Annals of Surgical Oncology Cite Track
HOME HELP FEEDBACK SUBSCRIPTIONS ARCHIVE SEARCH TABLE OF CONTENTS
10.1245/s10434-007-9793-x
Annals of Surgical Oncology 15:1322-1329 (2008)
© 2008 Society of Surgical Oncology
This Article
Right arrow Full Text
Right arrow Full Text (PDF)
Right arrow Alert me when this article is cited
Right arrow Alert me if a correction is posted
Services
Right arrow Similar articles in this journal
Right arrow Similar articles in PubMed
Right arrow Alert me to new issues of the journal
Right arrow Download to citation manager
Citing Articles
Right arrow Citing Articles via Google Scholar
Google Scholar
Right arrow Articles by Santillan, A. A.
Right arrow Articles by Cox, C. E.
Right arrow Search for Related Content
PubMed
Right arrow PubMed Citation
Right arrow Articles by Santillan, A. A.
Right arrow Articles by Cox, C. E.

Original Article

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

Alfredo A. Santillan, MD, MPH, John V. Kiluk, MD, John M. Cox, MD, Tammi L. Meade, BS, Nathon Allred, BA, Daniel Ramos, BS, Jeff King, BS and Charles E. Cox, MD, FACS

Departments of Surgery at the Comprehensive Breast Cancer Program, H. Lee Moffitt Cancer Center and Research Institute, University of South Florida, 12902 Magnolia Drive, Suite 3157, Tampa, FL 33612, USA

Correspondence: Address correspondence and reprint requests to: Charles E. Cox, MD, FACS; E-mail: coxce{at}hotmail.com

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.

Key Words: Breast carcinoma • Chest wall resection • Chest wall recurrence • Estrogen receptor • Progesterone receptor • HER2/neu






HOME HELP FEEDBACK SUBSCRIPTIONS ARCHIVE SEARCH TABLE OF CONTENTS
Copyright © 2008 by the Society of Surgical Oncology.