Satoh Eigo, Hara Masatake, Uehira Daisuke, Yonekura Koji, Murakata Ayano, Ohinata Ryoki, Toyofuku Yasuhiro, Tanami Hideaki, Osanai Takayuki, Sugano Norihide, Sakoma Takaaki
Dept. of Surgery, Tokyo Metropolitan Ohkubo Hospital.
Gan To Kagaku Ryoho. 2022 Dec;49(13):1491-1493.
We report a case of recurrent breast cancer with multiple bone metastasis in a 62-year-old woman. Her breast cancer (invasive ductal carcinoma, T2N0M0, Stage ⅡA)was resected in 2001(partial mastectomy plus axillary lymph node dissection) with adjuvant chemotherapy(UFT)and irradiation to her left remnant breast. In February 2018, she complained of severe pain in right femoral joint and hip. CT scan showed a left cystic breast tumor(17 cm)and multiple bone metastasis. The core needle biopsy of the costal bone lesion and left mastectomy were performed. These pathological findings were recurrence of the breast cancer(ER+). The endocrine therapy(exemestane, aromatase inhibitor), the administration of denosumab and irradiation to painful bone lesions were performed, but it did not suppress tumor progression. The treatment of letrozole plus palbociclib(CDK4/6 inhibitor)were continued for 3 months from May 2018, and this therapy made her bone lesions smaller, but palbociclib were stopped due to its severe neutropenia. After that, the single administration of letrozole was continued, but the tumor marker did not become normal. In February 2019, abemaciclib was administered in addition to letrozole. One year later, her symptoms improved and her bone metastases have showed partial response.
我们报告了一例62岁女性复发性乳腺癌伴多发骨转移的病例。她的乳腺癌（浸润性导管癌，T2N0M0，ⅡA期）于2001年接受手术切除（部分乳房切除术加腋窝淋巴结清扫术），并接受辅助化疗（优福定）及左侧残留乳房放疗。2018年2月，她主诉右股骨关节和髋部剧痛。CT扫描显示左乳腺囊性肿瘤（17厘米）及多发骨转移。对肋骨病变进行了粗针穿刺活检并实施了左侧乳房切除术。这些病理结果为乳腺癌复发（雌激素受体阳性）。给予内分泌治疗（依西美坦，芳香化酶抑制剂）、地诺单抗治疗及对疼痛性骨病变进行放疗，但未能抑制肿瘤进展。从2018年5月起持续使用来曲唑加帕博西尼（细胞周期蛋白依赖性激酶4/6抑制剂）治疗3个月，该治疗使她的骨病变缩小，但因严重中性粒细胞减少而停用帕博西尼。此后，继续单独使用来曲唑，但肿瘤标志物未恢复正常。2019年2月，除来曲唑外加用阿贝西利。一年后，她的症状改善，骨转移显示部分缓解。
