The Journal of thoracic and cardiovascular surgery · 2025
Short- and long-term outcomes of chest wall resection and reconstruction for breast cancer.
СтатьяНазвание и аннотация: Перевод пока не подготовлен
Обработка статьи · этапы, ошибки и управление
Загрузка состояния…
Ошибки и ограничения
История · было → стало
Состояние обновляется каждые 5 секунд, пока блок открыт. Процент показывается только там, где известен объём работы. Пауза останавливает продолжение этапа; текущий запрос к источнику может завершиться.
Dunne Elizabeth G, Tan Kay See, Bains Manjit S, Downey Robert J, Shahzad Farooq, Matros Evan, Adusumilli Prasad S, Rusch Valerie W, Gray Katherine, Isbell James M, Molena Daniela, Bott Matthew J, Huang James, Sihag Smita, Park Bernard J, Jones David R, Rocco Gaetano
Аннотация
OBJECTIVE: We sought to determine perioperative characteristics, rates of recurrence, and survival among patients who underwent chest wall resection for breast cancer.
METHODS: We identified patients who underwent chest wall resection for breast cancer at our institution from 2000 to 2024. Progression-free survival and overall survival were estimated using the Kaplan-Meier approach. Cumulative incidence of local recurrence was calculated, and its association with disease-free interval was analyzed using Gray's test. Cox models quantified the association between patient characteristics and survival outcomes.
RESULTS: Sixty-three patients were included. Chest wall resection was performed for recurrent breast cancer in 81% of patients (51/63). Most patients underwent rib resection (55/63; 87%) and partial or complete sternal resection (37/63; 59%). Fifty-five patients (87%) had a prosthesis placed for reconstruction; 55 patients (87%) received myocutaneous flaps. R0 resection was performed in 52 patients (83%). Eight patients (13%) had grade 3 or greater complications, nearly all of which (n = 7) were flap infection or necrosis. No patients died within 30 days; 3 patients (5%) died within 90 days. Median follow-up was 10 years (interquartile range, 5-17 years). At 5 years, cumulative incidence of local recurrence was 32%, progression-free survival was 13%, and overall survival was 31%.
CONCLUSIONS: Among patients with locally advanced or recurrent breast cancer, chest wall resection can provide local control and has acceptable morbidity and mortality. Given the known effect of chest wall disease on quality of life, chest wall resection should be considered in the multimodal management of patients with locally aggressive breast cancer.
METHODS: We identified patients who underwent chest wall resection for breast cancer at our institution from 2000 to 2024. Progression-free survival and overall survival were estimated using the Kaplan-Meier approach. Cumulative incidence of local recurrence was calculated, and its association with disease-free interval was analyzed using Gray's test. Cox models quantified the association between patient characteristics and survival outcomes.
RESULTS: Sixty-three patients were included. Chest wall resection was performed for recurrent breast cancer in 81% of patients (51/63). Most patients underwent rib resection (55/63; 87%) and partial or complete sternal resection (37/63; 59%). Fifty-five patients (87%) had a prosthesis placed for reconstruction; 55 patients (87%) received myocutaneous flaps. R0 resection was performed in 52 patients (83%). Eight patients (13%) had grade 3 or greater complications, nearly all of which (n = 7) were flap infection or necrosis. No patients died within 30 days; 3 patients (5%) died within 90 days. Median follow-up was 10 years (interquartile range, 5-17 years). At 5 years, cumulative incidence of local recurrence was 32%, progression-free survival was 13%, and overall survival was 31%.
CONCLUSIONS: Among patients with locally advanced or recurrent breast cancer, chest wall resection can provide local control and has acceptable morbidity and mortality. Given the known effect of chest wall disease on quality of life, chest wall resection should be considered in the multimodal management of patients with locally aggressive breast cancer.