Autologous breast reconstruction in a patient with thalidomide embryopathy: case report

Abstract

Background: Thalidomide has caused thalidomide embryopathy (TE) in more than 10,000 live-born children and is typically associated with phocomelia as well as several other abnormalities such as eye or ear malformations and internal organ defects. Nowadays, thalidomide survivors entered middle age, an age that is susceptible to breast cancer in women.Case Description: Sixty years after the well-known "Contergan Scandal", we present a patient with thalidomide induced phocomelia receiving autologous free flap breast reconstruction. At the age of 49 the patient was diagnosed with multicentric breast cancer requiring neoadjuvant chemotherapy followed by mastectomy and right axillary sentinel lymph node biopsy. One year after mastectomy, an immediate-delayed autologous breast reconstruction using a deep inferior epigastric artery perforator flap was performed. The patient has been followed for 11 years now and still reports to be very satisfied with her reconstructed breast. Conclusions:We demonstrate that the deep inferior epigastric artery perforator flap is a feasible and safe technique to reconstruct the breast in a patient with TE. Given the well-known increased risk for mental disorders in that specific patient population, this case highlights the importance to restore body integrity by breast reconstruction. To the best of our knowledge there exists no literature on breast reconstruction in patients with TE or other physical impairments so far.