Current Thoracic Surgery

Breast cancer is the most common malignancy in women, and the concept of oligometastasis supports local treatment in selected cases. Bone is the most frequent metastatic site, while isolated sternal involvement is uncommon. However, prior implant-based breast reconstruction introduces additional technical challenges, including the risk of intraoperative implant injury. A 40-year-old woman with a history of bilateral mastectomy and implant-based reconstruction presented with an isolated lytic metastasis of the sternal corpus 14 months after initial treatment. She underwent subtotal sternal resection with en bloc removal of adjacent costochondral segments, followed by chest wall reconstruction using titanium bars and costal clips. Intraoperatively, implant injury was detected and managed through the same incision with immediate replacement in collaboration with plastic surgery. The postoperative course was uneventful, and the patient was discharged on postoperative day three without complications. Isolated sternal metastasis from breast cancer is rare and may be amenable to surgical resection in selected patients. Although prior implant-based reconstruction increases technical complexity, sternal metastasectomy and chest wall reconstruction can be safely performed with careful planning and multidisciplinary management, even in the setting of intraoperative implant injury.