Magalhães Denise, Rangel Inês, Mesquita Alexandra
Oncology, Hospital Pedro Hispano, Matosinhos, PRT.
Cardiology, Hospital Pedro Hispano, Matosinhos, PRT.
Cureus. 2022 Mar 7;14(3):e22925. doi: 10.7759/cureus.22925. eCollection 2022 Mar.
HER2-positive inflammatory breast cancer (IBC) is associated with poor overall survival. Targeted therapies have led to improved outcomes. IBC is underrepresented in clinical trials due to its rareness. This case reports a 52-year-old woman diagnosed with IBC of 119x89mm, axillar node-positive, hormone receptor-negative, HER2 positive. The patient underwent neoadjuvant chemotherapy with dual HER2 blockage. Mastectomy histology showed pathological complete response. After two cycles of adjuvant trastuzumab, the patient developed asymptomatic cardiotoxicity leading to the therapeutic suspension. Early recurrence and persisting cardiac alterations prevented treatment with anti-HER2 therapy. At the time of brain recurrence, with cardio-oncology collaboration, it was possible to start TDM-1, with a reduction of 71% of brain lesions size, after two cycles. This case highlights the effectiveness of anti-HER therapy in IBC and the importance of multidisciplinary discussion in treatment choice and toxicity management.
人表皮生长因子受体2（HER2）阳性炎性乳腺癌（IBC）与总体生存率低相关。靶向治疗已改善了治疗结果。由于IBC病例罕见，其在临床试验中的代表性不足。本病例报告了一名52岁女性，诊断为IBC，肿瘤大小为119x89mm，腋窝淋巴结阳性，激素受体阴性，HER2阳性。该患者接受了双重HER2阻断的新辅助化疗。乳房切除术组织学显示病理完全缓解。在辅助曲妥珠单抗治疗两个周期后，患者出现无症状心脏毒性，导致治疗暂停。早期复发和持续的心脏改变使抗HER2治疗无法进行。在脑转移复发时，通过心脏肿瘤学协作，在两个周期后开始使用ado曲妥珠单抗（TDM-1）治疗，脑转移灶大小缩小了71%。本病例强调了抗HER治疗在IBC中的有效性以及多学科讨论在治疗选择和毒性管理中的重要性。
