Chest wall resection for locally recurrent breast cancer: Is it worthwhile?

Robert J. Downey, Valerie Rusch, F. Ida Hsu, Larry Leon, Ennapadam Venkatraman, David Linehan, Manjit Bains, Kimberly Van Zee, Robert Korst, Robert Ginsberg

Research output: Contribution to journalArticlepeer-review

57 Scopus citations

Abstract

Objective: The effectiveness of chest wall resection for locally recurrent breast cancer as cancer treatment remains poorly defined, possibly because of the general impression that locally recurrent disease is a harbinger of rapidly progressive metastatic disease and that extensive surgical treatment in these patients is inappropriate. Reports to date have focused on technical feasibility, not long-term outcome. Methods: We reviewed our experience with 38 women who underwent chest wall resection for locally recurrent breast cancer between October 1987 and May 1997. Overall survival was calculated by the Kaplan-Meier method and the significance of prognostic variables evaluated by log-rank and Cox regression analyses. Results: The operative mortality rate was 0%. Overall survival at 1, 3, and 5 years after chest wall resection was 74%, 41%, and 18%, respectively, and the proportion of patients free of local recurrence at 1, 3, and 5 years was 59%, 42%, and 13%, respectively. Regional nodal disease and size of largest tumor nodule (>4 cm) were significant predictors of local re-recurrence (P < .01, P = .04); lymph node metastasis was the only predictor of long-term survival (P < .01). Patients with and without synchronous sites of metastatic disease had near-identical 3-year survivals. Conclusions: Chest wall resection for locally recurrent breast cancer has a low mortality. However, a significant number of patients have the development of local re-recurrence or metastases, and 5-year survival is limited. It is unlikely that complete resection of all locally recurrent disease improves survival. Future studies should focus on the quality of palliation achieved.

Original languageEnglish
Pages (from-to)420-428
Number of pages9
JournalJournal of Thoracic and Cardiovascular Surgery
Volume119
Issue number3
DOIs
StatePublished - 2000
Externally publishedYes

Fingerprint

Dive into the research topics of 'Chest wall resection for locally recurrent breast cancer: Is it worthwhile?'. Together they form a unique fingerprint.

Cite this