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Pleural effusion in patients with isolated chest wall recurrences of breast cancer.

The reports of 66 patients with isolated chest wall recurrences of breast cancer after mastectomy who developed a pleural effusion were analyzed. The location of the pleural effusion was ipsilateral in 71.2%, contralateral in 21.2% and bilateral in 7.6%. The cumulative incidence of ipsilateral effusions after onset of chest wall recurrence is 81.4% within two years. The high frequency of ipsilateral effusions and the shorter interval after chest wall recurrence supports the hypothesis of locoregional tumor progression to the pleural space in patients with chest wall recurrences. High-voltage irradiation of the thoracic wall might effectively reduce the spread through to the pleural space.