Sakurai Kenichi, Enomoto Katsuhisa, Kitajima Akira, Tani Mayumi, Amano Sadao
Division of Breast and Endocrine Surgery, Dept. of Surgery, Nihon University School of Medicine.
Gan To Kagaku Ryoho. 2007 Nov;34(12):2065-7.
We report a case of advanced breast cancer (T4b, N3c, M1) achieving a significant improvement on QOL by multi-disciplinary therapy and S-1 administration. The patient was a 59-year-old woman who had ulcerative breast lump with bleeding. A core needle biopsy for breast tumor led to a diagnosis of an invasive ductal carcinoma negative for estrogen receptor, progesterone receptor, and HER2/neu protein expression. The aspiration biopsy cytology was performed from skin lesion, the diagnosis was class V. She received 6 cycles of tri-weekly CEF (C: 500 mg, E: 60 mg, F: 500 mg/m2) therapy. The effect of the breast tumor was partial response, and the bleeding from the breast lump was improved. But the response from metastatic skin tumor was less satisfactory. We performed a radiation therapy (20 Gy) to metastatic skin tumor, and the lesion disappeared after the radiation therapy. Then, we tried docetaxel, but the side effect appeared. So, we started administering S-1 after docetaxel. One year later, she was estimated to be in the long stable disease. Multi-disciplinary therapy can improve a patient QOL and the clinical outcomes in Stage IV advanced breast cancer.
我们报告了一例晚期乳腺癌(T4b,N3c,M1)患者,通过多学科治疗和服用S-1,其生活质量得到了显著改善。该患者为一名59岁女性,患有溃疡性乳腺肿块并伴有出血。对乳腺肿瘤进行的粗针活检诊断为雌激素受体、孕激素受体及HER2/neu蛋白表达均为阴性的浸润性导管癌。对皮肤病变进行了针吸活检细胞学检查,诊断为V级。她接受了6个周期的每三周一次的CEF(C:500mg,E:60mg,F:500mg/m²)治疗。乳腺肿瘤的疗效为部分缓解,乳腺肿块出血情况有所改善。但转移性皮肤肿瘤的反应不太令人满意。我们对转移性皮肤肿瘤进行了放射治疗(20Gy),放疗后病变消失。然后,我们尝试使用多西他赛,但出现了副作用。于是,在使用多西他赛后我们开始给予S-1。一年后,估计她处于长期疾病稳定状态。多学科治疗可以改善IV期晚期乳腺癌患者的生活质量和临床结局。