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与乳腺癌抗争,永远不会因年龄太大而无法:一例病例报告。

Never too old to fight breast cancer: A case report.

作者信息

Zuradelli Monica, Masci Giovanna, Ferraro Emanuela, Losurdo Agnese, De Sanctis Rita, Torrisi Rosalba, Santoro Armando

机构信息

Medical Oncology and Hematology Department, Humanitas Cancer Center, Rozzano, Milan, Italy.

出版信息

Medicine (Baltimore). 2018 Mar;97(9):e9981. doi: 10.1097/MD.0000000000009981.

Abstract

RATIONALE

Breast cancer is the most common cancer affecting females worldwide and its lifetime risk increases with age. Human epidermal growth factor receptor gene-2 (HER-2) positive breast cancer represents about 20% of all breast cancers, 1 out of 10 is diagnosed in women over 70 years of age. It tends to be more aggressive and to spread more quickly than other subtypes, but the introduction in clinical practice of new anti-HER-2 agents combined with chemotherapy has significantly improved progression free and overall survival. Elderly patients are frequently undertreated because of concerns about their age, performance status, and comorbidities. Here, we report a case of an octogenarian patient treated with T-DM1 with brilliant results.

PATIENT CONCERNS

An 87 years old woman affected with HER-2 positive breast cancer presented progression of disease with lymph node and skin metastases after 3 lines of chemoimmunotherapy.

DIAGNOSES

Breast cancer in elderly patient, lymph node, and skin metastases.

INTERVENTIONS

Chemoimmunotherapy (trastuzumab emtansine).

OUTCOME

Objective response of the disease and significant clinical benefit.

LESSONS

This case clearly suggests that age and comorbidities do not always represent an absolute contraindication to combined treatments.

摘要

原理

乳腺癌是全球影响女性的最常见癌症,其终生风险随年龄增长而增加。人表皮生长因子受体基因2(HER-2)阳性乳腺癌约占所有乳腺癌的20%,每10例中有1例是在70岁以上的女性中诊断出来的。它往往比其他亚型更具侵袭性且扩散更快,但新型抗HER-2药物与化疗联合应用于临床实践后,显著改善了无进展生存期和总生存期。老年患者常因对其年龄、体能状态和合并症的担忧而接受不足的治疗。在此,我们报告一例用曲妥珠单抗 emtansine(T-DM1)治疗取得显著效果的八旬患者病例。

患者情况

一名87岁的女性,患有HER-2阳性乳腺癌,在接受3线化学免疫治疗后出现疾病进展,伴有淋巴结和皮肤转移。

诊断

老年患者乳腺癌,淋巴结及皮肤转移。

干预措施

化学免疫治疗(曲妥珠单抗 emtansine)。

结果

疾病出现客观缓解且有显著临床获益。

经验教训

该病例清楚表明,年龄和合并症并不总是联合治疗的绝对禁忌证。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/cf7d/5851756/58ddf31e72ff/medi-97-e9981-g001.jpg

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