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转移性三阴性乳腺癌长期生存病例报告:转移性疾病的治疗可能性

Case report of long-term survival with metastatic triple-negative breast carcinoma: Treatment possibilities for metastatic disease.

作者信息

Chue Ben Man-Fai, La Course Bryce Douglas

机构信息

Lifespring Cancer Treatment Center, Seattle, WA.

出版信息

Medicine (Baltimore). 2019 Apr;98(16):e15302. doi: 10.1097/MD.0000000000015302.

Abstract

RATIONALE

Breast cancer is the most common as well as one of the most devastating cancers among women in the United States. Prognosis is poor for patients with metastatic breast cancer, especially for patients with so-called "triple-negative" disease. The lack of effective therapies for metastatic triple-negative breast cancer outlines the need for novel and innovative treatment strategies.

PATIENT CONCERNS

A 58-year-old underwent a mastectomy which revealed a recurrent triple-negative breast carcinoma. Afterward, she presented with a growing mass in her left axilla and chest wall. A computed tomography scan showed axillary and supraclavicular adenopathy, nodules in the left upper and lower lobe of the lungs, and 2 areas of disease in the liver. A bone scan showed lesions in the ribs.

DIAGNOSIS

The patient was diagnosed with a recurrent metastatic triple-negative breast carcinoma that spread to the lung, liver, and bones.

INTERVENTIONS

The patient was treated with metronomic chemotherapy, sequential chemotherapy regimens, and immunotherapy.

OUTCOMES

The patient is now over 15 years out from her diagnosis of metastatic disease without any evidence of recurrent disease, likely due to the patient's treatment strategy which included sequential metronomic chemotherapy regimens and immunotherapy.

LESSONS

Sequential metronomic chemotherapy regimens in combination with immunotherapy might be an effective treatment option for patients with metastatic triple-negative breast cancer. We hope that this case can provide some guidance for the treatment of metastatic triple-negative breast cancer and motivate research that can potentially lead to more cases of long-term survival for patients who develop this dismal disease.

摘要

理论依据

乳腺癌是美国女性中最常见且最具毁灭性的癌症之一。转移性乳腺癌患者的预后较差,尤其是所谓的“三阴性”疾病患者。转移性三阴性乳腺癌缺乏有效的治疗方法,这凸显了对新颖创新治疗策略的需求。

患者情况

一名58岁女性接受了乳房切除术,结果显示为复发性三阴性乳腺癌。之后,她左腋窝和胸壁出现肿块且不断增大。计算机断层扫描显示腋窝和锁骨上淋巴结肿大、左肺上下叶有结节以及肝脏有2处病灶。骨扫描显示肋骨有病变。

诊断

患者被诊断为复发性转移性三阴性乳腺癌,已扩散至肺、肝和骨。

干预措施

患者接受了节拍化疗、序贯化疗方案和免疫治疗。

结果

自诊断为转移性疾病以来,患者已超过15年,且无任何复发疾病迹象,这可能得益于患者的治疗策略,包括序贯节拍化疗方案和免疫治疗。

经验教训

序贯节拍化疗方案联合免疫治疗可能是转移性三阴性乳腺癌患者的一种有效治疗选择。我们希望这个病例能为转移性三阴性乳腺癌的治疗提供一些指导,并推动相关研究以可能为罹患这种严重疾病的患者带来更多长期生存的案例。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/8e80/6494386/149641814558/medi-98-e15302-g001.jpg

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