Full thickness chest wall resection for recurrent breast carcinoma involving the bony chest wall

Solitary recurrent breast cancer involving the bony chest wall (parasternal recurrence) is curable when no evidence of systemic spread is found. Radical full thickness chest wall resection is an effective mode of treatment; it remains the only available treatment for patients whose chest wall recurrence fails to respond to radiation therapy, and in those who develop complications due to heavy irradiation. This report covers a review of the records of 52 patients treated at Memorial Hospital by chest wall resection for recurrent breast cancer between 1950 and 1972. The technique of chest wall resection and immediate plastic reconstruction is described. The gross and determinate 5-year survival rates for patients who underwent chest wall resection as the initial mode of therapy for chest wall recurrence were 43% and 57%, respectively. On the other hand, when chest wall resection was performed on those patients whose chest wall recurrences failed to respond to radiation therapy, the gross and determinate 5-year survival rates dropped to 16% and 19%. Full thickness chest wall resection with immediate plastic reconstruction when employed as the first mode of therapy for chest wall recurrences provides a significant 5-year survival rate, and has a definite place in the management of recurrent breast cancer.