Date of Presentation
5-2-2024 12:00 AM
College
Rowan-Virtua School of Osteopathic Medicine
Poster Abstract
Background: Pacemaker leads within the breast are rare. Although it is infrequent, there are some reports of implanted cardiac devices or wires migrating into breast tissue or through the chest wall. To the best of our knowledge, there are no current reports of pacemaker leads within the breast tissue of a patient with concurrent breast cancer. This case aims to detail the surgical management of this rare phenomenon.
Case Presentation: A pacemaker-dependent, female patient presented to the operating room for a left breast excisional biopsy. Intraoperatively, two epicardial leads were unexpectedly found within the center of the patient’s breast tissue. Since the two leads were found to be transecting the left breast mass, the mass was removed in pieces. Postoperative pathology revealed a 2.2 cm invasive papillary carcinoma. Due to concern for unclear margin status, the patient elected for a left modified radical mastectomy and sentinel lymph node biopsy following the implantation of a new pacemaker lateralized to the right side of the chest. Following this operation, final pathology was negative for residual cancer. Sentinel lymph node biopsy was negative.
Conclusion: This case describes an interdisciplinary approach to the relocation of a permanent pacemaker and clinical treatment of a patient’s breast cancer. If encountered, the presence of a pacemaker lead within the breast of a patient with breast cancer will likely require an individualized management strategy. Therefore, collaboration between cardiologists and surgeons is vital to successful clinical management of this phenomenon.
Keywords
Breast cancer, pacemaker, cardiac pacemaker, mastectomy, Cardiac Pacemaker, Multidisciplinary Care
Disciplines
Cardiology | Medicine and Health Sciences | Neoplasms | Oncology | Patient Safety | Surgery | Surgical Procedures, Operative
Document Type
Poster
Included in
Cardiology Commons, Neoplasms Commons, Oncology Commons, Patient Safety Commons, Surgery Commons, Surgical Procedures, Operative Commons
An Unexpected Finding During a Breast Excisional Biopsy: A Case Report
Background: Pacemaker leads within the breast are rare. Although it is infrequent, there are some reports of implanted cardiac devices or wires migrating into breast tissue or through the chest wall. To the best of our knowledge, there are no current reports of pacemaker leads within the breast tissue of a patient with concurrent breast cancer. This case aims to detail the surgical management of this rare phenomenon.
Case Presentation: A pacemaker-dependent, female patient presented to the operating room for a left breast excisional biopsy. Intraoperatively, two epicardial leads were unexpectedly found within the center of the patient’s breast tissue. Since the two leads were found to be transecting the left breast mass, the mass was removed in pieces. Postoperative pathology revealed a 2.2 cm invasive papillary carcinoma. Due to concern for unclear margin status, the patient elected for a left modified radical mastectomy and sentinel lymph node biopsy following the implantation of a new pacemaker lateralized to the right side of the chest. Following this operation, final pathology was negative for residual cancer. Sentinel lymph node biopsy was negative.
Conclusion: This case describes an interdisciplinary approach to the relocation of a permanent pacemaker and clinical treatment of a patient’s breast cancer. If encountered, the presence of a pacemaker lead within the breast of a patient with breast cancer will likely require an individualized management strategy. Therefore, collaboration between cardiologists and surgeons is vital to successful clinical management of this phenomenon.