Feng Yu, Zhao Xia, Lv Shuzhen, Xiong Bingjun, Li Yanping, Zhang Man
Department of Breast Surgery, Beijing Shijitan Hospital, Capital Medical University, Beijing, China.
Department of Clinical Laboratory, Beijing Shijitan Hospital, Capital Medical University, Beijing Key Laboratory of Urinary Cellular and Molecular Diagnostics, Beijing, China.
Transl Cancer Res. 2020 Dec;9(12):7669-7675. doi: 10.21037/tcr-20-2031.
Breast cancer is one of the most common malignant tumors in woman. Ovarian and pelvic metastasis in breast cancer are very rare, and the prognosis is often poor. Lacking typical clinical manifestation, misdiagnose is common. We report a case about a middle-aged postmenopausal woman with complaints of finding a left breast mass and irregular vaginal bleeding. Through ultrasound-guided core-needle biopsy of the masses, the patient's final diagnosis was breast cancer with ovarian and pelvic metastasis. The patient received combinations of chemotherapy (intravenous infusion or peritoneal perfusion), radical surgery (gynecological operation and modified radical mastectomy), radiation and endocrine therapy. Forty-eight months follow-up showed that the patient is generally in good condition and had no signs of local recurrence or metastasis. Invasive ductal carcinoma (IDC) of the breast with unilateral ovarian and pelvic metastasis is rare. It is not easy to differentiate from primary ovarian malignant tumor, and the prognosis is generally poor. We chose a combination chemotherapy regimen sensitive to both breast and ovarian tumors for the patient. The therapeutic effect is remarkable. Only a small number of tumor cells were found in pelvic and ovarian tumors. The patient's breast tumors reached pathological complete remission (pCR), which might be the reason for the patient's good prognosis.
乳腺癌是女性最常见的恶性肿瘤之一。乳腺癌发生卵巢和盆腔转移非常罕见，且预后通常较差。由于缺乏典型临床表现，误诊很常见。我们报告一例病例，一名绝经后中年女性，主诉发现左侧乳房肿块及不规则阴道出血。通过对肿块进行超声引导下粗针活检，患者最终诊断为乳腺癌伴卵巢和盆腔转移。患者接受了化疗（静脉输注或腹腔灌注）、根治性手术（妇科手术及改良根治性乳房切除术）、放疗及内分泌治疗联合方案。48个月的随访显示患者总体状况良好，无局部复发或转移迹象。单侧卵巢和盆腔转移的乳腺浸润性导管癌（IDC）罕见。它不易与原发性卵巢恶性肿瘤相鉴别，且预后通常较差。我们为该患者选择了对乳腺和卵巢肿瘤均敏感的联合化疗方案。治疗效果显著。在盆腔和卵巢肿瘤中仅发现少量肿瘤细胞。患者的乳腺肿瘤达到病理完全缓解（pCR），这可能是患者预后良好的原因。
