内容紹介
A Case of Advanced Breast Cancer Effectively Treated with Bevacizumab and Letrozole
Summary
We report a case of primary advanced breast cancer that was locally controlled by treatment with bevacizumab. A 69-year-old woman presented at our hospital complaining of left breast hemorrhage. Her left breast had a large mass with an ulcer, and there was bleeding. Breast ultrasonography showed a large tumor that involved the whole left breast, and some swollen axillary lymph nodes. Breast MRI showed a mass of 77 mm and skin invasion around the medial area of the left breast. Histopathological examination indicated invasive ductal carcinoma, ER(+), PgR(+), HER2(-), Ki-67 20%. We diagnosed left breast carcinoma, T4bN1M0, stage ⅢB. She received paclitaxel plus bevacizumab as first-line therapy. Breast MRI showed a reduction in the primary tumor and axillary lymph node swelling. Adverse events including hypertension(Grade 3)and peripheral neuropathy(Grade 2)were observed. She received letrozole as second-line therapy. After commencing letrozole, the tumor reduced further, and the local ulcer disappeared showing only induration. Four years from the start of treatment, the woman has obtained good local control and has not developed other metastases.
要旨
症例は69歳,女性。1年前から左前胸部からの出血を主訴に当院皮膚科を初診した。初診時,左前胸部に潰瘍を伴う腫瘤を認め当科紹介となった。超音波で左乳房全体に腫瘤を認め,また24 mmまでの腋窩リンパ節を認めた。乳房造影MR検査では左乳房AB領域を中心に77 mmの腫瘤を認め,皮膚浸潤を認めた。左前胸部の腫瘤潰瘍部の一部を切除生検し,invasive ductal carcinoma,ER(+),PgR(+),HER2(-),Ki-67 20%の診断であった。左乳癌,T4bN1M0,stage ⅢBの診断で,first-lineとしてpaclitaxel+bevacizumab療法を行った。原発巣は縮小率32%,腋窩リンパ節は縮小率70%であったが副作用として高血圧Grade 3を認め,second-lineとしてレトロゾール内服を開始した。その後も腫瘍縮小効果を認め,局所の潰瘍は消失し,硬結を認めるのみとなった。現在,初診時より4年経過しているが遠隔転移を認めず,良好な局所コントロールが得られている。
目次
Summary
We report a case of primary advanced breast cancer that was locally controlled by treatment with bevacizumab. A 69-year-old woman presented at our hospital complaining of left breast hemorrhage. Her left breast had a large mass with an ulcer, and there was bleeding. Breast ultrasonography showed a large tumor that involved the whole left breast, and some swollen axillary lymph nodes. Breast MRI showed a mass of 77 mm and skin invasion around the medial area of the left breast. Histopathological examination indicated invasive ductal carcinoma, ER(+), PgR(+), HER2(-), Ki-67 20%. We diagnosed left breast carcinoma, T4bN1M0, stage ⅢB. She received paclitaxel plus bevacizumab as first-line therapy. Breast MRI showed a reduction in the primary tumor and axillary lymph node swelling. Adverse events including hypertension(Grade 3)and peripheral neuropathy(Grade 2)were observed. She received letrozole as second-line therapy. After commencing letrozole, the tumor reduced further, and the local ulcer disappeared showing only induration. Four years from the start of treatment, the woman has obtained good local control and has not developed other metastases.
要旨
症例は69歳,女性。1年前から左前胸部からの出血を主訴に当院皮膚科を初診した。初診時,左前胸部に潰瘍を伴う腫瘤を認め当科紹介となった。超音波で左乳房全体に腫瘤を認め,また24 mmまでの腋窩リンパ節を認めた。乳房造影MR検査では左乳房AB領域を中心に77 mmの腫瘤を認め,皮膚浸潤を認めた。左前胸部の腫瘤潰瘍部の一部を切除生検し,invasive ductal carcinoma,ER(+),PgR(+),HER2(-),Ki-67 20%の診断であった。左乳癌,T4bN1M0,stage ⅢBの診断で,first-lineとしてpaclitaxel+bevacizumab療法を行った。原発巣は縮小率32%,腋窩リンパ節は縮小率70%であったが副作用として高血圧Grade 3を認め,second-lineとしてレトロゾール内服を開始した。その後も腫瘍縮小効果を認め,局所の潰瘍は消失し,硬結を認めるのみとなった。現在,初診時より4年経過しているが遠隔転移を認めず,良好な局所コントロールが得られている。