Cellulitis Occurring 21 Years After Radiofrequency Ablation for Breast Cancer: A Case Report

A 67-year-old woman had undergone radiofrequency ablation (RFA) for right breast cancer at a university hospital 21 years before and visited our hospital for annual breast surveillance after finishing the 10-year follow-up. During the annual breast surveillance, unexplained and unintentional weight loss made the subcutaneous fat just above the RFA nodule thin. It caused cellulitis due to the RFA nodule-related stimuli to the overlying skin. Image evaluation clarified the strong adhesion between the RFA nodule and the overlying skin. After recovery from cellulitis, the patient requested resection of the RFA nodule to prevent recurrence. The patient, however, already had marked asymmetry of the breasts due to the radiation-induced shrinkage of the right breast. The patient, therefore, underwent breast surgeries as follows to get better cosmetic outcomes. The patient underwent RFA nodule resection via a retromammary space approach through a lateral vertical skin incision, achieving a difficult but successful complete removal of the RFA nodule. After that, the shrunken and hard right mammary gland was partially incised in several linear fashions from the retromammary space, followed by immediate breast augmentation using the latissimus dorsi musculocutaneous flap. Additionally, the left breast was treated with inverted T reduction mammoplasty, successfully leading to the favorable cosmesis of the breasts. The patient recovered uneventfully, is fully satisfied with the cosmetic outcomes of her breasts after the operation, and is scheduled to further receive annual breast surveillance on an outpatient basis. Breast surgeons should note that the RFA indication for breast cancer should not only include breast cancer characteristics but also late and aging-related complications.