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Zhang J, Zhang J, Niu X, Zhou Y, Guo Y, Wang Y, Shou F. Discussing the safety and effectiveness of transcatheter arterial embolization combined with intravenous chemotherapy in treating locally advanced breast cancer. Sci Rep 2024; 14:6003. [PMID: 38472493 PMCID: PMC10933325 DOI: 10.1038/s41598-024-56642-w] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/12/2023] [Accepted: 03/08/2024] [Indexed: 03/14/2024] Open
Abstract
To investigate the efficacy and safety of drug-eluting bead-transarterial chemoembolization (DEB-TACE) combined with systemic chemotherapy in HR+/Her2- locally advanced breast cancer (LABC) patients. A controlled study was conducted on LABC patients treated at Jianyang People's Hospital and the First Affiliated Hospital of Chengdu Medical College from December 2020 to June 2022. The patients were randomly divided into the experimental group and the control group. The experimental group received DEB-TACE combined with the TAC regimen (175 mg/m2 paclitaxel-loaded albumin, 50 mg/m2 Doxorubicin, and 500 mg/m2 cyclophosphamide), while the control group received the TAC regimen intravenously. The therapeutic efficacy was evaluated using the mRECIST criteria. Statistical analysis was performed using SPSS 22.0 software, and baseline characteristics, overall response rate (ORR), pathological complete response (PCR), adverse reactions, and complications were compared between the two groups using paired t-test and chi-square test. A total of 60 patients were included, with 30 patients in the experimental group (50%) and 30 patients in the control group (50%). After the first treatment, the ORR was 90% in the experimental group and 60% in the control group (P < 0.05). The overall ORR was 100% in the experimental group and 83% in the control group (P < 0.05). PCR was achieved in 14 patients (47%) in the experimental group and 4 patients (13%) in the control group. The main adverse reactions in the experimental group were skin blistering, pigmentation, and pain. There was no statistically significant difference in vomiting and grade II or above bone marrow suppression between the two groups. No grade III or above adverse events occurred in either group. The comparison of tumor shrinkage between the two groups was P = 0.051, and axillary lymph node shrinkage was P < 0.05. The use of drug-eluting beads in combination with neoadjuvant chemotherapy is a feasible and safe treatment option for locally advanced breast cancer patients.
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Affiliation(s)
- Jingjun Zhang
- Jianyang People's Hospital, Jianyang City, 641400, Sichuan Province, China
| | - Jie Zhang
- The First Affiliated Hospital of Chengdu Medical College, Chengdu City, Sichuan Province, China
| | - Xiangke Niu
- Affiliated Hospital of Chengdu University, Chengdu City, Sichuan Province, China
| | - Yongxiang Zhou
- Jianyang People's Hospital, Jianyang City, 641400, Sichuan Province, China
| | - Yufeng Guo
- Jianyang People's Hospital, Jianyang City, 641400, Sichuan Province, China
| | - Yuanzhi Wang
- Jianyang People's Hospital, Jianyang City, 641400, Sichuan Province, China
| | - Feng Shou
- Jianyang People's Hospital, Jianyang City, 641400, Sichuan Province, China.
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Atzori G, Diaz R, Gipponi M, Cornacchia C, Murelli F, Depaoli F, Sparavigna M, Barbero V, Petrocelli F, Pitto F, Franchelli S, Friedman D, Fregatti P. A Case of Life-Threatening Bleeding Due to a Locally Advanced Breast Carcinoma Successfully Treated with Transcatheter Arterial Embolization. Curr Oncol 2023; 30:2187-2193. [PMID: 36826130 PMCID: PMC9955003 DOI: 10.3390/curroncol30020169] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/16/2023] [Revised: 02/07/2023] [Accepted: 02/08/2023] [Indexed: 02/12/2023] Open
Abstract
Locally advanced breast cancer (LABC) may rarely present with acute severe bleeding. A case report dealing with transcatheter arterial embolization to control acute bleeding in a patient with a voluminous ulcerated breast mass is described. Our findings confirm that the endovascular approach is effective in such patients in order to stabilize the patient whenever conventional treatments have failed or bleeding may be life-threatening.
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Affiliation(s)
- Giulia Atzori
- Breast Surgery Clinic, San Martino Policlinic Hospital, 16132 Genoa, Italy
- Correspondence:
| | - Raquel Diaz
- Breast Surgery Clinic, San Martino Policlinic Hospital, 16132 Genoa, Italy
| | - Marco Gipponi
- Breast Surgery Clinic, San Martino Policlinic Hospital, 16132 Genoa, Italy
| | - Chiara Cornacchia
- Breast Surgery Clinic, San Martino Policlinic Hospital, 16132 Genoa, Italy
| | - Federica Murelli
- Breast Surgery Clinic, San Martino Policlinic Hospital, 16132 Genoa, Italy
- Department of Surgical Sciences and Integrated Diagnostic (DISC), School of Medicine, University of Genoa, 16132 Genoa, Italy
| | - Francesca Depaoli
- Breast Surgery Clinic, San Martino Policlinic Hospital, 16132 Genoa, Italy
| | - Marco Sparavigna
- Breast Surgery Clinic, San Martino Policlinic Hospital, 16132 Genoa, Italy
| | | | - Francesco Petrocelli
- Department of Interventional Radiology, San Martino Policlinic Hospital, 16132 Genoa, Italy
| | - Francesca Pitto
- Pathology Unit, San Martino Policlinic Hospital, 16132 Genoa, Italy
| | | | - Daniele Friedman
- Breast Surgery Clinic, San Martino Policlinic Hospital, 16132 Genoa, Italy
- Department of Surgical Sciences and Integrated Diagnostic (DISC), School of Medicine, University of Genoa, 16132 Genoa, Italy
| | - Piero Fregatti
- Breast Surgery Clinic, San Martino Policlinic Hospital, 16132 Genoa, Italy
- Department of Surgical Sciences and Integrated Diagnostic (DISC), School of Medicine, University of Genoa, 16132 Genoa, Italy
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Kennoki N, Hori S, Yuki T, Hori A. Transcatheter Arterial Chemoembolization with Spherical Embolic Agent in Patients with Pulmonary or Mediastinal Metastases from Breast Cancer. J Vasc Interv Radiol 2017; 28:1386-1394. [PMID: 28728935 DOI: 10.1016/j.jvir.2017.06.003] [Citation(s) in RCA: 20] [Impact Index Per Article: 2.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/26/2016] [Revised: 05/31/2017] [Accepted: 06/02/2017] [Indexed: 12/16/2022] Open
Abstract
PURPOSE To evaluate safety and feasibility of transcatheter arterial chemoembolization with superabsorbent polymer microspheres (SAP-MS) for patients with pulmonary or mediastinal metastasis from breast cancer. METHODS Between November 2002 and January 2015, 14 patients with 29 unresectable pulmonary or mediastinal breast cancer metastases underwent transcatheter arterial chemoembolization using SAP-MS (50-100 μm) after injection of a combination of 2-4 types of anticancer drugs (eg, cisplatin [30 mg] + fluorouracil [500 mg], or epirubicin [40 mg] + mitomycin C [4 mg] + fluorouracil [500 mg]). As a primary endpoint, local tumor response and adverse events were evaluated 1 month after the first transcatheter arterial chemoembolization, according to Response Evaluation Criteria In Solid Tumors Version 1.1 and Common Terminology Criteria for Adverse Events Version 4 criteria. Transcatheter arterial chemoembolization was repeated as needed. Overall survival was analyzed as a secondary endpoint. RESULTS Response rate was 28.6% (partial response, 4 patients; stable disease, 10 patients). Median progression rate was -12.7%. No cases of hematologic toxicity of grade 3 or higher were observed. A grade 3 maculopapular rash was observed in 1 patient. After the first transcatheter arterial chemoembolization sessions, 63 additional transcatheter arterial chemoembolization sessions were performed (average, 5.5 sessions per patient; range, 2-10 sessions). The median overall survival time after the first session was 29 months, and the 5-year survival rate was 49.5%. CONCLUSIONS Transcatheter arterial chemoembolization with SAP-MS is a well-tolerated and feasible palliative treatment option for patients with pulmonary or mediastinal metastasis from breast cancer.
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Affiliation(s)
- Norifumi Kennoki
- Department of Radiology, Tokyo Medical University Hachioji Medical Center, 1163 Tatemachi, Hachiouji-shi, Tokyo, Japan.
| | - Shinichi Hori
- Department of Radiology, IGT Clinic, Image Guided Therapy, Osaka, Japan
| | - Takeo Yuki
- Department of Radiology, Shiraniwa Hospital, Nara, Japan
| | - Atsushi Hori
- Department of Radiology, IGT Clinic, Image Guided Therapy, Osaka, Japan
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Kennoki N, Hori S, Hori A, Takeo Y, Oshiro H. Transcatheter arterial chemoembolization with spherical embolic material for locally advanced breast cancer: first report of HepaSphere™ treatment for primary breast cancer. BJR Case Rep 2016; 2:20150417. [PMID: 30460025 PMCID: PMC6243306 DOI: 10.1259/bjrcr.20150417] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/22/2015] [Accepted: 05/26/2016] [Indexed: 11/05/2022] Open
Abstract
A 57-year-old female was diagnosed as having primary breast cancer (invasive carcinoma of no special type), which was immunohistochemically negative for oestrogen receptor, androgen receptor and human epidermal growth factor receptor Type 2. The main tumour was 54 × 35 mm in size and was located in the internal upper area of the left breast. The tumour had markedly invaded the skin and a daughter nodule was observed in the external upper area of the ipsilateral breast. An enlarged lymph node measuring 12mm in diameter was present in the axilla and an affected parasternal lymph node was also observed. A blood test showed no abnormalities and the patient was negative for tumour markers. We performed three sessions of transcatheter arterial chemoembolization with docetaxel-loaded HepaSphere™. The treatment procedure was successfully performed in all the three sessions. No adverse events higher than Grade 3 were observed. The sizes of the primary lesion and axillary lymph node decreased to 26 × 14 mm (37% reduction) and 10mm, respectively. The parasternal lymph node completely resolved. 2 months later, left total mastectomy and axillary lymph node dissection were performed. The histopathological post-therapy effect was considered to be a mild response (Grade 1a) in the breast lesion and a complete response (Grade 3) in the axillary lymph node. The mean±standard deviation of the minor axis of the vessels embolized with spherical particles was 183.0±96.5 μm. Our results indicate that transcatheter arterial chemoembolization used together with HepaSphere can be an alternative and effective therapy for locally advanced breast cancer.
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Affiliation(s)
- Norifumi Kennoki
- Department of Radiology, Tokyo Medical University Hachioji Medical Center, Tokyo, Japan
| | - Shinichi Hori
- Department of Radiology, Gate Tower Institute for Image Guided Therapy, Osaka, Japan
| | - Atsushi Hori
- Department of Radiology, Rinku Dejima Clinic, Osaka, Japan
| | - Yuki Takeo
- Department of Radiology, Gate Tower Institute for Image Guided Therapy, Osaka, Japan
| | - Hisashi Oshiro
- Department of Pathology, Tokyo Medical University Hospital, Tokyo, Japan
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Moriarty JM, Xing M, Loh CT. Particle embolization to control life-threatening hemorrhage from a fungating locally advanced breast carcinoma: a case report. J Med Case Rep 2012; 6:186. [PMID: 22762410 PMCID: PMC3423047 DOI: 10.1186/1752-1947-6-186] [Citation(s) in RCA: 15] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/05/2011] [Accepted: 03/22/2012] [Indexed: 11/16/2022] Open
Abstract
Introduction Sudden severe hemorrhage from locally advanced fungating breast carcinoma and its associated cutaneous lesions is rarely reported. Transcatheter arterial embolization has been used widely in the setting of intractable neoplastic hemorrhage arising from primary and metastatic tumors of the lung, liver, kidney, and gastrointestinal tract. Here, we detail the use of transcatheter arterial embolization in controlling torrential hemorrhage in a patient with advanced invasive breast cancer and multiple comorbidities. Case presentation We report the case of a 28-year-old African-American woman who presented with acute torrential hemorrhage from a high-grade invasive ductal breast carcinoma. A computed tomography scan demonstrated a 14cm mass with extensive muscle, fascial, and cutaneous invasion. Owing to the extent of invasion and multiple comorbidities, she was deemed to be unsuitable for surgical management. Selective angiography of the left internal mammary artery revealed no tumoral blush, extravasation, or pseudoaneurysm. Transcatheter arterial embolization was undertaken, and complete occlusion of the vessel was demonstrated. No further episodes of hemorrhage occurred. Conclusions Though rare, sudden severe hemorrhage from advanced breast cancer may be definitively managed by embolization alone and thus surgery may be avoided.
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Affiliation(s)
- John M Moriarty
- Department of Radiological Sciences, David Geffen School of Medicine at UCLA, Los Angeles, CA, USA.
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Leung JWT, Gotway MB, Sickles EA. Preoperative embolization of vascular phyllodes tumor of the breast. AJR Am J Roentgenol 2005; 184:S115-7. [PMID: 15727999 DOI: 10.2214/ajr.184.3_supplement.0184s115] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/18/2022]
Affiliation(s)
- Jessica W T Leung
- Department of Radiology, University of California, San Francisco Medical Center, San Francisco, CA 94115, USA.
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