Shiba E, Kobayashi T, Takeda T, Miya A, Kawano I, Takai S, Mori T
Department of Surgery II, Osaka University Medical School, Japan.
Gan To Kagaku Ryoho. 1992 Nov;19(13):2255-8.
A 66-year-old postmenopausal woman presented in June 1991 with a giant ulcerated left breast tumor. She had discovered the tumor two years previously, but had never visited any medical institution. She was diagnosed as advanced breast cancer with multiple lung metastases, bone metastasis, and both supraclavicular lymph node metastases by physical examination, fine needle aspiration cytology, chest X-P, and bone scintigraphy. Incisional biopsy, performed to confirm the histological type of breast cancer and to evaluate estrogen and progesterone receptor (ER and PgR) status, revealed solid-tubular carcinoma. Both ER and PgR were highly positive at 322.6 and 228.0 fmol/mg protein, respectively. Therefore, endocrine therapy was chosen to treat this advanced breast cancer patient, although she had multiple organ metastases. Twenty mg of Tamoxifen a day was administered per os. After treatment with tamoxifen, the size of ulceration started to decreased and the dyspnea caused by multiple lung metastases was reduced. Eight weeks after, she showed partial response (PR) determined from the size of the ulceration and chest X-P. She has been maintaining PR for more than 9 months. Thus, Tamoxifen was shown to be very effective for this case of advanced breast cancer with multiple organ metastases.
一名66岁的绝经后女性于1991年6月就诊，患有巨大的溃疡性左乳腺肿瘤。她两年前发现了这个肿瘤，但从未去过任何医疗机构。通过体格检查、细针穿刺细胞学检查、胸部X线片和骨闪烁显像，她被诊断为晚期乳腺癌，伴有多发肺转移、骨转移和双侧锁骨上淋巴结转移。为了确定乳腺癌的组织学类型并评估雌激素和孕激素受体（ER和PgR）状态而进行的切开活检显示为实性-管状癌。ER和PgR均高度阳性，分别为322.6和228.0 fmol/mg蛋白。因此，尽管该患者有多个器官转移，但仍选择内分泌治疗来治疗这名晚期乳腺癌患者。每天口服20毫克他莫昔芬。用他莫昔芬治疗后，溃疡大小开始减小，多发肺转移引起的呼吸困难减轻。八周后，根据溃疡大小和胸部X线片确定她显示出部分缓解（PR）。她的部分缓解状态已维持了9个月以上。因此，他莫昔芬被证明对该例伴有多个器官转移的晚期乳腺癌非常有效。
