Jiang Lingting, Shao Yingkuan, Chen Qiang, Tao Sifeng
Department of Breast Surgery, Haiyan People's Hospital, Zhejiang, China.
Key Laboratory of Cancer Prevention and Intervention, Ministry of Education, Department of Breast Surgery and Oncology, Cancer Institute, Second Affiliated Hospital, School of Medicine, Zhejiang University, Zhejiang, Hangzhou, China.
Front Oncol. 2025 Jun 6;15:1505354. doi: 10.3389/fonc.2025.1505354. eCollection 2025.
This case report presents a premenopausal patient with high-risk hormone receptor (HR)-positive, HER2-low breast cancer who underwent breast-conserving surgery and axillary lymph node dissection after neoadjuvant chemotherapy. Despite postoperative radiotherapy, the patient did not adhere to endocrine therapy recommendations. Approximately five years later, metastases were identified in the liver, retroperitoneal lymph nodes, bones, and bladder. Notably, bladder metastasis, an exceptionally rare occurrence in breast cancer, was confirmed. Treatment with trastuzumab deruxtecan (T-DXd) demonstrated partial efficacy, though progression-free survival (PFS) was limited to six months. This case underscores the importance of vigilant follow-up and consideration of rare metastatic sites as breast cancer treatments evolve and improve. Bone-targeted therapies played a critical role, but the patient's short PFS suggests significant tumor heterogeneity. This report discusses a rare case of bladder metastasis originating from HR-positive, HER2-low breast cancer, emphasizing innovative treatments such as T-DXd.
本病例报告介绍了一名绝经前高危激素受体（HR）阳性、HER2低表达乳腺癌患者，该患者在新辅助化疗后接受了保乳手术和腋窝淋巴结清扫术。尽管术后进行了放疗，但患者未遵循内分泌治疗建议。大约五年后，在肝脏、腹膜后淋巴结、骨骼和膀胱中发现了转移灶。值得注意的是，经证实出现了乳腺癌中极为罕见的膀胱转移。曲妥珠单抗德曲妥珠单抗（T-DXd）治疗显示出部分疗效，尽管无进展生存期（PFS）仅为六个月。随着乳腺癌治疗的发展和改进，本病例强调了密切随访以及考虑罕见转移部位的重要性。骨靶向治疗发挥了关键作用，但患者较短的PFS表明肿瘤存在显著异质性。本报告讨论了一例罕见的源自HR阳性、HER2低表达乳腺癌的膀胱转移病例，强调了如T-DXd等创新治疗方法。
