Superficial microwave-induced hyperthermia in the treatment of chest wall recurrences in breast cancer.

Our study concerns 42 patients with chest wall recurrences from breast cancer: 17 Stage 1 (less than 4 cm in diameter), 11 Stage 2 (more than 4 cm), seven Stage 3 (skin ulceration whatever tumor size), and seven Stage 4 (neoplastic lymphangitis and/or skin nodules covering chest wall beyond midline). All the patients were treated with 2450 MHz microwaves by means of a generator with 4 magnetrons (250 to 300 W) and arterial applicators delivering 5 to 10 W/cm2. Each applicator is coupled with an infrared thermometer allowing an atraumatic temperature control processed by a PC-compatible computer using a Turbo Pascal program. A temperature of 41.5 degrees C to 42.5 degrees C was maintained for 45 minutes from the skin surface to a 2.5-cm depth within tissues. Hyperthermia alone was done in four patients; hyperthermia was combined with chemotherapy in four patients, and with electrontherapy (2 X 450 cGy or 3 X 350 cGy/week) in 34 patients: tumor dose under 3000 cGy in seven patients and over 3000 cGy in 27 patients. We observed a complete response in 22 patients (52.3%), a partial response (greater than 50%) in 11 patients (26.1%), and no response in nine patients (21.4%). No complete response was observed in patients treated with hyperthermia alone or in conjunction with chemotherapy. The local control was demonstrated to be improved only in patients treated with hyperthermia and radiotherapy. The results were correlated with tumor stage: ten complete responses out of 12 Stage 1, and one complete response out of four Stage 4. We noted nine side effects completely reversible within a month with no late skin reaction. Our results show that hyperthermia can give improved local control without any morbidity in treating chest wall recurrences of breast cancer.