Chest wall involvement by breast cancer remains a difficult clinical challenge that may occur at the time of the primary diagnosis or later as a result of locoregional breast cancer recurrence. A case-by-case multidisciplinary approach is strongly recommended, and a multimodality therapy should be always considered. Full-thickness resection of the chest wall can be done with acceptable morbidity and mortality, providing a good palliation and a better quality of life even to patients with poor prognosis. Moreover, in well-selected cases, chest wall resection results in locoregional control of disease and prolongation of life.