INTRAARTERIAL CHEMOTHERAPY FOR PALLIATION OF FUNGATING BREAST-CANCER - A CASE-REPORT AND REVIEW OF THE LITERATURE

The infusion of chemotherapy into arteries that feed locally advanced tumors has theoretical appeal, since the tumor mass may be exposed to high drug concentrations with administration of reduced or conventiona l doses of chemotherapy. Experience in applying this technique to pati ents with breast cancer in the United States is limited. Locally advan ced, fungating breast cancers pose particularly difficult management p roblems for which intra-arterial drug delivery may be appropriate in c arefully selected cases. Disseminated cancer, physical deformity, foul odor, bleeding, and infection, as well as associated psychosocial fac tors, contribute to the complexity of caring for these patients. We re port the case of a patient with a massive fungating breast cancer who was effectively palliated with intra-arterial administration of mitomy cin, fluorouracil, cisplatin, and mitozantrone. The rapidity of our pa tient's response using this approach supports the observations of othe r investigators. We offer a review of the literature reporting the app lication of this technique for patients with locally advanced breast c ancer. Further study of intra-arterial chemotherapy in carefully selec ted patients with locally advanced and fungating breast cancers is war ranted.