[Advanced breast cancer with onset of multi-organ metastases successfully treated with combined loco-regional therapies: a case report].

A 56-year-old woman was referred to Shizuoka General Hospital on April 17, 1992, because of progressive jaundice and massive pleural effusion. A thorough work-up revealed the diagnosis of advanced left breast cancer complicated with direct invasion of the thoracic wall, pleural carcinomatosis, multiple liver and bone metastases and obstructive jaundice due to the hilar mass. From a prognostic point of view, we scheduled the treatment course as follows. First, we treated the chief complaints. After emergency drainage and chemo-adhesive therapy of the pleural lesion, percutaneous biliary drainage and radiotherapy were done for obstructive jaundice, followed by internal drainage with self-expandable metallic stents. For the primary cancer of the left breast, standard mastectomy was performed following 57 Gy of radiotherapy. MPA was also administered because estrogen-receptor was positive on the histological examination of the resected specimen. To complete the multi-disciplinary treatment, we implanted a vascular access percutaneously via the left femoral artery and started intermittent hepatic arterial infusion chemotherapy on an outpatient basis. The patient was discharged on the 123rd hospital day and is well and active without any symptom 9 months thereafter.