Case Series: Auto-Amputation of the Breast in Patients with Advanced Breast Cancer

Authors

  • Solomon N Elenwo Department of Surgery, University of Port Harcourt Teaching Hospital
  • Alex A Dimoko Department of Surgery, University of Port Harcourt Teaching Hospital
  • Rex F Ijah Department of Surgery, University of Port Harcourt Teaching Hospital

Keywords:

Breast cancer, Auto-amputation, Breast

Abstract

Background: Breast auto-amputation has been reported in a few articles and it seems to be uncommon, with cases in literature reported in Israel, India, Turkey and South Africa. The aim is to report a case-series of observed breast auto-amputation in patients with advanced breast cancer between 2016 and 2019 at the University of Port Harcourt Teaching Hospital.

Materials and Methods: Information was obtained from patients’ medical records.

Results: Three cases were presented. Case 1 was a 58year old female with histologic diagnosis of ductal carcinoma of the breast who defaulted for three years, represented in advanced stage, and latter had auto-amputation of the breast while on chemotherapy.

Conclusion: There appear to be an emerging need to emphasize on the dangers of delayed breast cancer treatment in favor of alternative care. Inability to afford conventional cancer care is a common denominator in this case-series.

Author Biographies

Solomon N Elenwo, Department of Surgery, University of Port Harcourt Teaching Hospital

Department of Surgery; Consultant Surgeon

Alex A Dimoko, Department of Surgery, University of Port Harcourt Teaching Hospital

Department of Surgery; Consultant Surgeon

Rex F Ijah, Department of Surgery, University of Port Harcourt Teaching Hospital

Department of Surgery; Senior Registrar

References

Favazza AR, Rosenthal RJ. Diagnostic issues in self-mutilation. Hosp Community Psychiatry. 1993; 44(2):134–40.

Rahmanian H, Petrou NA, Sarfraz MA. Self-Amputation in Two Non-Psychotic Patients. Iran J Psychiatry Behav Sci. 2015 Sep; 9(3): e231. doi: 10.17795/ijpbs-231

Jachimowski A, Beil-Gawełczyk J, Trędzbor B. Auto-amputation in a severe depressive episode with psychotic symptoms: case report Archives of Psychiatry and Psychotherapy, 2018; 1: 12–16. DOI: 10.12740/APP/81580.

The Free Dictionary. Auto-amputation. https://medical-dictionary.thefreedictionary.com/autoamputation. (Retrieved on 6th of June 2019)

Kuten A, Cohen Y, Kerner V. Malignant melanoma of the nipple with auto-amputation of the breast. Harefuah 1976; 90: 321-322.

Van der Bijl P. Auto-amputation of a breast due to ductal carcinoma. SAMJ, S. Afr. med. j. 2008; vol.98 n.4 (Accessed on 5th June 2019 @ http://www.scielo.org.za/scielo.php?script=sci_arttext&pid=S0256-95742008000400017)

Mintz U, Keinan Z. Mammary auto-amputation in inoperable carcinoma of the female breast. Harefuah 1975; 88: 531-532.

Firat D, Ozturk G, Demirbas E, Idiz O, Isik A, Eken H. Auto-Amputation of the Breast; a Rare Case Caused by Invasive Ductal Carcinoma. The Breast Journal 2017; Volume 23 Number 1:102–103. DOI: 10.1111/tbj.12696

Moinfar F, Mannion C, Man Y, et al. Mammary 'comedo' DCIS: apoptosis, oncosis and necrosis: an electron microscopic examination of 8 cases. Ultrastruct Pathol. 2000; 24: 135-144.

El Saghir NS, Eniu A, Carlson RW, Aziz Z, Vorobiof D, Hortobagyi GN, Breast Health Global Initiative Systemic Therapy Focus Group. Locally advanced breast cancer: Treatment guideline implementation with particular attention to low‐and middle‐income countries. Cancer. 2008 Oct 15;113(S8):2315-24.

Souchon R, Wenz F, Sedlmayer F, Budach W, Dunst J, Feyer P, Haase W, Harms W, Sautter-Bihl ML, Sauer R. DEGRO practice guidelines for palliative radiotherapy of metastatic breast cancer. Strahlentherapie und Onkologie. 2009 Jul 1;185(7):417-24.

Geels P, Eisenhauer E, Bezjak A, Zee B, Day A. Palliative effect of chemotherapy: objective tumor response is associated with symptom improvement in patients with metastatic breast cancer. Journal of Clinical Oncology. 2000 Jun 12;18(12):2395-405.

DeWALD RL, Bridwell KH, Prodromas CH, Rodts MF. Reconstructive spinal surgery as palliation for metastatic malignancies of the spine. Spine. 1985;10(1):21-6.

Beslija S, Bonneterre J, Burstein HJ, Cocquyt V, Gnant M, Heinemann V, Jassem J, Köstler WJ, Krainer M, Menard S, Petit T. Third consensus on medical treatment of metastatic breast cancer. Annals of oncology. 2009 Nov 1;20(11):1771-85.

Sledge Jr GW, Hu P, Falkson G, Tormey D, Abeloff M, Eastern Cooperative Oncology Group. Comparison of chemotherapy with chemohormonal therapy as first-line therapy for metastatic, hormone-sensitive breast cancer: An Eastern Cooperative Oncology Group study. Journal of clinical oncology. 2000 Jan 1;18(2):262-.

Lipton A, Ali SM, Leitzel K, Demers L, Chinchilli V, Engle L, Harvey HA, Brady C, Nalin CM, Dugan M, Carney W. Elevated serum Her-2/neu level predicts decreased response to hormone therapy in metastatic breast cancer. Journal of Clinical Oncology. 2002 Mar 15;20(6):1467-72.

Hortobagyi GN, Hug V, Buzdar AU, Kau SW, Holmes FA, Fritsche HA. Sequential cyclic combined hormonal therapy for metastatic breast cancer. Cancer. 1989 Sep 1;64(5):1002-6.

Badwe R, Parmar V, Hawaldar R, Nair N, Kaushik R, Siddique S, Navale A, Budrukkar A, Mittra I, Gupta S. Abstract S2-02: Surgical removal of primary tumour and axillary lymph nodes in women with metastatic breast cancer at first presentation: A randomized controlled trial.

Carmichael AR, Anderson ED, Chetty U, Dixon JM. Does local surgery have a role in the management of stage IV breast cancer? European Journal of Surgical Oncology (EJSO). 2003 Feb 1;29(1):17-9.

Hazard HW, Gorla SR, Scholtens D, Kiel K, Gradishar WJ, Khan SA. Surgical resection of the primary tumour, chest wall control, and survival in women with metastatic breast cancer. Cancer. 2008 Oct 15;113(8):2011-9.

Morrow M, Van Zee KJ, Patil S, Petruolo O, Mamtani A, Barrio AV, Capko D, El-Tamer M, Gemignani ML, Heerdt AS, Kirstein L. Axillary dissection and nodal irradiation can be avoided for most node-positive Z0011-eligible breast cancers: a prospective validation study of 793 patients. Annals of surgery. 2017 Sep;266(3):457.

Prat A, Pineda E, Adamo B, Galván P, Fernández A, Gaba L, Díez M, Viladot M, Arance A, Muñoz M. Clinical implications of the intrinsic molecular subtypes of breast cancer. The Breast. 2015 Nov 1;24: S26-35.

Hon JD, Singh B, Sahin A, Du G, Wang J, Wang VY, Deng FM, Zhang DY, Monaco ME, Lee P. Breast cancer molecular subtypes: from TNBC to QNBC. American journal of cancer research. 2016;6(9):1864.

Anders CK, Peppercorn J. Treating in the dark: unanswered questions on costs and benefits of late line therapy for metastatic breast cancer. Cancer investigation. 2009 Jan 1;27(1):13-6.

Agarwal P, Sharma D. Autoamputation of breast following breast carcinoma. The Internet Journal of Surgery. 2008; Volume 18 Number 1. Accessed on 5th July 2019 @ http://ispub.com/IJS/18/1/6994

Downloads

Published

2020-10-08

How to Cite

Elenwo, S. N., Dimoko, A. A., & Ijah, R. F. (2020). Case Series: Auto-Amputation of the Breast in Patients with Advanced Breast Cancer. The Nigerian Health Journal, 20(2), 72–77. Retrieved from https://tnhjph.com/index.php/tnhj/article/view/473

Issue

Section

Case Report and Series

Similar Articles

1 2 3 > >> 

You may also start an advanced similarity search for this article.