Radical forequarter amputation with chest wall resection

Forequarter amputation with resection of the chest wall is indicated for primary bony and soft tissue tumors involving the shoulder girdle, axilla, and chest wall, as well as for recurrent breast cancer in the axilla after irradiation. We describe a modification of this procedure that includes an initial thoracotomy for intraoperative staging and a median sternotomy, which avoids individual division of the anterior ribs and clavicle.