Progressive ulceration and wound healing complication secondary to bevacizumab in a patient with metastatic breast cancer

Bevacizumab(B) is a monoclonal antibody that inhibits tumor angiogenesis. In the setting of metastatic breast cancer(MBC) the addition of B to paclitaxel(P) results in an improvement of PFS. Side effects include hypertension,proteinuria,gastrointestinal perforation,arterial thrombosis and wound healing complications. A 38-year-old patient with MBC presented with two metastatic cutaneous tumor nodes. She received P80mg/m2q7d and B15mg/m2q21d. After the 2nd cycle the patient presented two ulcerations, one at the left thoracic wall and another near the clavicle. B was stopped but the defects spreaded. The cutis dis…