Split thickness skin graft in oncologic surgery for ulcerating breast cancer – a case report

Summary Surgery for locally advanced breast cancer represents a challenge for the senologist especially with large exophytic cancer and no response to chemotherapy. This case report demonstrates the beneficial effects of autologous split thickness skin (German: "Spalthaut") grafting as a palliative option in oncologic surgery which could promote patient comfort, hygiene and satisfaction.

Anamnesis and clinical findings 67 years old woman with oligo-metastatic triple negative breast cancer was referred to our hospital after experiencing a decline from palliative surgery in other centers due to difficulty of covering the large defect. Clinical examination showed an ulcerating, fungating tumor sized 25 cm in diameter in the right breast associated with lymphedema in the right arm.The patient underwent different chemotherapy cycles as a palliative treatment over one year without locoregional improvement.

Therapy and outcome Following the patient´s request, a radical mastectomy and split thickness skin grafting was performed by IBR, MCR, WS and JS as ultima ratio since no local or distant flap was reasonable. Recovery was uneventful with satisfactory healing of graft tissue and functional aspect of the arm. We present a palliative surgery technique which can readily be adopted by other centers ([Fig. 1]), ([Fig. 2]).

Fig. 1 Finding before (A) and after.

Fig. 1 (B) operation

Publication History

Article published online:
11 October 2022