Wu Rongrong, Adachi Kayo, Koyama Yoichi, Orimoto Kyoko, Okazaki Miki, Asaoka Mariko, Teraoka Saeko, Ueda Ai, Miyahara Kana, Kawate Takahiko, Kaise Hiroshi, Yamada Kimito, Sato Eichi, Ishikawa Takashi
Department of Breast Oncology and Surgery, Tokyo Medical University, Tokyo, Japan.
Department of Pathology, Tokyo Medical University, Tokyo, Japan.
J Surg Case Rep. 2021 Apr 14;2021(4):rjab018. doi: 10.1093/jscr/rjab018. eCollection 2021 Apr.
A 52-year-old woman with a strong family history of breast cancer was diagnosed as having triple-negative breast cancer (TNBC) in her right breast. Neoadjuvant chemotherapy (NAC; four cycles of epirubicin/cyclophosphamide/5-fluorouracil) was performed, followed by breast-conserving surgery and axillary lymph node dissection. Histopathological analysis of the surgical specimens demonstrated a few focal tumor cells remaining in the stroma, but not a pathological complete response (pCR). Weekly paclitaxel was subsequently added to the treatment regimen. A total of 17 months after the adjuvant treatments, TNBC recurred in her left breast with massive lymph node metastasis. Because of the early recurrence after standard treatment, NAC was administered together with carboplatin and paclitaxel. Histopathological analysis of the partially resected breast and axillary lymph nodes demonstrated a pCR. No recurrent disease was found 2 years after the second TNBC treatment. This case underlines the importance of platinum-based chemotherapy and prophylactic mastectomy for patients with BRCA dysfunction.
一名有乳腺癌家族史的52岁女性被诊断为右乳三阴性乳腺癌（TNBC）。进行了新辅助化疗（NAC；四个周期的表柔比星/环磷酰胺/5-氟尿嘧啶），随后进行了保乳手术和腋窝淋巴结清扫。手术标本的组织病理学分析显示，基质中残留有一些局灶性肿瘤细胞，但未达到病理完全缓解（pCR）。随后在治疗方案中加入了每周一次的紫杉醇。辅助治疗共17个月后，TNBC在她的左乳复发并伴有大量淋巴结转移。由于标准治疗后早期复发，给予了NAC联合卡铂和紫杉醇治疗。对部分切除的乳房和腋窝淋巴结进行组织病理学分析显示达到了pCR。第二次TNBC治疗后2年未发现复发疾病。该病例强调了铂类化疗和预防性乳房切除术对BRCA功能障碍患者的重要性。
