Preoperative transcatheter arterial infusion chemotherapy for locally advanced breast cancer (stage IIIb) for down-staging and increase of resectability

Abstract 

Objectives: To evaluate the clinical usefulness of preoperative transcatheter arterial infusion chemotherapy (TAIC) for locally advanced breast cancer. Methods: Seven patients with unresectable locally advanced breast cancer (stage IIIb) underwent TAIC percutaneously 1–3 times (mean, 1.7 times) until tumors became resectable. Anticancer drugs were injected into both the internal mammary and the distal subclavian arteries. Results: There was no major complication related to the procedure. The mean tumor size was significantly decreased from 10.0±3.9 to 5.1±2.5 cm (P=0.0086). Skin and muscle invasions were improved in two patients (28%) and lymph nodes disappeared in one patient (14%). In two patients (28%), down-staging was achieved from stage IIIb to stage IIIa. All tumors turned into resectable, and mastectomy was performed with a mean period of 35 days (range 9–60 days) after TAIC. Marked decrease in tumor size allowed one patient to receive breast-conserving surgery. There was no local recurrence in any patient. However, five patients (71%) experienced distant metastases. The 3-year disease free and overall survival were 0 and 71.4%, respectively. Conclusions: TAIC for locally advanced breast cancer is useful in reducing tumor size and achieving down-staging in a relatively short period, leading to an expanded surgical indication.

Keywords:  Neoadjuvant therapy, Locally advanced breast cancer, Transcatheter arterial infusion chemotherapy