Radiation-associated lesions of the chest wall

A ten year review of 31 patients with chest wall complications associated with radiation therapy is presented. Carcinoma of the breast accounted for 23 instances, postradiation sarcomas for five and other complications for three. Twenty patients had radionecrotic ulcerations, nine of which were found to contain recurrent malignant disease. This finding significantly and unfavorably influenced survival in comparison with those whose ulcer was free of tumor (p less than or equal to 0.0001). Of 27 surgically treated patients, the regimen which correlated with the fewest complications included extensive removal of all poor quality tissue, avoidance of prosthetic materials and bone grafts and immediate reconstruction with well vascularized muscle or omental flaps.