Chest wall resection for breast cancer: 21st century Mayo clinic experience

Diane M. Durgan, Gabriel De La Cruz Ku, Mathew Thomas, Barbara A. Pockaj, Sarah A. McLaughlin, William J. Casey, Aparna Vijayasekaran, Dennis Wigle, John C. Cheville, Jennifer Tonneson, Tanya L. Hoskin, James W. Jakub

Research output: Contribution to journalArticlepeer-review

Abstract

Background: We hypothesized full-thickness chest wall resection (FTCWR) with advanced surgical techniques and modern systemic therapy is safe, provides local control, and good overall survival. Methods: Retrospective review of FTCWR (including rib or part of sternum) for breast cancer between 2000 and 2020. Primary endpoints included 90-day morbidities and all-cause mortality. Secondary endpoints were loco-regional and distant recurrence, DFS and overall survival (OS). Results: A total of 35 patients met the criteria. 34 FTCWR were for recurrence and the median time to chest wall recurrence was 6 years. Tumor subtype was triple-negative in 51% and the remainder HR+ Her2−. 58% were palliative resections. FTCWR included rib(s) in 89% and portion of sternum in 57%; 94% required reconstruction and 80% were R0 resections. There were no 90-day mortalities. Overall morbidity was 10/35(28%). 17(49%) patients received neoadjuvant systemic therapy for their recurrence and three received neoadjuvant radiation. Adjuvant treatment included chemotherapy (8), endocrine therapy (3), and both (8). Ten patients (28%) received adjuvant radiation. The Median follow-up was 31 months and there were 6 (17%) loco-regional and 7 (20%) distant recurrences. OS was 86% and 67% at 1 and 3 years, respectively. Conclusion: FTCWR was associated with low morbidity, mortality, recurrence rates, and good OS. Selective FTCWR is safe and has acceptable short-term survival rates.

Original languageEnglish
Pages (from-to)962-969
Number of pages8
JournalJournal of Surgical Oncology
Volume126
Issue number6
DOIs
StatePublished - Nov 2022

Keywords

  • curative
  • locally advanced
  • morbidity
  • palliative
  • survival

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