A giant papillary carcinoma of the breast treated with mastectomy and bipedicled TRAM flap

In cases of large tumours with skin infiltration the radi-cal mastectomy with breast reconstruction may be thefirst indication. Many surgical options are available.However, since Hartrampf first described the transverserectus abdominis myocutaneous (TRAM) flap for brea-st reconstruction in 1982, this procedure has becomevery popular and largely used both for breast recon-struction and thoracic wall repair