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July 27, 2016

Chemotherapy With CMF for Triple-Negative Breast Cancer With Carcinoma Erysipelatoides

Author Affiliations
  • 1Department of Dermatology, Chang Gung Memorial Hospital, Taoyuan, Taiwan
  • 2Department of General Surgery, MacKay Memorial Hospital, Taipei, Taiwan

Copyright 2016 American Medical Association. All Rights Reserved. Applicable FARS/DFARS Restrictions Apply to Government Use.

JAMA Dermatol. Published online July 27, 2016. doi:10.1001/jamadermatol.2016.2502

An obese woman with underlying triple-negative breast cancer (TNBC) was diagnosed as having carcinoma erysipelatoides (CE) and was treated successfully with cyclophosphamide, methotrexate, and fluorouracil combination chemotherapy (CMF). To our knowledge, there have been no other cases of TNBC with CE responding to CMF.

A woman in her 30s had a history of right breast cancer, stage IIIa (cT2N2M0), with negative immunohistochemical findings for estrogen receptor (ER), progesterone receptor (PR), and human epidermal growth factor receptor 2 (HER2). She was initially administered neoadjuvant chemotherapy with 4 cycles of docetaxel (75 mg/m2) and cisplatin (60 mg/m2) followed by 4 cycles of combination chemotherapy with cyclophosphamide (500 mg/m2), liposomal doxorubicin (40 mg/m2), and fluorouracil (500 mg/m2) and subsequently underwent right modified radical mastectomy. Postoperative radiotherapy was administered as 28 fractions (total, 5040 cGy) to the right chest wall and 5 booster fractions (total, 1000 cGy) to the right axilla in a span of 6 weeks. After undergoing postoperative radiotherapy, the patient noticed a pruritic erythema lesion with multiple nodules over the operation site of the right breast. The lesion was initially treated as postradiotherapy dermatitis with a combination of topical betamethasone valerate and fradiomycin sulfate, but there was no response to these topical treatments.

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