TREATMENT OF A LARGE SUPERFICIAL BASAL-CE LL CARCINOMA OF THE BREAST WITH COMBINATION OF PHOTODYNAMIC THERAPY AND SURGERY CONTROLLED BY PHOTODYNAMIC DIAGNOSIS

We treated a large superficial basal cell carcinoma (ca. 10x6 cm) on t he right breast in a 48-year old woman with photodynamic terapy (PDT). Fractionated PDT was performed by topical application of delta-aminol evulinic acid (delta-ALA, 20%) with subsequent red light (570-750 nm; 180 J/cm(2)) in three sessions. Nearly total remission of the tumor re sulted; however, a few residual neoplastic islands partly infiltrating the nipple-areola complex could be detected by photodynamic diagnosis (PDD). These fluorescent areas were marked, excised, and the defect w as closed by a rotation advancement flap. Total excision of the tumor was verified histologically. By combining PDT and surgery, this large tumor was treated with excellent cosmetic results. This case demonstra tes the efficiency of topical PDT with adjunctive plastic surgery cont rolled by PDD even in large tumors.