Evaluation of chest wall resection in the patients with breast cancer involving chest wall]

Twenty-three patients with advanced or recurrent breast cancer involving bony chest wall were treated by extended full-thickness chest wall resection and immediate reconstruction. The results were as follows: 1) Distant metastases were found concurrently or subsequently in more than half of the patients. Therefore, we should regard chest wall lesions as a systemic disease. 2) Long term result was encouraging, with 73.9% local control rate. 3) Post-surgical prognosis of the patients with sternal metastasis and solitary chest wall lesions were favorable, in that order. 4) Both local control rate and survival of the patients with mediastinal invasion, however, were fairly poor. 5) Disease-free interval (D.F.I.) after mastectomy longer than 5 years correlated significantly with a long survival after chest wall resection. As a result, we confirmed that chest wall resection was the treatment of choice for the patients with long D.F.I. and solitary chest wall lesion without mediastinal invasion nor metastasis, but the postoperative systemic therapy was indispensable to improve the patient's survival.