OBJECTIVE We sought to evaluate clinical and oncologic outcomes of selected patients with locally advanced breast cancer undergoing full thickness chest wall resection (FTCWR) and reconstruction in a multidisciplinary setting. METHODS Between 2008 and 2010, five women underwent FTCWR followed by chest wall repair for locally advanced primary breast cancer. In all cases, chest wall repair was performed with a Peri-Guard Repair Patch (Synovis, St. Paul, MN, USA). At follow-up (7-12 months) quality of life, respiratory function and oncologic status were assessed. RESULTS Successful chest wall resection and repair were achieved in all patients. Plastic reconstruction of post-mastectomy tissue defects was necessary in one case. One patient was treated by breast conserving therapy. Chest ultrasound imaging confirmed absence of adhesions, haematoma or seroma and normal expansion and respiratory movement of the underlying lung in all patients. On follow-up all patients reported good quality of life. CONCLUSIONS Multidisciplinary surgical approaches to chest wall resection and reconstruction in selected patients with locally advanced primary breast cancer are feasible, safe, associated with short operation time and hospital stay and negligible morbidity.