Debulking mastectomy with electrochemotherapy: a case report of no surgery approach to recurrent breast cancer

Electrochemotherapy has been shown to be safe, effective and non-invasive loco-regional treatment for chest wall breast cancer recurrence. Electrochemotherapy is a palliative treatment offered to patients with cutaneous metastases from breast cancer, which are not eligible for resection and/or systemic therapy is ineffective or contraindicated. Electrochemotherapy combines the administration of bleomycin with electroporation of tumor cell, intraoperatively. Here we present the case of a women affected by multidrug resistant metastatic synchronous solid cancers who refused radical mastectomy after being diagnosed with recurrent ulcerated right breast cancer. We first describe an extended indication to electrochemotherapy to treat breast cancer recurrence after previous breast conserving surgery. Electroporation-induced necrosis through electrochemotherapy replaced surgery and was delivered in 30 minutes at 5,000 Hz frequencies at 730 V by hexagonal needle under general anesthesia. The necrosis of the remaining breast resulted in a voluminous eschar that was easily removed few months after leaving the chest wall free from macroscopic disease turning in a “bladeless mastectomy”. This kind of breakthrough application of electrochemotherapy might be considered to avoid palliative mastectomy in very selected patients. New technologies may help clinicians to find agreement between patient’ will and the burden of treatment and might contribute in selected cases to give options to patients not keen on having surgery.