Palliative Surgery to Restore Function and Dignity: A Case of Massive Breast Tumor Debulking in Rural Uganda.

BACKGROUND

Palliative surgery plays a critical role in alleviating symptom burden and thus improving quality of life in patients with advanced disease.

CASE PRESENTATION: This is a case of a 23-year-old female in rural Uganda with an untreated, massive right breast mass present since infancy and progressive abdominal distention of unclear etiology. Over time, the breast mass impaired her mobility, rendering her largely homebound and dependent on others for basic movement. Despite evidence of profound malnutrition, the patient expressed a clear goal: to regain the ability to walk in the time she had left. After multidisciplinary discussions and goals-of-care conversations, she was able to undergo medical optimization. She underwent a right total mastectomy under limited anesthesia. A 9.6 kg mass was successfully removed without complication. Postoperatively, she regained independent ambulation and reported significant improvement in quality of life.

DISCUSSION: This case highlights the value of palliative surgery in restoring function and dignity in the context of limited life expectancy. Patient-centered decision-making prioritizing patient values, clear communication, and interdisciplinary collaboration are all important considerations in decision-making. In low-resource settings, where access to early diagnosis and treatment is often limited, palliative surgical interventions can offer meaningful improvements in autonomy and well-being.

CONCLUSION

Palliative surgery, when aligned with patient goals, can provide substantial functional and psychosocial benefits.