The Role of Electrochemotherapy in Managing Cutaneous Metastases from Breast Carcinoma: A Narrative Review.

Cutaneous metastases from breast carcinoma represent a debilitating complication of advanced disease progression, significantly impacting patients' quality of life. Electrochemotherapy (ECT), which combines cytotoxic drugs such as bleomycin or cisplatin with electric pulses to enhance cellular permeability, has shown promising efficacy as a local treatment for these lesions. Objectives: This literature review examines the principles of ECT, its mechanisms of action and the clinical outcomes in patients with primary breast cancer. Across clinical series, patient-level ORR typically ranges from ~70-90% and CR up to ~58% at 6-12 weeks, with lower rates in larger (>3 cm) or deeper lesions. ECT is safe, well tolerated, and potentially synergistic with other systemic therapies. However, its efficacy is influenced by factors such as lesion size, tumor receptor status, and prior radiotherapy. Optimizing patient selection, standardizing treatment protocols, and developing combination approaches with immunotherapy or targeted therapies represent key future directions to improve clinical outcomes.