Emergency Toilet Mastectomy for Bleeding, Locally Advanced Triple-Negative Breast Cancer in a High-Risk Cardiac Patient: A Case Report

Abstract We present the case of a 66-year-old Sudanese woman with multiple comorbidities and advanced triple-negative breast cancer (TNBC), who required an emergency toilet mastectomy due to life-threatening hemorrhage from a large, fungating breast mass. The procedure was initially attempted under an axillary block because of her high anesthetic risk; however, the patient developed severe pain and hemodynamic instability intraoperatively. This necessitated urgent airway management with a laryngeal mask airway and conversion to a rapid, damage-control mastectomy to achieve hemostasis. We report this case to highlight the role and feasibility of emergency damage-control toilet mastectomy in a critically unstable patient with advanced TNBC presenting with uncontrollable hemorrhage and to discuss its implications for multidisciplinary decision-making in high-risk oncology patients.