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From 1991 to 1996, we performed neoadjuvant intra-arterial infusion chemotherapy in 5 eligible patients among 21 patients with Stage III breast carcinoma. The treatment regimen for neoadjuvant chemotherapy was intra-arterial Epirubicin (EPR) on Day 1, 3, 5, 7 combined with endocrine therapy (MPA 1,200 mg). The effects of the treatment were compared among 8 patients given adjuvant intravenous chemotherapy. The clinical response rate was 100% with all partial response and metastatic lymph nodes were disappeared histologically in 2 cases. The median disease-free interval and overall survivals are 44 months (range 28-64) and 48 months (range 28-64), respectively. Neoadjuvant (intra-arterial) group had a longer disease-free interval than the adjuvant (intravenous) group. We are applying this treatment for down staging, and it is possible to use minimal invasive surgery for cure of stage III breast carcinoma.

From 1991 to 1996, 11 eligible patients (median age 50.4 years, range 33-71 years) with over Stage III and inflammatory breast carcinoma have been treated with neoadjuvant intra-arterial infusion chemotherapy. There were three Stage III a, one III b, three IV and four inflammatory carcinoma. Patients were treated with Epirubicin (10) and Doxorubicin (1), with a total amount of 120-190 mg. Three cases were combined with endocrine therapy (MPA 1,200 mg). In terms of morphological efficacy, 10 of 11 achieved PR, and three of those with endocrine therapy had over Grade 2 in histological efficacy. Carcinoma cells were especially deceased in one inflammatory carcinoma with MPA. Three of 11 died of liver metastasis, the others are still alive (median 24.5 months, range 7-51 months). Combined endocrine therapy should be considered applicable for the treatment strategy of the breast carcinoma.