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Chest wall resection for locally recurrent breast cancer: is it worthwhile?
1Divisions of Thoracic Surgery, Memorial Sloan-Kettering Cancer Center, New York, NY 10021, USA. downeyr@mskcc.org
The Journal of Thoracic and Cardiovascular Surgery
|March 1, 2000
Summary
Chest wall resection for locally recurrent breast cancer has low operative mortality but limited long-term survival. Further research should explore palliative care quality over complete resection effectiveness.
Area of Science:
- Oncology
- Surgical Oncology
- Breast Cancer Research
Background:
- Effectiveness of chest wall resection for locally recurrent breast cancer is unclear.
- Recurrent breast cancer is often perceived as rapidly progressing metastatic disease, making extensive surgery seem inappropriate.
- Previous reports focused on surgical feasibility rather than long-term outcomes.
Purpose of the Study:
- To evaluate the effectiveness and long-term outcomes of chest wall resection for locally recurrent breast cancer.
- To identify prognostic variables influencing survival and re-recurrence after chest wall resection.
Main Methods:
- Retrospective review of 38 women undergoing chest wall resection for locally recurrent breast cancer (1987-1997).
- Kaplan-Meier method for overall survival calculation.
- Log-rank and Cox regression analyses for prognostic variable significance.
Main Results:
- Zero operative mortality.
- 1, 3, and 5-year overall survival rates were 74%, 41%, and 18%, respectively.
- Regional nodal disease and tumor size >4 cm predicted local re-recurrence; lymph node metastasis predicted long-term survival.
Conclusions:
- Chest wall resection for locally recurrent breast cancer demonstrates low mortality but significant rates of re-recurrence and metastasis.
- Limited 5-year survival suggests complete resection may not improve outcomes.
- Future research should prioritize the quality of palliative care in these patients.