Extravasation of Epirubicin

A 63-year-old woman with a diagnosis of infiltrative ductal carcinoma of the breast (stage T2N1M0[IIB], according to the tumor–node–metastasis staging system) that was estrogen receptor–negative and HER2-negative was referred for adjuvant chemotherapy after undergoing modified radical mastectomy and axillary lymph-node dissection. Epirubicin, at a dose of 90 mg per square meter of body-surface area, was infused at 21-day intervals, along with fluorouracil and cyclophosphamide. During the third period of administration, the patient reported having excruciating pain in the left wrist, near the intravenous-catheter site (arrow). The infusion was stopped, and a diagnosis of extravasation of epirubicin was made. Physical examination . . .