title: Ulcerative locally advanced breast cancer: the efficacy of combined anthracycline-based and hormonal therapy.
abstract: OBJECTIVE
  In the literature there are numerous large prospective studies on patients with locally advanced breast cancer, however little is reported on the management of ulcerative breast cancer. The aim of this study was to evaluate the employment of combined anthracycline-based chemotherapy and hormonal therapy in ulcerative locally advanced mammary carcinoma.
  
  
  METHODS
  Four patients, aged from 67 to 83 years, presented with ulcerative breast cancer resulting in breast destruction. Histological examination of biopsy specimens revealed highly differentiated estrogen receptor-positive ductal carcinomas. All tumours were classified as locally advanced since there was no clinical or radiologic evidence of distant metastasis in any of the patients. Due to their religious beliefs all patients refused any other treatment but chemotherapy. In these patients hemostasis and reduction of bacterial overgrowth were followed by administration of anthracycline-based chemotherapy and hormonal therapy.
  
  
  RESULTS
  All patients responded well; ulcer healing and partial remission were achieved for a period ranging from 19 to 28 months before disease progression.
  
  
  CONCLUSIONS
  There is clinical evidence from this study that the combination of anthracycline-based palliative chemotherapy coupled with tamoxifen is beneficial for patients with inoperable ulcerative breast cancer.
authors.affiliation: Department of Surgery, Democritus University of Thrace, Alexandroupolis, Greece.
authors.forename: D
authors.initials: D
authors.lastname: Kakagia
authors.forename: M
authors.initials: M
authors.lastname: Trichas
authors.forename: N
authors.initials: N
authors.lastname: Papadopoulos
authors.forename: A
authors.initials: A
authors.lastname: Tsalkidis
authors.forename: T
authors.initials: T
authors.lastname: Jivannakis
authors.forename: D
authors.initials: D
authors.lastname: Tamiolakis
mesh_terms: D000368:Aged; D000369:Aged, 80 and over; D018943:Anthracyclines / Q000008:administration & dosage*; D000971:Antineoplastic Combined Chemotherapy Protocols / Q000627:therapeutic use*; D001943:Breast Neoplasms / Q000188:drug therapy* / Q000401:mortality* / Q000473:pathology; D002606:Charcoal / Q000008:administration & dosage; D003520:Cyclophosphamide / Q000008:administration & dosage; D018572:Disease-Free Survival; D015251:Epirubicin / Q000008:administration & dosage; D005260:Female; D005472:Fluorouracil / Q000008:administration & dosage; D006115:Greece / Q000453:epidemiology; D006801:Humans; D012834:Silver / Q000008:administration & dosage; D012883:Skin Ulcer / Q000473:pathology / Q000628:therapy
chemical_list: D018943:Anthracyclines; D002606:Charcoal; D012834:Silver; D015251:Epirubicin; D003520:Cyclophosphamide; D005472:Fluorouracil