The treatment of malignant pleural effusion via video-assisted thoracoscopy ( VATS) in breast carcinoma

Advanced breast cancer almost always leads to a malignant pleural effusion..

Palliative treatment of pleural effusion may be performed with a chemical pleurodesis using asbestoses-free sterilized talc via video-assisted thoracoscopy ( VATS).  

Talc pleurodesis via Vats has a very efficacy in terms of long-term effusion control at the first attempt .Breast cancer is a cronic disease and the high rate of success to control the recurrence the pleural effusion may be determinant to ameliorate the quality of life of these patients.

This procedure is performed with two small incision in the skin of the patient: one is the camera porth that is utilized for exploration of the cavity and the second one in useful to perform the biopsy of the pleura and to talc the pleural cavity under optic vision.

The advantages of this procedure are  the possibility of conducting the procedure in direct view and permits the distribution of the talc in a uniform manner, it enables the drainage tubes( two) to be optimally positioned so as to favour complete lung expansion and finally under general anesthesia is a painless procedure.  

The other important factor is the pleural biopsy to assess the high degree of expression of hormone receptors and c-erbB2. This information may be useful in predicting responsitivity to specific drugs, such as endocrine agents and trastuzumab.  

Bibliographical reference:

Roberto Gasparri and Lorenzo Spaggiari: "Video-Assisted Management of Malignant Pleural Effusion in Breast Carcinoma", Cancer 2006 Jan15,106(2)271-6