Comprising less than five percent of all thoracic malignancies, cancers of the chest wall are rare and difficult to treat. Chest wall tumors can develop in the bones, soft tissues and cartilage of the chest cavity, which contains the heart, lungs and other organs. These tumors typically involve invasion or have metastasized from adjacent thoracic tumors, and are malignant in more than half of cases.
The most common chest wall cancer is sarcoma of the chest wall, including:
- Ewing’s sarcoma
- Fibrosarcoma and malignant fibrous histiocytoma (MFH), leiomyosarcoma
Other chest wall cancers include metastatic cancer, desmoid tumor and neurogenic tumors.
Tumors in the chest wall typically manifest as painful, quickly growing and easily palpable masses. Surgery is often necessary, and may be followed by plastic surgery reconstruction to recreate a normal appearance.
Physicians and surgeons at the Brigham and Women’s Hospital (BWH) Lung Center provide comprehensive, specialized care for patients with chest wall cancer. As the thoracic surgical and pulmonary medicine specialists for Dana-Farber/Brigham and Women’s Cancer Center, our physicians collaborate with other specialists to provide patients with a highly informed diagnosis and a cohesive treatment plan.
- Risk Factors for Chest Wall Cancer
- Symptoms of Chest Wall Cancer
- Diagnosis of Chest Wall Cancer
- Treatment for Chest Wall Cancer
- What You Should Expect
- Multidisciplinary Care
- Appointments and Locations
While chest wall cancer is rare, factors contributing to an increased risk for chest wall cancer include:
- Advanced age, as certain chest wall cancers are more prevalent among elderly
- Previous radiation to the chest
- Living in certain parts of the world
- History of a previous cancer
The most common symptoms of chest wall cancer are:
- Chest pain
- Swelling in the chest
- A mass or lump protruding from the chest
- Muscle atrophy
- Impaired movement
Sometimes chest wall cancer does not exhibit any symptoms. About 20 percent are found incidentally on chest X-rays. For that reason, it is important that you regularly see your physician and alert him or her should you notice any irregularities.
To diagnose your chest wall cancer, our specialists will carefully review your medical history and conduct a full physical examination. He or she will likely order additional tests, including:
- Bone density test
- Chest X-ray
- Computerized tomography (CT) scan
- Endobronchial ultrasound (EBUS)
- Endoscopic ultrasound (EUS)
- Incisional or excisional biopsy
- Magnetic resonance imaging (MRI)
- Positron emission tomography (PET) scan
Our thoracic radiologists confine all their work to reading radiographic studies of the chest. They are highly skilled at recognizing chest wall cancers and patterns of spread. Our pathologists are internationally recognized as research leaders in the accurate diagnosis of rare sarcomas. The ability to provide a definitive diagnosis is invaluable to our multi-specialty treatment team.
Specialists at Brigham and Women’s Hospital offer both conventional and novel therapies for the treatment of chest wall cancer, personalized to each patient. Depending on your medical history and the stage of the cancer, your treatment may include chemotherapy, radiation therapy and/or surgery.
Although a traditional surgical approach is still needed for complex chest wall cancers, Brigham and Women’s Hospital has pioneered and refined the most advanced surgical treatments for chest wall cancer, including intraoperative chemotherapy. Surgery for chest wall cancer is typically used in conjunction with a combination of other treatments, including:
- Chemotherapy involves anticancer drugs that aim to kill cancer cells throughout the entire body. Chemotherapy is often used before or after surgery, although it can be used alone in advanced cases.
- Radiation therapy uses high-energy rays to shrink or kill cancer cells. It is often used alongside chemotherapy before and after surgery.
The purpose of surgery is to remove all visible disease. We also strive to preserve function of the chest and arms so patients can continue to enjoy activities important to them, including golf and other sporting activities. Surgical options for chest wall cancer include:
- Chest wall resection and reconstruction is the primary surgical option for chest wall tumors. This surgery involves the removal of one or more ribs to extract the tumor, followed by reconstruction to recreate a normal appearance after invasive surgery. This can involve prosthetic materials and/or rotation of muscle flaps.
- Video-assisted thoracic surgery (VATS), a minimally invasive procedure that involves the insertion of a thoracoscope (small camera) and surgical instruments into small incisions in the chest to remove the tumor.
A multidisciplinary team will work with you every step of the way, from diagnostics through evaluation, to create a cohesive and comprehensive treatment plan. Our unique approach features same day consultations with multiple specialists and fosters seamless, expert care. Your medical condition will be closely monitored and managed to promote optimal lung functioning and an improved quality of life.
If you require surgery, you will meet with your healthcare team first for pre-operative information and tests. On the day of your surgery, you will receive care from surgeons, anesthesiologists and nurses who specialize in thoracic surgery and interventional pulmonary procedures. After surgery, you will recover in our designated thoracic post-surgical care unit where you will receive comprehensive care by an experienced surgical and nursing staff.
Chest wall cancer patients benefit from the wide range of specialists at The Lung Center, including thoracic surgeons, medical and radiation oncologists, pulmonologists and imaging experts. This collaboration ensures comprehensive diagnosis and targeted treatment for patients.
Any recommended surgery or procedure will be performed by an experienced, board-certified surgeon, in collaboration with the treatment team including nurses and physician assistants, all of whom specialize in taking care of patients with chest wall cancer.
Learn more about thoracic cancer topics in our health library.
Visit the Kessler Health Education Library in the Bretholtz Center for Patients and Families to access computers and knowledgeable staff.
Visit the Brigham and Women’s Hospital HealthHub Blog, which features information on a variety of topics, including chest and lung diseases.
This page was last modified on 10/24/2016