Radica Margherita Koleva, Fabbri Nicolò, Santandrea Giorgia, Bonazza Simona, Stefanelli Antonio, Carcoforo Paolo
Department of Morphology, Experimental Medicine and Surgery, University of Ferrara, Ferrara, Italy.
Unit of General Surgery, Azienda USL di Ferrara, Ferrara, Italy.
AME Case Rep. 2020 Oct 30;4:30. doi: 10.21037/acr-20-54. eCollection 2020.
Breast cancer is the most common cause of chest wall recurrence, skin, and subcutaneous tissue metastases which mainly occur as multiple nodes in the skin and subcutaneous tissue. When it occurs, surgery (re-excision or totalization) is the treatment of choice. Unfortunately, it is not possible in rare cases for example after multiple plastic reconstructions and particular anatomical sites not eligible for resection. Moreover, in some cases where radiation therapy has already been used, and systemic therapy is ineffective or contraindicated, electrochemotherapy could represent a choice of palliation treatment. The principle of electrochemotherapy is based on a physical approach to permeabilize cells in the tissue exposed to electric pulses with increased cellular uptake of hydrophilic chemotherapeutics as bleomycin. We present a case of a 62-year-old woman suffering from chest wall recurrence of triple-negative breast cancer, previously treated with chemotherapy, surgery, and radiotherapy. The persistence of the tumor disease with abundant losses of blood serum material led the patient to a progressive decay of the general physical conditions. For this reason, we performed an electrochemotherapy session with an improvement in pain management and partial necrosis of the tumor tissue and devascularization that reduced bleeding and serum production leading to a better quality of life.
乳腺癌是胸壁复发、皮肤及皮下组织转移的最常见原因,主要表现为皮肤和皮下组织中的多个结节。发生这种情况时,手术(再次切除或全切)是首选治疗方法。不幸的是,在罕见情况下,例如经过多次整形重建后或特定解剖部位无法切除时,手术是不可能的。此外,在一些已经使用过放射治疗且全身治疗无效或禁忌的情况下,电化学疗法可能是一种姑息治疗的选择。电化学疗法的原理基于一种物理方法,即通过电脉冲使暴露于其中的组织中的细胞通透性增加,从而使亲水性化疗药物如博来霉素的细胞摄取增加。我们报告一例62岁女性三阴性乳腺癌胸壁复发的病例,该患者先前接受过化疗、手术和放疗。肿瘤疾病持续存在,伴有大量血清物质流失,导致患者全身身体状况逐渐恶化。因此,我们进行了一次电化学疗法治疗,疼痛管理得到改善,肿瘤组织部分坏死且血管闭塞,减少了出血和血清生成,从而提高了生活质量。