Morioka Emi, Ohno Yukako, Noguchi Miki, Nakano Yasuharu, Noguchi Masakuni, Kosaka Takeo, Takanaka Tsuyoshi
Dept. of Breast and Endocrine Surgery, Kanazawa Medical University Hospital, Japan.
Gan To Kagaku Ryoho. 2012 Nov;39(12):1942-4.
A 52-year-old woman developed right breast cancer and underwent modified radical mastectomy in 1994. Histologically, the tumor was invasive ductal carcinoma. She was positive for estrogen receptor (ER) but negative for progesterone receptor(PgR), while her human epidermal growth factor receptor type 2(HER2) status was not examined. Although she received adjuvant hormone therapy and chemotherapy[cyclophosphamide+doxorubicin+5-fluorouraci(l CAF), 6 courses ], she underwent partial pulmonary resection on both sides with right oophorectomy in 1997. Subsequently, she was treated with weekly doses paclitaxel(12 courses). However, she developed a pulmonary metastasis in the left breast. In 2002, she underwent a partial left pulmonary resection (ER-positive and HER2 3+) and treatment with an aromatase inhibitor. Subsequently, she was treated with trastuzumab because of repeated lung metastasis. A complete response was obtained after the administration of trastuzumab. In 2008, she developed bone metastasis in the sternum and the left seventh rib, and subsequently underwent stereotactic body radiotherapy (SBRT). She was treated with trastuzumab and aromatase inhibitor. At present, she is free of pain and is still living 15 years after breast cancer recurrence. This case suggests that the interaction of local treatment(surgery and SBRT) and systemic therapy(chemotherapy, hormonal therapy, and monoclonal therapy) may improve the survival of patients with recurrent breast cancer.
一名52岁女性于1994年患右乳癌并接受了改良根治性乳房切除术。组织学检查显示,肿瘤为浸润性导管癌。她雌激素受体(ER)阳性,但孕激素受体(PgR)阴性,而其人类表皮生长因子受体2(HER2)状态未检测。尽管她接受了辅助激素治疗和化疗[环磷酰胺+阿霉素+5-氟尿嘧啶(CAF),6个疗程],但在1997年进行了双侧部分肺切除术并切除了右侧卵巢。随后,她接受了每周一次的紫杉醇治疗(12个疗程)。然而,她出现了左乳肺转移。2002年,她接受了左肺部分切除术(ER阳性且HER2 3+)并接受了芳香化酶抑制剂治疗。随后,由于反复出现肺转移,她接受了曲妥珠单抗治疗。给予曲妥珠单抗后获得了完全缓解。2008年,她出现了胸骨和左第七肋骨骨转移,随后接受了立体定向体部放疗(SBRT)。她接受了曲妥珠单抗和芳香化酶抑制剂治疗。目前,她没有疼痛,在乳腺癌复发后仍存活15年。该病例表明,局部治疗(手术和SBRT)与全身治疗(化疗、激素治疗和单克隆治疗)的相互作用可能会提高复发性乳腺癌患者的生存率。