Successful Local Control With High-dose Palliative Radiation Therapy for Local Advanced Breast Cancer of Mucinous Carcinoma With Malignant Wound.

Background: Patients with breast cancer who refuse standard treatment often suffer from malignant wounds due to the growth of local tumors. However, treatment strategies for patients with unresectable locally advanced breast cancer who have refused standard treatment have been unclear.Case presentation: A 44-year-old female was diagnosed with breast cancer of mucinous carcinoma in the right breast. She refused standard treatment for her breast cancer for six years. She suddenly visited the emergency department because of acute bleeding from the right breast cancer with malignant wounds. Macroscopically, the tumor in the right breast measured over 20 cm in diameter. The tumor was exudative, exhibited ulceration and slight bleeding, and gave off an odor. Imaging findings showed multiple lymph node and bone metastases, and the final diagnosis was breast cancer of stage IV (cT4bN1M1). Although the surgeon recommended chemotherapy for the breast cancer, the patient refused to receive chemotherapy or other therapy due to concerns about complications during treatment. Considering the symptoms of advanced breast cancer with malignant wounds, she finally agreed to receive radiation therapy (RT). We performed RT of 70 Gy in 35 fractions over a period of 7 weeks. The tumor-associated symptoms were disappeared after RT. At three months after RT, the tumor had almost disappeared. We administered luteinizing hormone-releasing hormone agonists after RT. At two years after RT, she died due to multiple liver metastases and appearance of ascites; however, there was no disease progression in the right breast.Conclusions: High-dose RT for local advanced breast cancer of MC with malignant wounds is therefore considered to be an effective therapeutic option.