Full-thickness chest wall resection for recurrence of breast malignancy

We present outcomes in 13 consecutive patients with solitary, local chest wall recurrence subsequent to mastectomy for breast malignancy who were operated on in 1983--2001. All patients underwent full-thickness chest wall resection (FTCWR) and immediate reconstruction. The mean chest wall defect area was 108 cm(2). The choice of reconstruction method was individualized. The reconstruction was accomplished with the patient's own tissues, in three cases supported by artificial mesh. Most commonly we used the contralateral breast or myocutaneous flap. We did not observe postoperative complications. The tissues used for the reconstruction provided sufficient stiffness of the rib cage. In all specimens the surgical margins were negative. The estimated 5-year survival after excision of recurrent tumor is 62%. FTCWR with immediate reconstruction with soft tissues should be considered in patients with local solitary recurrence after mastectomy for breast malignancy. This option offers good long-term results and minimal morbidity.