Tomita Masafumi, Oura Shoji, Makimoto Shinichiro
Department of Surgery, Kishiwada Tokushukai Hospital, Kishiwada, Japan.
Division of Breast Surgery, Kishiwada Tokushukai Hospital, Kishiwada, Japan.
Case Rep Oncol. 2020 Mar 24;13(1):261-265. doi: 10.1159/000506195. eCollection 2020 Jan-Apr.
A 42-year-old woman with locally advanced luminal breast cancer was referred to our hospital. Ultrasonography showed marked skin thickening with obscured breast mass. Positron emission tomography showed bilateral swelling in the axillar, parasternal, and supraclavicular lymph nodes in addition to the primary breast cancer. Following the patient's request, we treated her with primary bevacizumab-containing chemotherapy followed by radiotherapy to the breast due to the histologically proven widely spreading cancer remnants in the skin after chemotherapy. Thereafter, the patient underwent mastectomy and axillary dissection with a vertical rectus abdominis musculo-cutaneous flap to cover the skin defect. Pathological examination showed no viable cancer cells both in the breast and lymph nodes but imperceptible cytokeratin AE1 + 3-positive cells in the skin. Although wound healing needed 3 months due to the influence of preoperative radiotherapy, the patient has been well on endocrine therapy without any recurrence for more than 7 years.
一名42岁局部晚期腔面型乳腺癌女性被转诊至我院。超声检查显示皮肤明显增厚，乳腺肿块边界不清。正电子发射断层扫描显示，除原发性乳腺癌外，腋窝、胸骨旁和锁骨上淋巴结出现双侧肿大。应患者要求，我们对她进行了含贝伐单抗的一线化疗，由于化疗后组织学证实皮肤中存在广泛扩散的癌残留，随后对乳房进行了放射治疗。此后，患者接受了乳房切除术和腋窝淋巴结清扫术，并采用腹直肌肌皮瓣修复皮肤缺损。病理检查显示，乳房和淋巴结中均无存活癌细胞，但皮肤中有难以察觉的细胞角蛋白AE1 + 3阳性细胞。尽管术前放疗的影响导致伤口愈合需要3个月，但患者接受内分泌治疗后情况良好，7年多来未出现任何复发。
