OBJECTIVE: In this study, we investigated the surgical results for chest wall invasion of local recurrence of breast cancer. PATIENTS AND METHODS: We reviewed eight patients who underwent a chest wall resection for local recurrence of breast cancer in our department between 1986 and 2004. RESULTS: All of the patients had local recurrence without any distant metastasis. All of them had skin ulcers with blood oozing. The operation procedures were Bt + Ax + Ic + Mj + Mn (Halsted mastectomy) in four patients, Bt + Ax + Ic + Mn (Patey procedure) in two patients, Bt + Ax + Ic (muscle-preserving mastectomy) in one patient, and Bt + Ax (Auchincloss procedure) in one patient. The intervals from the primary operation ranged from 14 months to 20 years. The maximum and minimum areas of the chest wall defect were 18 x 16 cm and 4.5 x 3.5 cm, respectively. Reconstruction of the chest wall was performed using a flap of the rectus abdominis muscle with polypropylene (Marlex) mesh in four patients, a flap of the rectus abdominis muscle combined with sandwich prosthesis of polypropylene mesh and methylmethacrylate in one patient, a flap of latissimus dorsi muscle in one patient, polypropylene mesh with pectoralis major muscle in one patient, and by direct closure in one patient. A survival of more than 3 years was achieved in seven patients and only one patient died 1 year and 2 months after the chest wall resection. CONCLUSION: In patients with the chest wall recurrence of breast cancer without distant metastasis, a surgical resection of the chest wall may be effective both for relieving pain and for control of the local hemorrhage. Seven out of the eight patients survived more than 3 years, suggesting that this surgical treatment could facilitate home health care and maintain a good quality of life for patients with breast cancer.
OBJECTIVE: In this study, we investigated the surgical results for chest wall invasion of local recurrence of breast cancer. PATIENTS AND METHODS: We reviewed eight patients who underwent a chest wall resection for local recurrence of breast cancer in our department between 1986 and 2004. RESULTS: All of the patients had local recurrence without any distant metastasis. All of them had skin ulcers with blood oozing. The operation procedures were Bt + Ax + Ic + Mj + Mn (Halsted mastectomy) in four patients, Bt + Ax + Ic + Mn (Patey procedure) in two patients, Bt + Ax + Ic (muscle-preserving mastectomy) in one patient, and Bt + Ax (Auchincloss procedure) in one patient. The intervals from the primary operation ranged from 14 months to 20 years. The maximum and minimum areas of the chest wall defect were 18 x 16 cm and 4.5 x 3.5 cm, respectively. Reconstruction of the chest wall was performed using a flap of the rectus abdominis muscle with polypropylene (Marlex) mesh in four patients, a flap of the rectus abdominis muscle combined with sandwich prosthesis of polypropylene mesh and methylmethacrylate in one patient, a flap of latissimus dorsi muscle in one patient, polypropylene mesh with pectoralis major muscle in one patient, and by direct closure in one patient. A survival of more than 3 years was achieved in seven patients and only one patient died 1 year and 2 months after the chest wall resection. CONCLUSION: In patients with the chest wall recurrence of breast cancer without distant metastasis, a surgical resection of the chest wall may be effective both for relieving pain and for control of the local hemorrhage. Seven out of the eight patients survived more than 3 years, suggesting that this surgical treatment could facilitate home health care and maintain a good quality of life for patients with breast cancer.
Authors: Rend Al-Khalili; Ali Alzeer; Giang-Kimthi Nguyen; Erin P Crane; Judy H Song; Janice L Jeon; Michael Nellamattathil; Erini V Makariou; Victoria L Mango Journal: Radiographics Date: 2021-05-14 Impact factor: 6.312