Multidisciplinary Management of Complicated Locally Advanced and Fungating Breast Cancer: A Narrative Review

Area of Science:

• Oncology
• Surgical Oncology
• Radiology

Background:

• Locally advanced fungating breast cancer with hemorrhage or infection presents complex clinical challenges.
• Existing guidelines offer limited recommendations for managing these complicated fungating forms.

Purpose of the Study:

• To propose a pragmatic, symptom-oriented clinical framework for managing fungating breast cancer with hemorrhage or infection.
• To integrate various therapeutic modalities for complex clinical scenarios.

Main Methods:

• A structured narrative review of literature from PubMed, Scopus, and Web of Science (December 2019 - March 2026).
• Inclusion of studies on locally advanced breast cancer with fungating forms complicated by hemorrhage or infection.

Main Results:

• Data are heterogeneous, primarily from case reports and small series.
• Local interventions (embolization, wound care, antibiotics) are crucial for stabilizing acute complications.
• Systemic therapy is key for oncologic control, often following stabilization of acute issues.

Conclusions:

• Individualized, multidisciplinary management is essential, guided by clinical presentation.
• A proposed framework integrates systemic therapy, radiotherapy, interventional radiology, surgery, and supportive care.
• The framework aims to support decision-making in complex fungating breast cancer cases.