Management of inflammatory carcinoma of the breast with combined modality therapy including intraarterial infusion chemotherapy as an induction therapy. Long-term follow-up results of 28 patients.

Abstract

Twenty-eight patients with inflammatory breast cancer were treated with combined modality therapy consisting of (1) intraarterial infusion chemotherapy (IA chemotherapy) through the internal thoracic artery and subclavian artery, (2) surgical ablation, (3) extended radical mastectomy, and (4) adjuvant chemotherapy in that order. The IA chemotherapy included Adriamycin (n = 14) and mitomycin C plus 5-Fluorouracil (n = 14) were used. The response rate of the primary breast lesions to IA chemotherapy was as high as 83%, and complete necrosis of the tumor was histologically documented in 43% of the cases. The median interval from the initiation of IA chemotherapy to surgery was 7 weeks. Toxicity was acceptable and every patient completed the treatment. The 5- and 10-year disease-free survival rates were 59% and 53%, respectively. These results suggest that IA chemotherapy is a very useful induction therapy for inflammatory breast cancer in terms of excellent local effects and the short time required for therapy before surgery.