Particle embolization to control life-threatening hemorrhage from a fungating locally advanced breast carcinoma: a case report

Moriarty, John M.; Xing, Minzhi; Loh, Christopher

doi:10.1186/1752-1947-6-186

Cited by 19 publications

(11 citation statements)

References 12 publications

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“…The left internal mammary artery was fully blocked. The hemorrhage was successfully controlled [11]. However, in a developing country like Pakistan, interventional radiology services are not easily available and accessible to everyone so there is no option left but surgery.…”

Section: Discussionmentioning

confidence: 99%

Bloody Aggressive: A Case Report on a Fungating Breast Mass in a Paraplegic Requiring Emergency Mastectomy

Sabir

Abbas

2020

Cureus

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Fungating malignant lesions pose a huge deal of agony to the patients. Their management is also deemed as difficult by most physicians. This report describes a case of a 45-year-old paraplegic female with delayed presentation of a very aggressive fungating left breast mass, which was diagnosed as invasive ductal carcinoma. The uncontrollable hemorrhage had the surgeons succumb to the option of emergency mastectomy as a palliative treatment to save the life of the patient. Hence, we infer that the emergency mastectomy in a hemorrhagic fungating breast lesion can be life-saving and can be performed with little to no risk to the patient. Such a procedure, surprisingly, has never been documented in the surgical literature before.

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Section: Discussionmentioning

confidence: 99%

Bloody Aggressive: A Case Report on a Fungating Breast Mass in a Paraplegic Requiring Emergency Mastectomy

Sabir

Abbas

2020

Cureus

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“…In these cases, the tumours can enlarge, invade the chest wall, skin, pectoralis major muscle, and become ulcerated, subsequently resulting in metastasis to various organs and leading to death of the individual, or can even result in life-threatening haemorrhage. 3 Breast cancers are hypervascularized tumours. When a massive haemorrhage occurs, it is difficult to control the bleeding.…”

Section: Discussionmentioning

confidence: 99%

Transcatheter arterial chemoembolization with spherical embolic material for locally advanced breast cancer: first report of HepaSphere™ treatment for primary breast cancer

Kennoki¹,

Hori²,

Hori³

et al. 2016

BJR|case reports

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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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“…Moriarty et al (9), reported successful control of a life-threatening bleed that originated from a fungating LABC via TAE with microspheres. The authors suggested using this method with minimal risk when conventional treatment modalities fail or are too morbid to perform.…”

Section: Discussionmentioning

confidence: 99%

Transcatheter Arterial Embolization for Controlling Severe Bleeding From Recurrent Locally-Advanced Breast Cancer

Aksoy¹,

Akçe²,

Kılıçkesmez³

et al. 2016

J Breasth Health

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IntroductionBreast cancers, particularly those that are locally advanced, may rarely present with acute severe bleeding. They usually appear in the form of fungating and/or ulcerating tumors. This condition can be difficult to manage through a surgical procedure. Interventional radiology has gained an increased role in coping with this problem. The most frequently used method to achieve safe and efficacious hemostasis is transcatheter arterial embolization (TAE). This method was also reported to ensure a reduction in tumor size. Case PresentationA woman aged 47 years who had recently undergone a toilet mastectomy plus axillary dissection for locally-advanced breast cancer, presented with sudden severe bleeding from a loco-regionally recurrent tumor that had developed rapidly. She had been diagnosed as having locally-advanced left breast cancer with axillary metastasis at the age of 46 years, which was histopathologically determined as a triplenegative breast cancer. The tumor had remained unresponsive to the neoadjuvant of chemotherapy (NACT), therefore she underwent toilet mastectomy plus axillary dissection to prevent further complications. However, in the very early postoperative period, a locoregional recurrent tumor began to develop on the chest wall and in the axillary region. Recurrent masses, especially the ones in the axilla, tended to ulcerate over the course of time. Owing to ulceration, radiotherapy (RT) was not considered as an option in the treatment. Finally, approximately three months after the operation, the patient presented with sudden severe bleeding from the recurrent breast tumor. She was admitted to our general surgery clinic for treatment of this acute bleeding. On physical examination, the patient was alert, conscious, and cooperative. She had moderate pallor. Her initial blood pressure was 100/60 mmHg, and heart rate of 90 bpm. Inspection of the chest wall showed that there was a very large loco-regionally recurrent breast tumor on the left side along the incision line; the bleeding originated from the deep part of the left axilla where many large ulcerated recurrent tumors were located. She also had an apparent upper limb edema. The results of the lab tests on admission showed a low hemoglobin level of 6 mg/dL and hematocrit of 20.9%. The platelet count was found 241 x 10 3 /microliter. INR and aPTT were within normal ranges. First, a temporary control of bleeding was performed by dressing the wound with sterile gauze pads and compressing them with an elastic bandage around the chest wall. Soon after, an intravenous access was established and replacement of isotonic fluid was initiated. Three units of red cell suspension were transfused consecutively as quickly as possible. Following these resuscitative measures, her vital signs improved with a blood pressure of 120/90 mmHg, and heart rate of 76 bpm. Hemoglobin and hematocrit increased to 11.1 mg/dL and 33.7%, respectively.An interventional radiologist's opinion was requested to aid in providing safer hemostasis and the patient was tra...

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Particle embolization to control life-threatening hemorrhage from a fungating locally advanced breast carcinoma: a case report

Cited by 19 publications

References 12 publications

Bloody Aggressive: A Case Report on a Fungating Breast Mass in a Paraplegic Requiring Emergency Mastectomy

Bloody Aggressive: A Case Report on a Fungating Breast Mass in a Paraplegic Requiring Emergency Mastectomy

Transcatheter arterial chemoembolization with spherical embolic material for locally advanced breast cancer: first report of HepaSphere™ treatment for primary breast cancer

Transcatheter Arterial Embolization for Controlling Severe Bleeding From Recurrent Locally-Advanced Breast Cancer

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