Preoperative chemotherapy for fungating breast cancer

Thirty cases of fungating breast cancer (stages III and IV) were treated preoperatively by combination chemotherapy using cyclophosphamide (Endoxan), methotrexate, 5-fluorouracil, and prednisone. Mastectomy was performed after 2 cycles of preoperative chemotherapy followed by 6 more cycles postoperatively. Of 30 patients, 25 (83.3%) were made operable and had better disease-free survival. Preoperative chemotherapy has an advantage as regards improvement in quality and longevity without much toxicity, and provides a better palliation.