When radiotherapy offers no more: the surgical management of advanced breast malignancy.

Recurrent local carcinoma of the breast can present a challenging problem of control and reconstruction to the surgeon. The pattern of ulceration, which may extend over a wide area of the chest wall and deeply into the ribs and pleura, is often similar in appearance to the sequelae of excessive radiation therapy, which can therefore be considered as a similar management problem. Advanced carcinoma of the breast can make the last few months of life miserable. Surgery can greatly assist in the amelioration of appearance, smell, and discharge from the ulcer. We report 41 patients managed surgically between 1978 and 1987.