Qin Ruoyan, Qian Jie, Shan Mengjun, Ruan Guangxin, Yang Xiaofeng, Wang Yanwen, Liu Lingshuang
Department of Oncology, Longhua Hospital, Shanghai University of Traditional Chinese Medicine, Shanghai, China.
Department of Emergency Medicine, Shanghai Chest Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, China.
Front Oncol. 2023 Feb 14;13:1023787. doi: 10.3389/fonc.2023.1023787. eCollection 2023.
Triple-negative breast cancer refers to breast cancer patients with negative estrogen receptor (ER), progesterone receptor (PR) and human epidermal growth factor receptor (HER2). Metastatic triple-negative breast cancer is predominantly treated with chemotherapy, but later-line treatment remains challenging. Breast cancer is highly heterogeneous, and the expression of hormone receptors is often inconsistent between primary and metastatic lesions. Here, we report a case of triple-negative breast cancer 17 years after surgery with lung metastases for 5 years that progressed to pleural metastases after multiple lines of chemotherapy. The pleural pathology suggested ER (+) and PR (+) and transformation to luminal A breast cancer. This patient received fifth-line letrozole endocrine therapy and achieved partial response (PR). The patient's cough and chest tightness improved after treatment, associated tumor markers decreased, and progression-free survival (PFS) exceeded 10 months. Our results may be of clinical relevance for patients with hormone receptor alterations in advanced triple-negative breast cancer and suggest that individualized regimens should be developed for breast cancer based on the molecular expression of tumor tissue at the primary and metastatic sites.
三阴性乳腺癌是指雌激素受体（ER）、孕激素受体（PR）和人表皮生长因子受体（HER2）均为阴性的乳腺癌患者。转移性三阴性乳腺癌主要采用化疗进行治疗，但后续治疗仍然具有挑战性。乳腺癌具有高度异质性，原发性和转移性病灶之间激素受体的表达往往不一致。在此，我们报告一例三阴性乳腺癌患者，术后17年出现肺转移5年，在接受多线化疗后进展为胸膜转移。胸膜病理提示ER（+）和PR（+），并转化为腔面A型乳腺癌。该患者接受了五线来曲唑内分泌治疗并获得部分缓解（PR）。治疗后患者的咳嗽和胸闷症状改善，相关肿瘤标志物下降，无进展生存期（PFS）超过10个月。我们的结果可能对晚期三阴性乳腺癌激素受体改变的患者具有临床意义，并提示应根据原发性和转移部位肿瘤组织的分子表达为乳腺癌制定个体化治疗方案。
