Sternal/para-sternal resection for parasternal local recurrence in breast cancer

Abstract

En bloc sternal resection for parasternal recurrence in breast cancer involves extensive surgery but in our experience can be performed with very low mortality and morbidity. In selected patients it provides good long term local control, relief of pain and improved cosmesis.

Sternal Resection and Reconstruction for Local Recurrence of Breast Cancer Using the Sternal Allograft Transplantation Technique

“…Sternal involvement from breast cancer can occur as a result of haematological spread of tumour cells and/or from spread of the tumour by contiguity from the breast or the intra-mammary nodes [4]. In all cases the treatment of the recurrence should be based on a multimodality approach [3,4].…”

“…The most challenging part is the reconstruction of the anterior chest wall in order to prevent respiratory insufficiency, local infection, injuries to mediastinal structures, functional and cosmetic results. The literature reports various techniques using different materials for sternochondral reconstruction [4,6,7]. We report our experience using sternal allograft transplantation as the reconstruction technique [8] in two patients who underwent partial sternectomy because of sternal involvement from recurrent breast cancer.…”

“…Nowadays, the treatment of haematogenous solitary sternal metastases or direct local sternal/parasternal invasion by the breast cancer is still controversial [3,4]. Partial or complete sternectomy associated or not with the resection of other related surrounding tissues is the technique of choice to obtain safety margins and the radical treatment of the disease [3][4][5][6]. The most challenging part is the reconstruction of the anterior chest wall in order to prevent respiratory insufficiency, local infection, injuries to mediastinal structures, functional and cosmetic results.…”

Adenovirally Delivered Enzyme Prodrug Therapy with Herpes Simplex Virus–Thymidine Kinase in Composite Tissue Free Flaps Shows Therapeutic Efficacy in Rat Models of Glioma

“…Whilst radical approaches to tumour excision, in the context of primary disease, are more selectively utilised than historically practised (1-3), they still retain a major role in the management of locally advanced and recurrent disease (4,5). When such resections take place, the most popular technique for the reconstruction of extirpative defects is free tissue transfer (6)(7)(8), however, free flaps currently do not deliver any therapy to the underlying disease process.…”

Immediate Chest Wall Reconstruction After Oncoplastic Surgery

“…Multiple treatment combinations are possible, depending on the location and size of the defect, the state of the wall adjacent to it, and the preferences of the surgical team. Furthermore, we should deliver an acceptable esthetic result that will allow the patient to achieve an optimal quality of life [3].…”