Effusions are a frequent complication in the course of disseminated breast cancer. Intracavitary instillation of radioactive gold, particulate irritants such as talc, alkylating agents, quinacrine, fluorouracil, bleomycin have been used for symptomatic control. The usefulness of intracavitary administration of antineoplastic agents in the management of recurrent, intractable neoplastic effusions has been evaluated in 43 patients in which 67 instillations were made and 58 were evaluable (table 1). Many drugs were used, particularly alkylating agents an HN2 and as Thio-TEPA and antimetabolite as fluorouracil (table 2). In the present series 19 of the 58 patients (32.7 %) with metastatic carcinoma of the breast had objective control of the neoplastic effusion for periods ranging from 45 to 485 days (table 2). In comparison with other methods of treatment, cytostatic therapy of pleural effusion caused by metastatic carcinoma of the breast does not produce a higher percentage of therapeutic response. Particularly talc poudrage has been employed with better results.
Talc poudrage versus talc slurry in the treatment of malignant pleural effusion.
