# Surgical Management of Breast Cancer Adjacent to a Calcified Ventriculoperitoneal Shunt: A Case Report

## TL;DR

A rare case of breast cancer near a calcified shunt was managed with mastectomy and catheter removal, showing no cancer spread.

## Contribution

This case report provides guidance on managing VP shunt hardware during breast cancer surgery.

## Key findings

- The VP shunt catheter was rerouted and removed with the breast tissue during mastectomy.
- Pathological analysis confirmed invasive ductal carcinoma without cancer progression along the catheter.

## Abstract

Breast cancer arising in tissue adjacent to a ventriculoperitoneal (VP) shunt is exceptionally rare, and there is little guidance on how to manage the shunt hardware during oncologic surgery in such cases.

The patient was a 46-year-old woman with a history of intellectual disability and hydrocephalus. She had undergone VP shunt placement via the left chest wall for hydrocephalus during childhood. Decades later, she was admitted to our hospital for the examination and treatment of left breast cancer. Imaging studies revealed a tumor in the left nipple, with the shunt catheter passing as close as 12 mm from the tumor. During radical mastectomy for breast cancer, it became clear that preserving the catheter was not feasible. Consequently, the shunt catheter was rerouted, and both the left breast and the catheter were removed as a single unit. Pathological findings of a resection specimen revealed invasive ductal carcinoma pT2N1M0, pStage IIB. Although the catheter had been positioned very closely to the tumor, no cancer progression was observed along the catheter.

The present case is noteworthy for describing a rare case of mastectomy for breast cancer involving repositioning of an ipsilateral catheter. Included in this report is a review of past studies.