Continuous Arterial Infusion of 5-Fluorouracile in Patients with Advanced Breast Cancer

Fifteen women with advanced breast cancer underwent chemotherapeutical treatment with continuous arterial infusion of 5-Fluorouracile. The age of the patients ranged from 36 to 68 years; the patient of 36 had been previously ovariectomized. For cancer of internal or central quadrants of the breast, internal mammary artery was incannulated, while for those of the external ones, the tip of the catheter was led into subclavian artery through an arterotomy of brachial artery. In the cases in which the tumor was extended to the whole breast two vessels were incannulated, namely internal mammary and brachial artery. The drug was administered in a dose of 1 g a day, for a period of time ranging from 2 to 8 days, in 1000 ml of dextrose solution. The results of the treatment are the following: regression of more than 50% in 4 cases; regression of less than 50% in 5 cases; in 5 cases poor or no result was obtained. One woman died after one day of treatment from coma cerebralis. In 7 cases complications were observed, mainly spasm and thrombosis of the arteries and flittenular dermatitis; in 2 cases a decrease of WBC down to 3000/cmm was observed. In our experience, this method of chemotherapy seems to be indicated in a limited number of cases in which the tumor, though locally advanced, is still contained within the limits of the anatomic region. It is also indicated in case of local recurrences of tumors previously operated and expecially in carcinomatous mastitis.

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Incidence of internal mammary node in locally advanced breast cancer and its correlation with metastatic disease: a retrospective observational study

British Journal of Radiology ◽

10.1259/bjr.20190098 ◽

2019 ◽

Vol 92 (1103) ◽

pp. 20190098

Author(s):

Somesh Singh ◽

Subhash K Ramani ◽

Ashita Rastogi ◽

Meenakshi H Thakur

Keyword(s):

Breast Cancer ◽

Advanced Breast Cancer ◽

Metastatic Disease ◽

Locally Advanced Breast Cancer ◽

Locally Advanced ◽

Distant Metastases ◽

Advanced Breast ◽

Internal Mammary Nodes ◽

Imaging Results ◽

Internal Mammary

Objective: To determine incidence of internal mammary nodes (IMN) at baseline CT of locally advanced breast cancer (LABC) and ascertain prognostic implication. Methods and materials: Retrospective review of all LABC patients from 1 January 2012 through 31 December 2014 was performed after approval from institutional review board. CTs of 182 patients enrolled were reviewed by two radiologists independently, and IMNs were documented based on size, location and relation with location of breast primary. 3-year follow-up was analysed and incidence of metastases was calculated as overall incidence, incidence in patients with and without discernible IMN at baseline imaging. Results are presented as numbers and percentages. Differences in metastases of two groups were compared using χ2 test. 95% CI was calculated and p < 0.05 was considered significant. Results: 77 of 182 had identifiable IMN (42.3% incidence). Majority of identifiable nodes were on ipsilateral side of primary (incidence 90.90%) with higher incidence in patients with upper-outer quadrant tumours (55.9%). Majority were seen in second intercostal space (44.4%). 36 (19.7%) developed distant metastases within 3 years of therapy. Of these, 21 (27.3%) had IMN as compared with 15 (14.3 %) without IMN on baseline imaging. Patients with identifiable IMN on baseline CT had significantly higher incidence of distant metastases (p = 0.0321). Conclusion: Significant number LABC patients have identifiable IMN on baseline imaging with patients showing IMN on baseline CT showing significantly higher rate of metastatic disease following therapy. Advances in knowledge: Many LABC patients have identifiable IMNs on baseline imaging which show higher incidence of subsequent metastatic disease.

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