内容紹介
A Case of a Patient with Breast Cancer, Diagnosed from Sternal Metastasis
Summary
A 32-year-old woman was seen in our hospital for complaints of bulge and pain in the sternum, and upon examination showed a lump in the left breast and enlarged left axillary lymph nodes. The patient was diagnosed with invasive ductal carcinoma with metastasis to the sternum that was T2N1M1(OSS), Stage Ⅳ, hormone-receptor-positive, and HER2-negative. Four courses each of EC and taxane therapy were performed as primary systemic chemotherapy in combination with zoledronic acid, which resulted in calcification of the osteolytic lesion in the sternum and reduced tumor mass in the breast. The patient was judged to have a partial response(PR)to the treatment. Eight months later, breast-conserving surgery and axillary lymph node dissection were performed, followed by radiation therapy to the left breast and sternum. Treatment with zoledronic acid is ongoing and postoperative hormonal therapy has been started. Four years and 4 months after the initial diagnosis, the lesion in the sternum has calcified and hardened and the patient has not had a recurrence in the same breast or elsewhere in the body.
要旨
症例は32歳,女性。胸骨部の膨隆および痛みで当院を受診した。左乳房のしこりおよび左腋窩リンパ節の腫大が発見され,胸骨転移を伴う浸潤性乳管癌でT2N1M1(OSS),Stage Ⅳ,ホルモン受容体陽性,HER2陰性と診断された。primary systemic chemotherapyとして,ECおよびtaxane療法がそれぞれ4コース施行された。同時にzoledronic acidが投与された。胸骨溶解病変は石灰化,乳癌腫瘤も縮小し,部分奏効(partial response: PR)と判定された。8か月後,乳房温存+腋窩リンパ節郭清術が施行された。術後,左乳房と胸骨に放射線治療を追加した。zoledronic acidの投与は継続され,術後ホルモン療法が開始されている。初診から4年4か月を経過して,胸骨病変は石灰硬化し他部位にも再発をみていない。
目次
Summary
A 32-year-old woman was seen in our hospital for complaints of bulge and pain in the sternum, and upon examination showed a lump in the left breast and enlarged left axillary lymph nodes. The patient was diagnosed with invasive ductal carcinoma with metastasis to the sternum that was T2N1M1(OSS), Stage Ⅳ, hormone-receptor-positive, and HER2-negative. Four courses each of EC and taxane therapy were performed as primary systemic chemotherapy in combination with zoledronic acid, which resulted in calcification of the osteolytic lesion in the sternum and reduced tumor mass in the breast. The patient was judged to have a partial response(PR)to the treatment. Eight months later, breast-conserving surgery and axillary lymph node dissection were performed, followed by radiation therapy to the left breast and sternum. Treatment with zoledronic acid is ongoing and postoperative hormonal therapy has been started. Four years and 4 months after the initial diagnosis, the lesion in the sternum has calcified and hardened and the patient has not had a recurrence in the same breast or elsewhere in the body.
要旨
症例は32歳,女性。胸骨部の膨隆および痛みで当院を受診した。左乳房のしこりおよび左腋窩リンパ節の腫大が発見され,胸骨転移を伴う浸潤性乳管癌でT2N1M1(OSS),Stage Ⅳ,ホルモン受容体陽性,HER2陰性と診断された。primary systemic chemotherapyとして,ECおよびtaxane療法がそれぞれ4コース施行された。同時にzoledronic acidが投与された。胸骨溶解病変は石灰化,乳癌腫瘤も縮小し,部分奏効(partial response: PR)と判定された。8か月後,乳房温存+腋窩リンパ節郭清術が施行された。術後,左乳房と胸骨に放射線治療を追加した。zoledronic acidの投与は継続され,術後ホルモン療法が開始されている。初診から4年4か月を経過して,胸骨病変は石灰硬化し他部位にも再発をみていない。