A NEW TREATMENT OPTION IN PATIENTS WITH CUTANEOUS LESIONS FROM BREAST-CANCER - TOPICAL ADMINISTRATION OF MILTEFOSINE

Despite the increasing use of adjuvant therapy locoregional relapse an d skin metastases remain a problem in the treatment of patients with b reast cancer. Topical administration of miltefosine supplements the av ailable local treatment modalities. Especially patients with superfici al lesions - no deep skin or soft tissue infiltrations, node size not exceeding 1-2 cm - may achieve clinically relevant remissions in about 40%. After superficial exulceration a scab formation and reepitheliza tion may be expected. An attempt at topical treatment should be indica ted if surgical excision and radiotherapy are no longer applicable or in case such therapy cannot be provided due to logistic difficulties. Concomitant local therapy, in addition to a systemic treatment indicat ed by nonskin metastases, may be meaningful and necessary. Together wi th surgery and radiotherapy as the treatments of choice, topical treat ment with miltefosine constitutes a new treatment option which is reas onably well tolerated and can be employed in ambulatory patients. Duri ng the course of the disease the therapeutic response to skin metastas es may become a major problem for patients, and additive local treatme nt therefore may be to improve considerably the quality of life of the patients. The position of this new treatment modality within the over all treatment approach has to be defined by an oncologist.