2010 Volume 24 Issue 7 Pages 1037-1040
We successfully treated metastasis of breast cancer to the sternum in a 65-yo female for whom an extended mastectomy was carried out 10 years ago. After the mastectomy, chemotherapy, but not hormonal therapy, was carried out because hormonal receptors were negative in the first excised specimen. However, since the metastatic tumor enlarged in the short term and then became malodorous due to rupture and infection of the tumor, we carried out resection of the metastatic tumor in combination with reconstructive surgery employing a vertical rectus abdominis musculo-cutaneous flap. First, since the metastatic tumor was 8 cm in maximum diameter, had destroyed the entire sternum, protruded into the pleural space, and invaded the fat tissue in the mediastinum, a combined excision of the tumor, sternum, and three costal cartilages was carried out. Second, the reconstructive surgery was followed by the application of a pedicled right rectus abdominis myocutaneous flap in association with an anastomosis between the left deep inferior epigastric vessels and right internal thoracic vessels. Since the surgery was successful, there is little shift of the chest wall during respiration, with little deterioration of the respiratory function, and there has been no finding of recurrence for 28 months after the second surgery.
