[The surgical treatment of the thoracic recurrences of operated breast cancer]

Authors report their experience concerning surgical treatment of thoracic recurrence from previously operated breast cancer. 96 patients were treated: 9 with loco-regional chest wall recurrence, 84 with malignant pleural effusion, 3 with solitary lung metastasis. Eight of 9 cases with chest wall recurrence underwent skin and soft tissue "en bloc" resection while in one case a thoracectomy was performed. Malignant pleural effusions were treated by thoracentesis in 21 cases (25%), tube thoracostomy in 8 (4.76%), tube thoracostomy plus chemical pleurodesis in 54 (64.2%) and pleurectomy in one case (1.19%). In all the cases with solitary lung metastasis a wedge resection was performed. Two out of 9 patients with chest wall recurrence are not evaluable as they did not enter the minimum follow-up period (15 months), 6 died after a mean period of 18.6 months (range 15-25) following surgery and one is alive at the end of the follow-up (39 months). Among the 3 patients with solitary lung metastasis 2 died respectively 26 and 31 months after procedure and 1 is alive at 28 months. Above 54 patients treated by tube thoracostomy plus pleurodesis for malignant pleural effusion, 35 showed a complete response, 13 a partial response and 6 were non-responders. No postoperative complications were observed in the patient who underwent pleurectomy while an almost complete resolution of the pain was achieved.