This is a pleasant 64 year old female who was initially diagnosed with tubular carcinoma of the breast.  She was treated with breast conservation therapy which included left breast radiation.  This was all done out of state.  After this, she underwent breast augmentation surgery.  Unfortunately, she had a recurrent ductile carcinoma in situ arise, for which she underwent mastectomy and reconstruction out of state.  Her left reconstruction failed due to infection and she presented for salvage reconstruction at our practice in Castle Rock, Colorado.