Reduction mammoplasty as a treatment for symptomatic central venous stenosis

Central venous stenosis is a rare cause of unilateral breast edema occurring in hemodialysis patients that needs to be differentiated from other differential diagnoses, including, but not limited to, inflammatory breast carcinoma, mastitis, lymphedema, and congestive heart failure. All reports of similar cases in the available literature have described improvement or resolution of the edema after treatment. Herein, we report and discuss the pathophysiology of breast edema formation in a patient who presented with massive left-sided breast edema 7 years after being diagnosed with central venous stenosis. Medical and minimally invasive therapy had not been successful, so she underwent reduction mammoplasty to relieve the symptoms.

Keywords

Breast - Edema - Axillary vein - Upper extremity deep vein thrombosis

Publication History

Received: 06 December 2016

Accepted: 26 May 2017

Article published online:
22 May 2022

• REFERENCES

• 1 Akan H, Arik N, Yalin T, Malazgirt Z. Unilateral breast enlargement: a rare complication of subclavian vein catheterization for hemodialysis. Comput Med Imaging Graph 2001; 25: 357-9
• 2 Kwak JY, Kim EK, Chung SY. et al. Unilateral breast edema: spectrum of etiologies and imaging appearances. Yonsei Med J 2005; 46: 1-7
• 3 Blum C, Baker M. Venous congestion of the breast mimicking inflammatory breast cancer: case report and review of literature. Breast J 2008; 14: 97-101
• 4 Gadallah MF, El-Shahawy MA, Campese VM. Unilateral breast enlargement secondary to hemodialysis arteriovenous fistula and subclavian vein occlusion. Nephron 1993; 63: 351-3
• 5 Kavallieratos N, Kokkinos A, Kalocheretis P. Axillary to saphenous vein bypass for treatment of central venous obstruction in patients receiving dialysis. J Vasc Surg 2004; 40: 640-3
• 6 Kuerer HM, Wilson MW, Bowersox JC. Innominate vein stenosis mimicking locally advanced breast cancer in a dialysis patient. Breast J 2001; 7: 128
• 7 Lombi F, Garcia A, Young P. et al. Unilateral breast enlargement due to a high-flux ipsilateral hemodialysis fistula. J Vasc Access 2010; 11: 169-70
• 8 Mickley V. Central vein obstruction in vascular access. Eur J Vasc Endovasc Surg 2006; 32: 439-44
• 9 Miller GA, Friedman A, Khariton A, Jotwani MC, Savransky Y. Long thoracic vein embolization for the treatment of breast edema associated with central venous occlusion and venous hypertension. J Vasc Access 2010; 11: 115-21
• 10 Pacheo D, Polo JR, Lopez-Baena JA, Vega D, Echenagusia A, Ferreras I. Unilateral breast enlargement secondary to right brachiocephalic vein occlusion. Am J Kidney Dis 2000; 35: E26
• 11 Phillips GS, Scheel Jr PJ, Zeiger MA. Unilateral breast enlargement: four case reports of an “unusual” presentation of central vein stenosis in patients undergoing hemodialysis. Surgery 1998; 123: 699-701
• 12 Ruiz-Valverde MP, Fort J, Camps J, Olmos A, Piera L. Unilateral breast and arm enlargement secondary to haemodialysis arteriovenous fistula without subclavian vein occlusion. Nephrol Dial Transplant 1994; 9: 85-6
• 13 Schiffer JT, Jefferson BK. Cases from the Osler Medical Service at Johns Hopkins University. Am J Med 2003; 115: 404-6
• 14 Tekbas G, Oguzkurt L, Gurel K, Ozkan U, Gur S, Onder H. Is unilateral breast enlargement always a sign of cancer?. Hemodial Int 2011; 15: 553-8
• 15 Topf G, Jenkins P, Gutmann FD, Rieselbach RE, Saltzstein EC. Unilateral breast enlargement: a complication of an arteriovenous fistula and coincidental subclavian vein occlusion. JAMA 1977; 237: 571-2
• 16 Uzun M, Akkan MK, Uzun F, Karaosmanogu D. Asymmetric venous engorgement of the breast due to a high output hemodialysis fistula. J Clin Ultrasound 2009; 37: 163-4
• 17 Wright RS, Quinones-Baldrich WJ, Anders AJ, Danovitch GM. Pleural effusion associated with ipsilateral breast and arm edema as a complication of subclavian vein catheterization and arteriovenous fistula formation for hemodialysis. Chest 1994; 106: 950-2
• 18 Yalavarthy U, Agrawal VK, Showkat A. Unilateral breast swelling as a complication of innominate vein stenosis in a hemodialysis patient. Clin Nephrol 2011; 75 Suppl 1: 56-9
• 19 Youssef JJ, Brown CD, Friedman EA. Asymmetric breast enlargement minus central venous thrombosis in a hemodialysis patient. Hemodial Int 2008; 12: 30-3
• 20 Oguzkurt L, Tercan F, Yildirim S, Torun D. Central venous stenosis in haemodialysis patients without a previous history of catheter placement. Eur J Radiol 2005; 55: 237-42