title: Surgical treatment for chest wall invasion due to the local recurrence of breast cancer.
abstract: 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.
authors.affiliation: Second Department of Surgery, School of Medicine, University of Occupational and Environmental Health, Yahatanishi, Kitakyushu 807-8555, Japan. hanagiri@med.uoeh-u.ac.jp
authors.forename: Takeshi
authors.initials: T
authors.lastname: Hanagiri
authors.forename: Tadahiro
authors.initials: T
authors.lastname: Nozoe
authors.forename: Takashi
authors.initials: T
authors.lastname: Yoshimatsu
authors.forename: Makiko
authors.initials: M
authors.lastname: Mizukami
authors.forename: Yoshinobu
authors.initials: Y
authors.lastname: Ichiki
authors.forename: Masakazu
authors.initials: M
authors.lastname: Sugaya
authors.forename: Manabu
authors.initials: M
authors.lastname: Yasuda
authors.forename: Mitsuhiro
authors.initials: M
authors.lastname: Takenoyama
authors.forename: Kenji
authors.initials: K
authors.lastname: Sugio
authors.forename: Hiroshi
authors.initials: H
authors.lastname: Yasuda
authors.forename: Kosei
authors.initials: K
authors.lastname: Yasumoto
mesh_terms: 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*