Intra-arterial 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 conventional doses of chemotherapy. Experience in applying this technique to patients with breast cancer in the United States is limited. Locally advanced, fungating breast cancers pose particularly difficult management problems for which intra-arterial drug delivery may be appropriate in carefully, selected cases. Disseminated cancer, physical deformity, foul odor, bleeding, and infection, as well as associated psychosocial factors, contribute to the complexity of caring for these patients. We report the case of a patient with a massive fungating breast cancer who was effectively palliated with intra-arterial administration of mitomycin, fluorouracil, cisplatin, and mitozantrone. The rapidity of our patient's response using this approach supports the observations of other investigators. We offer a review of the literature reporting the application of this technique for patients with locally advanced breast cancer. Further study of intra-arterial chemotherapy in carefully selected patients with locally advanced and fungating breast cancers is warranted.