Chest-Wall Resection for Locally Recurrent Breast Cancer

Snyder, Arthur F.

doi:10.1001/archsurg.1968.01340020110013

Cited by 31 publications

(5 citation statements)

References 12 publications

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“…The extent of resection in most series is limited to the soft tissues, avoiding full‐thickness chest wall resection. Studies describing full‐thickness chest wall resection involving ribs,cartilage and pleura (requiring chest wall reconstruction to maintain respiratory function) do not have significantly higher rates of local control or survival 22–25 . Morbidity, however, is considerably increased.…”

Section: Discussionmentioning

confidence: 99%

Radical surgery with omental flap for uncontrolled locally recurrent breast cancer

Henderson

Burt

Jenner

et al. 2001

ANZ Journal of Surgery

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Section: Discussionmentioning

confidence: 99%

Radical surgery with omental flap for uncontrolled locally recurrent breast cancer

Henderson

Burt

Jenner

et al. 2001

ANZ Journal of Surgery

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“…In 43% to 68% of the patients, radiotherapy can provide local control, with a reported 5- and 10-year OS of 36% to 61% and 21% to 35%, respectively 5,23–25. In our opinion, these percentages are relatively high because a large number of patients with a small scar recurrence are included, although prognosis seems to be worse when CWR is performed after the failure of radiotherapy for BC recurrences 26. No differences in outcome were found between surgery and radiotherapy for small isolated lesions of local recurrence, but aggressive multimodality treatment was usually advised 9,10.…”

Section: Discussionmentioning

confidence: 76%

Prognostic Factors in 77 Curative Chest Wall Resections for Isolated Breast Cancer Recurrence

et al. 2009

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BackgroundFull-thickness chest wall resection (CWR) is the preferred treatment for breast cancer (BC) patients with extensive isolated locoregional recurrence. It remains a challenge to select patients that will benefit most from this treatment. The aim of this study was to define prognostic factors in patients who undergo CWR with curative intent.MethodsBC patients who underwent a CWR with curative intent for recurrence of disease between 1986 and 2006 were included in this retrospective study. Twenty-two factors were studied in a univariate analyses, and multivariate stepwise Cox regression analyses was performed.ResultsSeventy-seven patients were included in this study. The 5-year overall survival was 25%. There was one postoperative death. Univariate analyses showed that three prognostic factors were significantly correlated with OS and disease-free survival: (1) interval between primary treatment and CWR (P = .02 and .004, respectively), (2) chemotherapy for recurrence (P = .05 and .05, respectively), and (3) resection specimen smaller than 150 cm2 (P = .03 and .009, respectively). An interval lasting >10 years between primary treatment and CWR remained statistically significantly correlated with better overall survival and disease-free survival after multivariate analyses.ConclusionsCWR is a safe treatment in patients who have isolated extensive BC recurrence. The best survival outcome was seen in patients after a disease-free interval of ≥10 years. Existing data show that adjuvant radiotherapy and adjuvant hormone therapy for estrogen-positive tumors improves overall survival. Neoadjuvant chemotherapy may be considered in individual patients.

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“…This finding was consistent with Wakeam et al (10) who systematically reviewed the literature on chest wall resection for recurrent BC. From the 48 studies they searched, a disease-free interval (DFI) >24 months was one of the factors consistently associated with improved outcomes after resection of recurrence (13,(24)(25)(26). These findings challenge the impression that all chest wall recurrences portend a uniformly poor prognosis.…”

Section: Discussionmentioning

confidence: 99%

Surgical reduction in chest wall disease to prolong survival in breast cancer patients: a retrospective study

Zhu¹,

Yun²,

You³

et al. 2022

Gland Surg

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Background: Patients with breast cancer (BC) may develop locoregional recurrence alone or with distant metastases. Results of previous studies discussing the benefit of local surgery among patients with chest wall disease were controversial. Whether surgical reduction for chest wall disease could influence survival outcome is still a question. The objective of this study was to compare overall survival (OS) in patients with recurrence involving the chest wall who did or did not undergo surgical reduction after previous treatment of the primary BC to explore the role of surgical reduction. Methods:We retrospectively reviewed BC patients with chest wall as the first recurrent/metastatic site selected between January 2012 and December 2018 to explore whether surgical reduction for chest wall disease could influence OS. Clinicopathological data, including age at initial diagnosis, TNM stage, the pathological parameters, and treatment were recorded and analyzed. OS was primarily described using the Kaplan-Meier estimator for each group, with the statistical significance between groups being tested by the log-rank test.Results: A total of 198 patients with a median age of 48 years (range, 22-73 years) were analyzed. Chest wall as the only site of recurrence occurred in 139 patients (70.2%), and the other 59 (29.8%) patients had other metastatic sites. There were 88 patients who underwent surgical reduction for chest wall recurrence.The median OS was significantly longer for the patients who had chest wall disease reduction than for those who did not {194.2 months [95% confidence interval (CI): 140.4-247.9 months] vs. 102.7 months (95% CI: 79.7-125.7 months), respectively, P=0.001}. From multivariate analysis, surgical reduction was an independent factor significantly influenced OS (HR =0.52, 95% CI: 0.33-0.81, P=0.004). Subgroup analyses showed that OS was statistically longer in the chest wall disease surgical reduction group than in the no reduction group with respect to hormone receptor (HR) negative (−), human epidermal growth factor receptor 2 (HER2) negative (−), triple-negative breast cancer (TNBC), disease-free survival (DFS) >24 months, and chest wall disease only.Conclusions: BC patients with chest wall recurrence could benefit from surgical reduction with a prolonged OS. In a certain selected group, surgical reduction may be warranted.

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Chest-Wall Resection for Locally Recurrent Breast Cancer

Cited by 31 publications

References 12 publications

Radical surgery with omental flap for uncontrolled locally recurrent breast cancer

Radical surgery with omental flap for uncontrolled locally recurrent breast cancer

Prognostic Factors in 77 Curative Chest Wall Resections for Isolated Breast Cancer Recurrence

Surgical reduction in chest wall disease to prolong survival in breast cancer patients: a retrospective study

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