Rapid Hemostasis and Significant Tumor Regression in Ulcerative Breast Cancer Via Combined Modified Lattice...

Ulcerative giant breast cancer (UGBC) presents management challenges including uncontrolled bleeding, infection, and rapid tumor progression, which often culminate in life-threatening complications. Traditional spatially fractionated radiotherapy (SFRT) like lattice radiotherapy (LRT) offers potential for palliating bulky tumors, although its application in UGBC remains limited. We report a 51-year-old woman with a hormone receptor-positive, human epidermal growth factor receptor 2 (HER2)-negative stage IIIC UGBC (20.5 cm × 6.98 × 18.17 cm ulcerative lesion). Treatment consisted of modified lattice radiotherapy (mLRT: 15 Gy×3 fractions), followed by volumetric-modulated arc therapy (VMAT: 36 Gy/20 fractions) and systemic therapy (exemestane, capecitabine, CDK4/6 inhibitor). Rapid hemostasis was achieved within 5 days, with 39.7% tumor reduction at week 4 and progressive wound healing. At 3-month follow-up after the completion of mLRT and prior to definitive radiotherapy, the tumor had achieved a 61.8% volume reduction, with only minimal residual disease remaining. The radiation-induced skin reaction gradually alleviated with symptomatic treatment. This case demonstrates mLRT's efficacy in achieving rapid hemostasis and significant tumor regression for chemotherapy-refusing UGBC patients. The combined approach of mLRT, VMAT, and systemic therapy provides a promising multidisciplinary strategy for symptom control and quality-of-life improvement. Further prospective studies are needed to validate these findings.