内容紹介
Summary
The patient was a 65-year-old woman who was diagnosed with Stage ⅢA triple-negative breast cancer(T2N2aM0)at the age of 63. AC chemotherapy(3 months)followed by paclitaxel plus bevacizumab(4 months)was administered as neoadjuvant chemotherapy. After chemotherapy, she underwent mastectomy and lymph node dissection. Pathological examination revealed a partial response. After surgery, radiotherapy with a radiation dose of 50 Gy was applied to the chest wall and supraclavicular lymph node. Multiple pulmonary metastases and mediastinal lymph node metastases were diagnosed 23 months after initial treatment, and she was treated with S-1 administration. Two months after S-1 treatment, the PET-CT showed metastasis in the right atrium. Since there were no cardiac symptoms, S-1 treatment was continued without cardiovascular treatment. However, the mediastinal lymph node metastasis progressed; and therefore, S-1 administration was stopped and chemotherapy with eribulin was initiated. Brain metastasis was diagnosed at the same time and treated with a gamma knife. Although chemotherapy with eribulin was continued, the patient died 33 months after initial treatment owing to the brain metastasis. The cardiac metastasis did not progress during chemotherapy with eribulin. There was no sign of heart failure or arrhythmia during the treatment.
要旨
患者は65歳,女性。63歳時に右乳癌,cT2N2aM0,Stage ⅢA,ER 0%,PR 0%,HER2(0)の診断で術前化学療法後(AC療法,パクリタキセル+ベバシズマブ)にBt+Ax(レベルⅡ)を施行した。組織学的治療効果はGrade 2aであった。術後は右胸壁+鎖骨領域に放射線治療(50 Gy)を施行した。初回治療から1年11か月後に多発肺転移,縦隔リンパ節転移ありS-1を開始した。その2か月後にPET-CT検査で右心房転移を認めた。心症状がなかったため,循環器的治療は行わずにS-1を継続した。縦隔リンパ節転移が増悪したためS-1は4か月で中止しエリブリンに変更した。同時期に脳転移があり,ガンマナイフ治療を施行した。エリブリンを継続したが,脳転移増悪し初回治療から2年9か月後に死亡した。経過中,心不全兆候,不整脈はなかった。
目次
The patient was a 65-year-old woman who was diagnosed with Stage ⅢA triple-negative breast cancer(T2N2aM0)at the age of 63. AC chemotherapy(3 months)followed by paclitaxel plus bevacizumab(4 months)was administered as neoadjuvant chemotherapy. After chemotherapy, she underwent mastectomy and lymph node dissection. Pathological examination revealed a partial response. After surgery, radiotherapy with a radiation dose of 50 Gy was applied to the chest wall and supraclavicular lymph node. Multiple pulmonary metastases and mediastinal lymph node metastases were diagnosed 23 months after initial treatment, and she was treated with S-1 administration. Two months after S-1 treatment, the PET-CT showed metastasis in the right atrium. Since there were no cardiac symptoms, S-1 treatment was continued without cardiovascular treatment. However, the mediastinal lymph node metastasis progressed; and therefore, S-1 administration was stopped and chemotherapy with eribulin was initiated. Brain metastasis was diagnosed at the same time and treated with a gamma knife. Although chemotherapy with eribulin was continued, the patient died 33 months after initial treatment owing to the brain metastasis. The cardiac metastasis did not progress during chemotherapy with eribulin. There was no sign of heart failure or arrhythmia during the treatment.
要旨
患者は65歳,女性。63歳時に右乳癌,cT2N2aM0,Stage ⅢA,ER 0%,PR 0%,HER2(0)の診断で術前化学療法後(AC療法,パクリタキセル+ベバシズマブ)にBt+Ax(レベルⅡ)を施行した。組織学的治療効果はGrade 2aであった。術後は右胸壁+鎖骨領域に放射線治療(50 Gy)を施行した。初回治療から1年11か月後に多発肺転移,縦隔リンパ節転移ありS-1を開始した。その2か月後にPET-CT検査で右心房転移を認めた。心症状がなかったため,循環器的治療は行わずにS-1を継続した。縦隔リンパ節転移が増悪したためS-1は4か月で中止しエリブリンに変更した。同時期に脳転移があり,ガンマナイフ治療を施行した。エリブリンを継続したが,脳転移増悪し初回治療から2年9か月後に死亡した。経過中,心不全兆候,不整脈はなかった。