Bilateral Thoracodorsal Neuromas: A Cause of Persistent Breast Pain after Bilateral Latissimus Dorsi Breast Reconstruction

499 same procedure to access the IMC SLN immediately following a mastectomy. In the more difficult case where there is not a mastectomy, the use of the vertical mastopexy incision can allow access to the rib cartilage and the IMC without creating a parasternal incision, which would cause an unsightly scar. For these reasons, a plastic surgeon performs SLNB of IMC nodes at our institution. This case demonstrates the safety and efficacy of IMC SLN node biopsy when done by the reconstructive plastic surgeon, and how knowledge of IMC nodal status can influence the course of treatment. In a multidisciplinary approach to the treatment of breast cancer, the plastic surgeon is responsible for reconstruction but can also be instrumental in determining staging and treatment. IMC SLN biopsy is an important technique in the evaluation of early breast cancer in select patients, and we believe that the plastic surgeon has the ideal skill set to perform it safely and effectively.