Sakurai Kenichi, Enomoto Katsuhisa, Tani Mayumi, Kitajima Akira, Amano Sadao, Shiono Motomi
Division of Breast and Endocrine Surgery, Dept. of Surgery, Nihon University School of Medicine.
Gan To Kagaku Ryoho. 2008 Nov;35(12):2219-21.
We report a case of advanced breast cancer with skin ulceration and bleeding (T4bN3bM0: Stage IIIC) achieving a significant improvement of QOL by toremifene and paclitaxel therapy. The patient was a 38-year-old woman with slight anemia who had ulcerative breast lump with skin ulcer. A core needle biopsy for breast tumor led to a diagnosis of an invasive ductal carcinoma positive for estrogen receptor and progesteron receptor, and negative for HER2/neu protein expression. She received 6 cycles of tri-weekly FEC (C: 500 mg, E: 60 mg, F: 500 mg/m2) and 16 cycles of weekly paclitaxel (80 mg/m2) with toremifene (120 mg/day). The anemia and the bleeding from the tumor disappeared after FEC chemotherapy. The response for breast tumor after paclitaxel and toremifene therapy was evaluated as partial response, and the infraclavicular, subpectoral, and interpectoral lymph nodes metastasis disappeared. Muscle-preserving radical mastectomy (Bt + Ax: Auchincloss) with skin transplantation was performed. She had no recurrence during one year after the operation. Paclitaxel and Toremifene therapy was effective for advanced breast tumor, and can improve a patient QOL and the clinical outcomes in Stage IIIC advanced breast cancer.
我们报告一例晚期乳腺癌伴皮肤溃疡和出血(T4bN3bM0:IIIC期)患者,通过托瑞米芬和紫杉醇治疗,生活质量得到显著改善。该患者为一名38岁轻度贫血女性,患有溃疡性乳腺肿块伴皮肤溃疡。乳腺肿瘤的粗针活检诊断为雌激素受体和孕激素受体阳性、HER2/neu蛋白表达阴性的浸润性导管癌。她接受了6个周期的每三周一次的FEC方案(C:500mg,E:60mg,F:500mg/m²)以及16个周期的每周一次的紫杉醇(80mg/m²)联合托瑞米芬(120mg/天)治疗。FEC化疗后贫血及肿瘤出血消失。紫杉醇和托瑞米芬治疗后乳腺肿瘤反应评估为部分缓解,锁骨下、胸大肌下和胸肌间淋巴结转移消失。实施了保留肌肉的根治性乳房切除术(Bt + Ax:Auchincloss法)并进行了皮肤移植。术后一年她未出现复发。紫杉醇和托瑞米芬治疗对晚期乳腺肿瘤有效,可改善IIIC期晚期乳腺癌患者的生活质量及临床结局。