Electrochemotherapy of Skin Nodules in Metastatic Breast Cancer Patients: A Case Series from Iran

Abstract

Background and Objective: Breast cancer (BC), the second most prevalent cancer worldwide, poses a significant health challenge. Despite major advances in therapeutic modalities for BC, patients who undergo modified radical mastectomy face considerable risks of locoregional recurrence, ranging from 10% to 40%. Electrochemotherapy (ECT), a novel treatment modality, has demonstrated promising efficacy, particularly for skin and subcutaneous metastases, by enhancing drug penetration and minimizing systemic adverse effects. Methods: This case series was the first multicenter study in Iran to evaluate the effect of ECT on skin metastases in patients with recurrent BC following either lumpectomy or mastectomy. The study was conducted in 2 cancer referral centers from April 2023 to November 2024. Patients with BC who experienced treatment failure with skin metastasis or chest wall recurrence were included. Results: All included patients had large lesions (> 5 cm) with metastatic spread to the skin. Among the 10 cases, 2 patients achieved complete response, 3 patients developed clear skin margins and became operable for mastectomy, and 5 patients achieved local control of tumor-associated symptoms. Conclusions: These findings demonstrated an impressive overall response to ECT in skin metastases of BC and underscore its potential to improve treatment outcomes for patients experiencing recurrent disease while reducing the burden of systemic therapies.