Palliative Forequarter Amputation for Recurrent Breast Carcinoma

Mussey, Robert D.

doi:10.1001/archsurg.1956.01280010156020

Cited by 5 publications

(7 citation statements)

References 0 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…Over the past 50 years, several institutions have published case reports and small series on radical amputations for cancer 8, 16–24. Authors describe their experiences with FQ and HQ amputations in regards to local control of disease, overall survival, palliation of disabling symptoms, and quality of life 3, 7, 10, 19, 25–28.…”

Section: Discussionmentioning

confidence: 99%

The role of radical amputations for extremity tumors: A single institution experience and review of the literature

Parsons

Pimiento

Cheong

et al. 2011

Journal of Surgical Oncology

View full text Add to dashboard Cite

Background Major amputations are indicated for advanced tumors when limb-preservation techniques have been exhausted. Radical surgery can result in significant palliation and possible cure. Methods We identified 40 patients who underwent forequarter (FQ) or hindquarter (HQ) amputations between May 2000 and January 2011. Patient demographics, tumor-related factors, and outcomes were reviewed. Results There were 30 FQ and 10 HQ amputations. The most common diagnoses were sarcoma (55%) and squamous cell carcinoma (25%). Patients presented with primary tumors (35%), regional recurrence (57.5%), or unresectable limb metastatic disease (7.5%). Presenting symptoms included fungating wounds (35%), intractable pain (78%), and limb dysfunction (65%). Operations were performed with curative intent (10%), curative/palliative intent (70%), or palliation alone (20%). Wound complications occurred in 35%. Pain was improved in 78% of patients following surgery. Despite a 91% negative margin rate, 79% of patients recurred either locally or distantly. Median overall survival was 10.9, 13.2, and 3.4 months in the curative, curative/palliative, and palliative groups, respectively. Conclusions In the absence of conservative options, major amputations are indicated for the management of advanced tumors. These operations can be performed safely, resulting in effective palliation of debilitating symptoms. While recurrence rates remain high, some patients can achieve prolonged survival.

show abstract

Section: Discussionmentioning

confidence: 99%

The role of radical amputations for extremity tumors: A single institution experience and review of the literature

Parsons

Pimiento

Cheong

et al. 2011

Journal of Surgical Oncology

View full text Add to dashboard Cite

show abstract

“…In accordance with the suggestions of previous authors, we recommend that appropriate indications for curative forequarter amputation for recurrent breast cancer include: immobile unresectable (i.e., by direct neurovascular invasion or thoracic extension) recurrent tumor in the axilla, severe intractable pain with loss of extremity function, a negative comprehensive metastatic workup, and one or more tumor-related complications, such as: radionecrosis or ulceration, fungation, sepsis, hemorrhage, gangrene, severe lymphedema, or paralysis [22][23][24][25]29]. Prior to proceeding with the amputation, a thorough preoperative evaluation is necessary to define the anatomic boundaries of the tumor, and the overall physical and emotional status of the patient.…”

Section: Review Of Literature and Discussionmentioning

confidence: 99%

“…Since 1950, several small case series have been reported for the palliation of recurrent axillary breast malignancies. Mussey [23] reported on two patients who underwent forequarter amputation for painful, ulcerated, lymphedematous, useless upper extremities secondary to recurrent tumor invasion of the brachial plexus and subclavian vessels. Although both patients showed significant improvement in quality of life postoperatively, with only mild phantom limb discomfort, both deteriorated due to metastases and died at 4 and 22 months after amputation.…”

Section: Review Of Literature and Discussionmentioning

confidence: 99%

Forequarter amputation for recurrent breast cancer: A case report and review of the literature

et al. 2005

View full text Add to dashboard Cite

Axillary recurrence of breast cancer is an uncommon event that can lead to debilitating pain, lymphedema, and paralysis of the upper extremity. Multimodality therapy including surgery is usually used to control local recurrence. In a subset of patients, the extent of disease is such that local excision of the recurrence is not possible. In the absence of metastatic disease, forequarter amputation may be used as an effective means of surgical salvage and palliation for locally recurrent breast cancer. In this report, we describe management of a patient with advanced axillary recurrence treated with forequarter amputation and review the current literature on the use of this operation in breast cancer patients.

show abstract

“…Although the majority of forequarter amputations are performed for high-grade bone and soft tissue sarcomas or extensive osteomyelitis of the upper extremities, this radical operation may also be recommendedfor the curative treatment of recurrent breast cancer or the palliation of locally advanced breast cancer [ 3 – 6 , 20 , 24 – 27 ]. The feasibility of completely reducing tumor burden through the use of wide excision depends on the degree of tumor invasion to neighboring vital organs.…”

Section: Discussionmentioning

confidence: 99%

“…Most patients who have needed forequarter amputation have had distant metastasis or other local-regional recurrence, and therefore the amputations were for palliative purposes. Thus, most patients survived less than two years after forequarter amputation [ 19 , 20 , 24 – 27 ]. However, in cases of solitary lesions that do not have associated comorbidities, forequarter amputation is recommended not only for relief of symptoms, but also for a chance of curative treatment.…”

Section: Discussionmentioning

confidence: 99%

Curative use of forequarter amputation for recurrent breast cancer over an axillary area: a case report and literature review

et al. 2014

View full text Add to dashboard Cite

Axillary recurrence of breast cancer that involves the brachial neurovascular bundle is uncommon. However, for many patients with such recurrence, forequarter amputation can play a palliative role in relieving excruciating pain and paralysis of the upper limb. Further, for those patients who do not have distant metastasis or other local-regional recurrence, forequarter amputation provides a chance for a cure. Only a few case reports of curative amputations for recurrent breast cancer are present in the literature. Here, we report a case of forequarter amputation for curative treatment of axillary recurrent breast cancer, together with a literature review. To date, we have followed the patient for three years after amputation, during which there has been no evidence of recurrence or metastasis. Although radical resection is feasible, it can be accompanied by surgical wound complications and psychosocial stress. Therefore, an organized multidisciplinary approach is needed to ensure the success of radical resection.

show abstract

Palliative Forequarter Amputation for Recurrent Breast Carcinoma

Cited by 5 publications

References 0 publications

The role of radical amputations for extremity tumors: A single institution experience and review of the literature

The role of radical amputations for extremity tumors: A single institution experience and review of the literature

Forequarter amputation for recurrent breast cancer: A case report and review of the literature

Curative use of forequarter amputation for recurrent breast cancer over an axillary area: a case report and literature review

Contact Info

Product

Resources

About