Jinno Takanori, Kurumiya Yasuhiro, Niwa Tae, Sekoguchi Ei, Kobayashi Satoshi, Kawai Kiyotaka, Kiriyama Muneyasu
Dept. of Surgery, Toyota Kosei Hospital.
Gan To Kagaku Ryoho. 2016 Dec;43(13):2539-2542.
The first patient was a 62-year-old woman who was referred to our hospital with the complaint of a left breast tumor. She was diagnosed with invasive ductal carcinoma(T1N0M0, stage I). The tumor was ER-positive, PgR-negative, and HER2- negative. She was treated with toremifene, letrozole, and anastrozole as neoadjuvant hormone therapy for 4 months, but the tumor increased in size. The clinical response was judged as progressive disease, and a left partial mastectomy and axillary lymph node dissection were performed. Chemotherapy and radiotherapy were performed after surgery. The second patient was a 68-year-old woman who was referred to our hospital with the complaint of a right breast tumor. She was diagnosed as invasive ductal carcinoma(T1N0M0, stage I). The tumor was ER-positive, PgR-negative, and HER2-negative. She was treated with letrozole as neoadjuvant hormone therapy for 4 months, but the tumor increased in size. The clinical response was judged as progressive disease, and a right partial mastectomy and axillary lymph node dissection were performed. Chemotherapy and radiotherapy were performed after surgery. Although the evidence is still insufficient, with neoadjuvant hormone therapy for hormone-sensitive breast cancer, improved tumor shrinkage and breast conservation have been reported. We experienced two cases in which the tumor increased in size during neoadjuvant hormone therapy; however, even though these cases showed no apparent effect, chemotherapy may be effective in future cases.
首例患者为一名62岁女性，因左乳肿瘤前来我院就诊。她被诊断为浸润性导管癌（T1N0M0，I期）。肿瘤雌激素受体（ER）阳性，孕激素受体（PgR）阴性，人表皮生长因子受体2（HER2）阴性。她接受了托瑞米芬、来曲唑和阿那曲唑作为新辅助激素治疗4个月，但肿瘤大小增加。临床反应被判定为疾病进展，遂行左乳部分切除术和腋窝淋巴结清扫术。术后进行了化疗和放疗。第二例患者是一名68岁女性，因右乳肿瘤前来我院就诊。她被诊断为浸润性导管癌（T1N0M0，I期）。肿瘤ER阳性，PgR阴性，HER2阴性。她接受了来曲唑作为新辅助激素治疗4个月，但肿瘤大小增加。临床反应被判定为疾病进展，遂行右乳部分切除术和腋窝淋巴结清扫术。术后进行了化疗和放疗。尽管证据仍不充分，但对于激素敏感性乳腺癌的新辅助激素治疗，已有报道称肿瘤缩小情况有所改善且保乳率提高。我们遇到了两例在新辅助激素治疗期间肿瘤增大的病例；然而，尽管这些病例未显示出明显效果，但化疗在未来病例中可能有效。
