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Breast Cancer With Chest Wall Progression: Treatment With Photodynamic Therapy

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Abstract

Background: Chest wall progression of breast carcinoma affects up to 5% of breast cancer patients and is a major source of their pain. Treatment options are limited or may not be offered to these patients. Low-dose Photofrin-induced photodynamic therapy (PDT) offers an excellent clinical response with minimal morbidity. We report our continued experience with PDT in this setting.

Methods: Fourteen patients with more than 500 truncal metastases were treated with PDT. All received off-label Photofrin (.8 mg/kg) IV and light treatment at 630 nm from a diode laser with a microlens at a fluence of 1800 mW and a total light dose of 150 to 200 J/cm2 at 48 hours. One patient required re-treatment because of extensive disease.

Results: Follow-up was at least 6 months, and several extended to >24 months. All patients demonstrated tumor necrosis, with 9 of 14 complete responses, including with lesions >2 cm in thickness. Disease progression occurred outside of the treatment field. Several patients had initial regression of untreated lesions. Wound care, especially with disease in the deep tissues, was an issue.

Conclusions: Low-dose Photofrin-induced PDT offers patients with chest wall progression a treatment option with an excellent clinical response. To date, the response is prolonged and offers good local control. Surgical oncologists have an active role in this treatment option.

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Authors and Affiliations

  1. Photodynamic Therapy Program, Leo Jenkins Cancer Center, Departments of Surgery, The Brody School of Medicine, East Carolina University, Greenville, North Carolina

    Rosa E. Cuenca MD, Ron R. Allison MD, Claudio Sibata PhD & Gordon H. Downie MD, PhD

  2. Radiation Oncology, The Brody School of Medicine, East Carolina University, Greenville, North Carolina

    Ron R. Allison MD & Claudio Sibata PhD

  3. Medicine, The Brody School of Medicine, East Carolina University, Greenville, North Carolina

    Gordon H. Downie MD, PhD

  4. Department of Surgery, 600 Moye Blvd., PCMH TA-202, Greenville, NC, 27858

    Rosa E. Cuenca MD

Authors
  1. Rosa E. Cuenca MD
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  2. Ron R. Allison MD
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  3. Claudio Sibata PhD
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  4. Gordon H. Downie MD, PhD
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Corresponding author

Correspondence to Rosa E. Cuenca MD.

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Cuenca, R.E., Allison, R.R., Sibata, C. et al. Breast Cancer With Chest Wall Progression: Treatment With Photodynamic Therapy. Ann Surg Oncol 11, 322–327 (2004). https://doi.org/10.1245/ASO.2004.03.025

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  • DOI: https://doi.org/10.1245/ASO.2004.03.025

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