title: Preoperative transcatheter arterial infusion chemotherapy for locally advanced breast cancer (stage IIIb) for down-staging and increase of resectability.
abstract: OBJECTIVE
  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.
authors.affiliation: Department of Radiology, Mie University School of Medicine, Tsu, Japan. kakuya@clin.medic.mie-u.ac.jp
authors.forename: Kakuya
authors.initials: K
authors.lastname: Kitagawa
authors.forename: Koichiro
authors.initials: K
authors.lastname: Yamakado
authors.forename: Atsuhiro
authors.initials: A
authors.lastname: Nakatsuka
authors.forename: Naoshi
authors.initials: N
authors.lastname: Tanaka
authors.forename: Kaname
authors.initials: K
authors.lastname: Matsumura
authors.forename: Kan
authors.initials: K
authors.lastname: Takeda
authors.forename: Yoshifumi
authors.initials: Y
authors.lastname: Kawarada
mesh_terms: D000328:Adult; D000368:Aged; D000970:Antineoplastic Agents / Q000008:administration & dosage* / Q000627:therapeutic use; D001940:Breast / Q000473:pathology; D001943:Breast Neoplasms / Q000188:drug therapy* / Q000401:mortality / Q000473:pathology / Q000601:surgery; D003131:Combined Modality Therapy; D004317:Doxorubicin / Q000008:administration & dosage / Q000627:therapeutic use; D015251:Epirubicin / Q000008:administration & dosage / Q000627:therapeutic use; D005260:Female; D005472:Fluorouracil / Q000008:administration & dosage / Q000627:therapeutic use; D006801:Humans; D007261:Infusions, Intra-Arterial; D008875:Middle Aged; D016685:Mitomycin / Q000008:administration & dosage / Q000627:therapeutic use; D009367:Neoplasm Staging; D011300:Preoperative Care; D015996:Survival Rate
chemical_list: D000970:Antineoplastic Agents; D015251:Epirubicin; D016685:Mitomycin; D004317:Doxorubicin; D005472:Fluorouracil