Yamashita Yuji, Tanaka Yuko, Kono Seishi, Nishimura Meiko, Mukohara Toru, Morinaga Yukiko, Hara Shigeo, Takao Shintaro
Division of Breast and Endocrine Surgery, Department of Surgery, Kobe University Graduate School of Medicine, Kobe, Japan.
Division of Medical Oncology/Hematology, Department of Medicine, Kobe University Graduate School of Medicine, Kobe, Japan.
Breast Care (Basel). 2017 Mar;12(1):45-47. doi: 10.1159/000457948. Epub 2017 Feb 28.
Inflammatory breast cancer (IBC) is the most aggressive form of primary breast cancer.
A 40-year-old woman was referred to our hospital for evaluation of an induration in the right breast, suspected to be breast cancer. The tumor was diagnosed as estrogen receptor-negative, progesterone receptor-negative, HER2-positive, T4dN3cM0 stage IIIc IBC with axillary lymph node metastasis. Rather than surgical intervention, we chose a systemic treatment approach with pertuzumab, trastuzumab, and docetaxel (PTD) combination therapy which was shown to be effective for HER2-positive IBC in the NeoSphere trial. After 4 cycles of treatment, the patient had a partial response, allowing mastectomy of the right breast and axillary lymph node dissection to achieve local control. We review this case because of the success of PTD combination neoadjuvant chemotherapy for HER2-positive IBC.
To improve the poor prognosis of IBC, combined modality therapy is required, including chemotherapy and local treatment such as surgery and/or radiation therapy. In this case, combination neoadjuvant chemotherapy with PTD for HER2-positive IBC was effective, and this regimen may contribute to further improvements in the cure rate for this malignancy.
炎性乳腺癌(IBC)是原发性乳腺癌中最具侵袭性的类型。
一名40岁女性因右乳硬结被转诊至我院,怀疑为乳腺癌。该肿瘤被诊断为雌激素受体阴性、孕激素受体阴性、HER2阳性,T4dN3cM0 IIIc期炎性乳腺癌伴腋窝淋巴结转移。我们选择了曲妥珠单抗、帕妥珠单抗和多西他赛(PTD)联合治疗的全身治疗方法,而非手术干预,在NeoSphere试验中显示该疗法对HER2阳性炎性乳腺癌有效。经过4个周期的治疗,患者出现部分缓解,随后行右乳乳房切除术和腋窝淋巴结清扫术以实现局部控制。由于PTD联合新辅助化疗对HER2阳性炎性乳腺癌治疗成功,我们对该病例进行了回顾。
为改善炎性乳腺癌的不良预后,需要综合治疗,包括化疗和手术及/或放疗等局部治疗。在本病例中,PTD联合新辅助化疗对HER2阳性炎性乳腺癌有效,该方案可能有助于进一步提高这种恶性肿瘤的治愈率。