title: Chest wall resection for internal mammary lymph node metastases of breast cancer.
abstract: Evaluation of morbidity, mortality and oncologic outcome of patients treated with a chest wall resection for isolated breast cancer recurrences in the Internal Mammary Chain. Retrospectively we retrieved data from 29 patients. Multivariate analysis was performed to identify prognostic factors for (disease-free) survival. There were no postoperative deaths. Complications occurred in 11 patients. The median follow-up after CWR for all 16 patients still alive at the end of this study is 18.4 months. Nine patients were free of cancer. The 3-year overall and disease-free survival is 59.2% and 8.6%. The median survival is 40.7 months. After multivariate analysis for each of the four endpoints studied, only one prognostic factor remains significant for survival: systemic therapy before CRW (p=0.004). For local recurrence-free survival a first CRW recurrence (p<0.00001) and for disease-free survival radicality of the resection (p=0.008) are independent prognostic factors. Chest wall resection is a safe and effective treatment for isolated breast cancer recurrences in the IMC. Surgically treated patients have a fair survival and some of them are even cured.
authors.affiliation: Department of Surgical Oncology, Erasmus Medical Center/Daniel den Hoed Cancer Center, Rotterdam, The Netherlands. a.n.vangeel@erasmusmc.nl
authors.forename: Albertus N
authors.initials: AN
authors.lastname: van Geel
authors.forename: Michel W
authors.initials: MW
authors.lastname: Wouters
authors.forename: Carmen
authors.initials: C
authors.lastname: van der Pol
authors.forename: Paul I M
authors.initials: PI
authors.lastname: Schmitz
authors.forename: Titia
authors.initials: T
authors.lastname: Lans
mesh_terms: D000328:Adult; D000368:Aged; D001943:Breast Neoplasms / Q000473:pathology* / Q000601:surgery*; D018572:Disease-Free Survival; D005260:Female; D006801:Humans; D008207:Lymphatic Metastasis; D008323:Mammary Arteries; D008875:Middle Aged; D009364:Neoplasm Recurrence, Local / Q000601:surgery*; D012189:Retrospective Studies; D013899:Thoracic Neoplasms / Q000556:secondary* / Q000601:surgery*; D013908:Thoracotomy; D016896:Treatment Outcome