Annals of Surgical Oncology

, Volume 15, Issue 5, pp 1322–1329 | Cite as

Outcomes of Locoregional Recurrence after Surgical Chest Wall Resection and Reconstruction for Breast Cancer

  • Alfredo A. Santillan
  • John V. Kiluk
  • John M. Cox
  • Tammi L. Meade
  • Nathon Allred
  • Daniel Ramos
  • Jeff King
  • Charles E. Cox
Breast Oncology

Abstract

Background

Locoregional chest wall recurrences involving ribs and/or sternum after primary surgical treatment predict a poor outcome in patients with breast cancer. The precise natural history and surgical outcome of these chest wall recurrences are not fully understood. The objective of this study is to clarify the clinicopathological features of chest wall recurrence of breast cancer and evaluate prognostic factors predicting survival after chest wall resection and reconstruction (CWRR).

Methods

A total of 28 patients who underwent CWRR at the H. Lee Moffitt Cancer Center between December 1999 and September 2007 were retrospectively analyzed. Overall survival was calculated by the Kaplan–Meier method and the significance of prognostic variables was evaluated by log-rank and Cox regression analyses.

Results

The postoperative morbidity and mortality was 21% and 0%, respectively. Overall 5-year survival for the entire cohort was 18%. Disease-free interval <24 months (P = 0.03) and triple-negative phenotype (P = 0.002) were the only independent predictors of survival. Overall 1-, 2-, and 5-year survival rates for the triple-negative phenotype were 38%, 23%, and 0%, respectively. In contrast, overall 1-, 2-, and 5-year survival rates for the non-triple-negative phenotype were 100%, 70%, and 39%, respectively.

Conclusions

Radical chest wall resection can be done without mortality and acceptable morbidity to accomplish long-term palliation. The strongest predictor of overall survival was the triple-negative phenotype. Because the triple-negative phenotype is not amenable to any form of therapy, palliative resection may be warranted. Development of appropriate targeted therapies to this population of patients is critical.

Keywords

Breast carcinoma Chest wall resection Chest wall recurrence Estrogen receptor Progesterone receptor HER2/neu 

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Copyright information

© Society of Surgical Oncology 2008

Authors and Affiliations

  • Alfredo A. Santillan
    • 1
  • John V. Kiluk
    • 1
  • John M. Cox
    • 1
  • Tammi L. Meade
    • 1
  • Nathon Allred
    • 1
  • Daniel Ramos
    • 1
  • Jeff King
    • 1
  • Charles E. Cox
    • 1
  1. 1.Departments of Surgery at the Comprehensive Breast Cancer ProgramH. Lee Moffitt Cancer Center and Research Institute, University of South FloridaTampaUSA

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