A Feasibility Study of Trans-Arterial Chemoembolization as a First-Line Treatment for Locally Advanced Breast Cancer

To evaluate the feasibility of transarterial chemoembolization (TACE) for locally advanced breast cancer (LABC).

A total of 31 sequential patients with previously untreated LABC in Stages III or IV were evaluated retrospectively. Selective microcatheter insertion was performed on all branches angiographically identified to the breast tumours and axillary lymph node metastases. Angio-CT imaging was used to confirm the distribution of drugs within the tumour after the selective infusion of contrast material. The patients were treated with anti-neoplastic agents indicated for breast cancer therapy. Drugs were infused directly into the tumour-feeding arteries, and embolization was carried out with spherical embolic material, HepaSphere (50-100 µm). After the initial treatment, additional treatments were repeated as needed. The primary outcome measure was the local response of the primary tumours and lymph node metastases at 1, 3, 6, and 12 months after the initial therapy.

The mean number of sessions per patient was 6.8 (range 3-23). The response rates of primary breast lesions at 1, 2, 6, and 12 months were 19%, 48%, 79%, and 70%, respectively. No major adverse events requiring therapy were reported. Local pain, bleeding, or infection were well controlled after the initial treatment. A minor complication of treatment was a skin reaction characterised by discolouration. The 1 and 2-year survival rates were 87.1% and 67.6%, respectively. The overall survival was 29.7 months. The prognostic factor most strongly affecting survival was distant metastasis.

TACE is a safe and effective first-line treatment for LABC.