From failure in prevention to a hygienic mastectomy.

Mastectomía higiénica: cuando realizarla

Introduction: Cleaning or hygienic mastectomy is indicated for palliative purposes in locally advanced breast cancer, and has been proposed as an important surgical method through which abrupt problems that put the patient's life at risk can be resolved.

Objective: The objective of the manuscript patient is to present the case of one that required management with an emergency mastectomy.

Clinical case: A 63-year-old woman with a history of metastatic ductal left breast cancer. Assistance to the emergency service due to the appearance of bleeding in the left sinus with a metastatic mass. On physical examination, tachycardia was found, with obesity and in the left breast an indurated fungoid mass was observed that compromised the entire mammary gland with evidence of fibrin secretion and moderate active bleeding in layers at the level of the tumor lesion, she had severe normochromic normocytic anemia. (6.6 g/dl), for which he decided to perform a transfusion of 2 units of red blood cells, compressive bandage in the area of bleeding, tranexamic acid 500 mg every 8 hours and ampicillin-sulbactam 3 g every 6 hours. Given the poor response to the established management and persistent bleeding with a tendency to anaemia, a cleansing (hygienic) mastectomy was performed.

Conclusions: Cleaning or hygienic mastectomy is a therapeutic method which is not indicated as an optimal control measure for locally invasive breast cancer, however, this strategy can be used in some complications that can occur as in the case presented. where there was evidence of hemorrhage and infection of the tumor lesion.