safer approach that yields superior outcomes in terms of appearance care.