A Case of Titanium Clip Allergy after Breast Cancer Surgery Occurring after 3 Years and Resolving after Clip Removal

Abstract

A woman in her 50s presented with a 15-mm irregular mass in her left breast and was diagnosed with a left breast cancer (cT1N0M0 stage 1, ER+/PgR+/Her2-, Ki67 index 2%). Left breast-conserving surgery and sentinel lymph node biopsy were performed, and titanium clips were placed on the resection edge of the breast. As postoperative treatment, radiation therapy (50 Gy/25 Fr) and endocrine therapy (TAM to TOR) were administered. Three years after surgery, she presented again with hyperpigmentation, skin rash, and itching near the surgical site. After six months of follow-up, her symptoms did not improve. Suspecting allergy to titanium clips, we performed a titanium patch test, which produced a negative result. However, her symptoms worsened with generalized pruritus. Therefore, we decided to remove the intramammary clips. After marking the location of the clips under CT guidance, we performed an intramammary titanium clip removal. After the surgery, local and general skin symptoms gradually improved and disappeared. We report a case of metal allergy to titanium clips used for breast conservation surgery, occurring 3 years after surgery and resolving after surgical removal of the clips.