内容紹介
A Case of the Locally Advanced Breast Cancer with Serious Comorbidities Obtained a Good Local Control
Summary
A 66-years-old woman was referred to our hospital with the chief complaint of a huge exposed left breast mass, associated massive exudates, bleeding and foul-smelling discharge. Invasive ductal carcinoma was diagnosed by core needle biopsy. The computed tomography showed left axillary lymph node metastases and no distant metastasis. Her performance status(PS)was Grade 3. She had serious comorbidities such as non-alcoholic steatohepatitis and liver cirrhosis, renal dysfunction. DMpC therapy and Mohs paste therapy were started since her overall status was improved. The huge left breast tumor and left axillary lymph node metastases were reduced remarkably. Total mastectomy and axillary lymph node dissection and free skin grafting was perfomed, and PS was improved to Grade 0, She received DMpC therapy for 4 months postoperatively, and radiotherapy at left chest wall and supraclavicular fossa.
要旨
症例は66歳,女性。滲出液と出血および悪臭を伴う露出した巨大な左乳房腫瘤と,腹水貯留による腹部膨満を主訴に当院を受診した。針生検で浸潤性乳管癌と診断,CT検査では左腋窩リンパ節転移を認めたが,遠隔転移はなかった。performance status(PS)はGrade 3で,非アルコール性脂肪肝炎および肝硬変と腎機能障害といった重篤な併存症を有していた。全身状態が改善してからDMpC療法を開始,並行してMohsペーストによる処置を行った。巨大な左乳房腫瘤と腋窩リンパ節転移は著明に縮小した。乳房切除,腋窩リンパ節郭清および分層植皮術を施行,PSはGrade 0に回復した。術後に4か月間DMpC療法を行い,左胸壁と鎖骨上に放射線療法を行った。
目次
Summary
A 66-years-old woman was referred to our hospital with the chief complaint of a huge exposed left breast mass, associated massive exudates, bleeding and foul-smelling discharge. Invasive ductal carcinoma was diagnosed by core needle biopsy. The computed tomography showed left axillary lymph node metastases and no distant metastasis. Her performance status(PS)was Grade 3. She had serious comorbidities such as non-alcoholic steatohepatitis and liver cirrhosis, renal dysfunction. DMpC therapy and Mohs paste therapy were started since her overall status was improved. The huge left breast tumor and left axillary lymph node metastases were reduced remarkably. Total mastectomy and axillary lymph node dissection and free skin grafting was perfomed, and PS was improved to Grade 0, She received DMpC therapy for 4 months postoperatively, and radiotherapy at left chest wall and supraclavicular fossa.
要旨
症例は66歳,女性。滲出液と出血および悪臭を伴う露出した巨大な左乳房腫瘤と,腹水貯留による腹部膨満を主訴に当院を受診した。針生検で浸潤性乳管癌と診断,CT検査では左腋窩リンパ節転移を認めたが,遠隔転移はなかった。performance status(PS)はGrade 3で,非アルコール性脂肪肝炎および肝硬変と腎機能障害といった重篤な併存症を有していた。全身状態が改善してからDMpC療法を開始,並行してMohsペーストによる処置を行った。巨大な左乳房腫瘤と腋窩リンパ節転移は著明に縮小した。乳房切除,腋窩リンパ節郭清および分層植皮術を施行,PSはGrade 0に回復した。術後に4か月間DMpC療法を行い,左胸壁と鎖骨上に放射線療法を行った。