[A case of giant breast cancer performed a radical excision after neoadjuvant chemotherapy]

The patient was a 79-year-old woman with the giant breast cancer accompanied with the invasion to pectoralis major muscle and skin. We worried that we would need a skin grafting for the operation because of a wide skin defect. So we performed FEC regimen (a combination of epirubicin, cyclophosphamide and 5-FU) as neoadjuvant chemotherapy (NAC) to reduce the tumor size. Adverse reaction were stomatitis of grade 2 and leukocytopenia of grade 3. The tumor size was reduced by about 25% and tumor marker decreased after 6-cycle of NAC. Then we performed a radical operation (Bt+Ax with partial resection of invaded part of pectoralis major muscle). It was simply difficult to close the skin, but we could close it without skin grafting by sliding BD area and axial skin flap. The pathological examination of resected specimens revealed scirrhous carcinoma with invasion to pectoralis major and skin, but no cancer cell was seen on the excised margin. There was no lymph node involvement. Her postoperative course was uneventful. On the 17th POD, she went back to her home and she now has been taking paclitaxel weekly as adjuvant chemotherapy at an outpatient clinic.