Surgical treatment for chest wall invasion due to the local recurrence of breast cancer.
OBJECTIVE
In this study, we investigated the surgical results for chest wall invasion of local recurrence of breast cancer.


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.


CONCLUSIONS
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.
Hanagiri
Takeshi
T
Second Department of Surgery, School of Medicine, University of Occupational and Environmental Health, Yahatanishi, Kitakyushu 807-8555, Japan. hanagiri@med.uoeh-u.ac.jp
Nozoe
Tadahiro
T
Yoshimatsu
Takashi
T
Mizukami
Makiko
M
Ichiki
Yoshinobu
Y
Sugaya
Masakazu
M
Yasuda
Manabu
M
Takenoyama
Mitsuhiro
M
Sugio
Kenji
K
Yasuda
Hiroshi
H
Yasumoto
Kosei
K
D000328:Adult; D000368:Aged; D001943:Breast Neoplasms / Q000473:pathology / Q000601:surgery*; D005260:Female; D006801:Humans; D008408:Mastectomy; D008875:Middle Aged; D009361:Neoplasm Invasiveness; D009364:Neoplasm Recurrence, Local / Q000473:pathology / Q000601:surgery*; D011379:Prognosis; D019651:Plastic Surgery Procedures / Q000379:methods; D012883:Skin Ulcer / Q000209:etiology / Q000601:surgery; D013524:Surgical Flaps / Q000473:pathology; D015996:Survival Rate; D013899:Thoracic Neoplasms / Q000473:pathology / Q000601:surgery*; D035441:Thoracic Wall / Q000473:pathology / Q000601:surgery*