Extensive soft tissue resection with autologous tissue closure for locally recurrent breast cancer: lasting local control and acceptable morbidity.
BACKGROUND
Locoregional breast cancer recurrence can be detected at an advanced stage of the disease. To achieve local control for these larger local breast cancer recurrences, wide soft tissue resections with autologous tissue coverage of the defect is an option. The aim of this study was to assess the local control and morbidity of surgical salvage of patients with advanced local breast cancer recurrence using autologous tissue closure of the defect.


METHODS
Eighty-eight patients were treated with wide soft tissue resections with autologous tissue coverage from 1993 to 2006. Two different operating techniques were used for closure of the defect; transposition of the greater omentum covered with split skin graft and the latissimus dorsi musculo-cutaneous flap. Demographic, treatment and mortality information were retrieved from original patients' files.


RESULTS
Postoperatively 10 patients (11%) developed complications which required an additional operation. In patients treated with curative intent (n=67) median disease-free interval after extensive surgery was 24 months and median survival was 45 months. In 42 patients (47% of all included patients) the first recurrence after extensive surgery was a locoregional relapse. The two surgical techniques did not differ in overall survival (p=0.739) and local control.


CONCLUSIONS
Large soft tissue resection for extensive local relapse of breast cancer may result in lasting local control in half of the patients with acceptable morbidity.
Aukema
T S
TS
Department of Surgery, The Netherlands Cancer Institute/Antoni van Leeuwenhoek Hospital, Plesmanlaan 121, 1066 CX Amsterdam, The Netherlands.
Russell
N S
NS
Wesseling
J
J
Rutgers
E J
EJ
D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D001943:Breast Neoplasms / Q000473:pathology / Q000601:surgery*; D005260:Female; D006801:Humans; D016462:Mammaplasty / Q000379:methods*; D008875:Middle Aged; D009364:Neoplasm Recurrence, Local / Q000601:surgery*; D011183:Postoperative Complications; D013524:Surgical Flaps; D015996:Survival Rate; D014182:Transplantation, Autologous; D016896:Treatment Outcome