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Breast
Treatment
Focused Issues in Treatment
Pectoralis Muscle and Chest Wall Invasion
Pectoralis Muscle and Chest Wall Invasion
Jessica W. T. Leung, MD; Wei Tse Yang, MBBS
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KEY FACTS

  • Terminology

    • Imaging

      • Top Differential Diagnoses

        • Pathology

          • Clinical Issues

            TERMINOLOGY

            • Definitions

              • Pectoralis muscle invasion should be reported but does not constitute chest wall invasion
              • Chest wall invasion: Direct involvement of intercostal ± serratus anterior muscles by breast cancer
              • Chest wall recurrence (CWR): Local recurrence in residual tissue at site of prior mastectomy ± involvement of underlying muscles

            IMAGING

            • General Features

              • Mammographic Findings

                • Ultrasonographic Findings

                  • MR Findings

                    • Imaging Recommendations

                      DIFFERENTIAL DIAGNOSIS

                        PATHOLOGY

                        • Staging, Grading, & Classification

                          CLINICAL ISSUES

                          • Presentation

                            • Natural History & Prognosis

                              • Treatment

                                DIAGNOSTIC CHECKLIST

                                • Image Interpretation Pearls

                                  Selected References

                                  1. Arciero C et al: Multidisciplinary approaches to chest wall recurrences of breast cancer. Oncology (Williston Park). 32(8):392-6, 417, 2018
                                  2. Wadasadawala T et al: Management of isolated locoregional recurrences in breast cancer: a review of local and systemic modalities. Clin Breast Cancer. 17(7):493-502, 2017
                                  3. Petrella F et al: Chest wall resection and reconstruction for locally recurrent breast cancer: From technical aspects to biological assessment. Surgeon. 14(1):26-32, 2016
                                  4. Lee SC et al: Radiologist's role in breast cancer staging: providing key information for clinicians. Radiographics. 34(2):330-42, 2014
                                  5. Cancer Staging Handbook. In Edge SB et al: AJCC Cancer Staging Manual. 7th ed. Chicago: Springer. pp 417-60, 2010
                                  6. Ionta MT et al: Long-term outcomes in stage IIIB breast cancer patients who achieved less than a pathological complete response. Oncologist. 14(11):1051-60, 2009
                                  7. Hanagiri T et al: Surgical treatment for chest wall invasion due to the local recurrence of breast cancer. Breast Cancer. 15(4):298-302, 2008
                                  8. Buchanan CL et al: Locoregional recurrence after mastectomy: incidence and outcomes. J Am Coll Surg. 203(4):469-74, 2006
                                  9. Chagpar A et al: Chest wall recurrence after mastectomy does not always portend a dismal outcome. Ann Surg Oncol. 10(6):628-34, 2003
                                  10. Taylor ME: Breast cancer: chest wall recurrences. Curr Treat Options Oncol. 3(2):175-7, 2002
                                  11. Kinkel K et al: MR imaging: breast cancer staging and screening. Semin Surg Oncol. 20(3):187-96, 2001
                                  12. Morris EA et al: Evaluation of pectoralis major muscle in patients with posterior breast tumors on breast MR images: early experience. Radiology. 214(1):67-72, 2000
                                  13. Stomper PC et al: CT of pectoralis muscle invasion by breast carcinoma. J Comput Assist Tomogr. 17(5):829-31, 1993
                                  14. Harris JR et al: Breast cancer (2). N Engl J Med. 327(6):390-8, 1992
                                  Related Anatomy
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                                  Related Differential Diagnoses
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                                  References
                                  Tables

                                  Tables

                                  KEY FACTS

                                  • Terminology

                                    • Imaging

                                      • Top Differential Diagnoses

                                        • Pathology

                                          • Clinical Issues

                                            TERMINOLOGY

                                            • Definitions

                                              • Pectoralis muscle invasion should be reported but does not constitute chest wall invasion
                                              • Chest wall invasion: Direct involvement of intercostal ± serratus anterior muscles by breast cancer
                                              • Chest wall recurrence (CWR): Local recurrence in residual tissue at site of prior mastectomy ± involvement of underlying muscles

                                            IMAGING

                                            • General Features

                                              • Mammographic Findings

                                                • Ultrasonographic Findings

                                                  • MR Findings

                                                    • Imaging Recommendations

                                                      DIFFERENTIAL DIAGNOSIS

                                                        PATHOLOGY

                                                        • Staging, Grading, & Classification

                                                          CLINICAL ISSUES

                                                          • Presentation

                                                            • Natural History & Prognosis

                                                              • Treatment

                                                                DIAGNOSTIC CHECKLIST

                                                                • Image Interpretation Pearls

                                                                  Selected References

                                                                  1. Arciero C et al: Multidisciplinary approaches to chest wall recurrences of breast cancer. Oncology (Williston Park). 32(8):392-6, 417, 2018
                                                                  2. Wadasadawala T et al: Management of isolated locoregional recurrences in breast cancer: a review of local and systemic modalities. Clin Breast Cancer. 17(7):493-502, 2017
                                                                  3. Petrella F et al: Chest wall resection and reconstruction for locally recurrent breast cancer: From technical aspects to biological assessment. Surgeon. 14(1):26-32, 2016
                                                                  4. Lee SC et al: Radiologist's role in breast cancer staging: providing key information for clinicians. Radiographics. 34(2):330-42, 2014
                                                                  5. Cancer Staging Handbook. In Edge SB et al: AJCC Cancer Staging Manual. 7th ed. Chicago: Springer. pp 417-60, 2010
                                                                  6. Ionta MT et al: Long-term outcomes in stage IIIB breast cancer patients who achieved less than a pathological complete response. Oncologist. 14(11):1051-60, 2009
                                                                  7. Hanagiri T et al: Surgical treatment for chest wall invasion due to the local recurrence of breast cancer. Breast Cancer. 15(4):298-302, 2008
                                                                  8. Buchanan CL et al: Locoregional recurrence after mastectomy: incidence and outcomes. J Am Coll Surg. 203(4):469-74, 2006
                                                                  9. Chagpar A et al: Chest wall recurrence after mastectomy does not always portend a dismal outcome. Ann Surg Oncol. 10(6):628-34, 2003
                                                                  10. Taylor ME: Breast cancer: chest wall recurrences. Curr Treat Options Oncol. 3(2):175-7, 2002
                                                                  11. Kinkel K et al: MR imaging: breast cancer staging and screening. Semin Surg Oncol. 20(3):187-96, 2001
                                                                  12. Morris EA et al: Evaluation of pectoralis major muscle in patients with posterior breast tumors on breast MR images: early experience. Radiology. 214(1):67-72, 2000
                                                                  13. Stomper PC et al: CT of pectoralis muscle invasion by breast carcinoma. J Comput Assist Tomogr. 17(5):829-31, 1993
                                                                  14. Harris JR et al: Breast cancer (2). N Engl J Med. 327(6):390-8, 1992