Local recurrent mammary carcinoma failing multimodality therapy. A solution
P. M. McCormack, M. S. Bains, M. E. Burt, N. Martini, T. Chaglassian and D. A. Hidalgo
Department of Thoracic Surgery, Memorial Sloan-Kettering Cancer Center, New York.
Chest wall recurrence following radiation and hormonal therapy is an
uncommon but serious and disabling condition. A chest wall ulcer secondary
to treatment for recurrence also presents the same dilemma. Over the past
35 years, the Thoracic Service at our institution has treated 35 patients
for these problems by surgical resection and reconstruction. Eight patients
were seen after the first recurrence, six after the second, ten after the
third, and ten after the fourth. One patient had chest wall resection with
mastectomy when recurrence followed radiation therapy. Following resection
of the tumor, 21 patients had reconstruction using mesh or a mesh
"sandwich." There were no operative deaths and no respirator need. Twenty
patients are alive from five to 120 months, with a median of 50 months. One
of 35 patients had chest wall recurrence. Surgical resection of recurrent
mammary carcinoma resistant to all other therapy is a viable alternative
for both palliation and cure.
