内容紹介
Summary
A 53-year-old woman presented at our hospital because of a mass in the left breast. A mass measuring 2 cm in diameter was palpated in the upper outer region(C region)of the left breast. Mammography showed a mass with calcification. Mammary ultrasonography showed a mass measuring 18×16×14 mm and enlarged lymph nodes in the left axillary region. Core needle biopsy revealed Luminal B invasive ductal carcinoma(scirrhous type). The estrogen receptor(ER)positivity was 95%, progesterone receptor(PgR)positivity was 60%, human epidermal growth factor receptor type 2(HER2)score was 2+, fluorescence in situ hybridization(FISH)showed no amplification, and Ki-67 index was 60%. Clinical T1N1M0, StageⅡA cancer was thus diagnosed. As preoperative chemotherapy, the patient received 4 courses of treatment containing epirubicin(100 mg/m2), 5-fluorouracil(500 mg/m2), and cyclophosphamide(500 mg/m2; FEC100), and 4 courses of treatment containing docetaxel and cyclophosphamide(TC). Clinical complete response(cCR)was confirmed on imaging studies. The patient was explained about the need for surgery, but she refused to undergo surgery. The patient is being followed up while receiving endocrine therapy, and there has been no recurrence or metastasis as of 2 years. We described our encounter with a patient with breast cancer who refused surgery after preoperative chemotherapy and has had no recurrence or metastasis during follow-up.
要旨
症例は53歳,女性。主訴は左乳房腫瘤。左乳房C領域に2 cm大の腫瘤を触知した。マンモグラフィ(MMG)では石灰化を伴う腫瘤,乳房超音波検査では18×16×14 mmの腫瘤を認め,左腋窩にリンパ節腫大を認めた。乳房腫瘤の針生検にて浸潤性乳管癌(硬性型),ER 95%,PgR 60%,HER2 2+,FISH増幅なし,Ki-67 60%,Luminal Bであった。cT1N1M0,cStageⅡAと診断した。術前化学療法はFEC100,TC(4コースずつ)を施行し,画像上臨床的完全奏効(clinical complete response: cCR)を得た。患者は手術の必要性を説明するも拒否した。ホルモン療法にて経過観察し,2年経過した時点で再発・転移は認めていない。今回,腋窩リンパ節転移を伴うLuminal B乳癌の術前化学療法後cCR症例で,2年再発・転移なく経過している症例を経験した。
目次
A 53-year-old woman presented at our hospital because of a mass in the left breast. A mass measuring 2 cm in diameter was palpated in the upper outer region(C region)of the left breast. Mammography showed a mass with calcification. Mammary ultrasonography showed a mass measuring 18×16×14 mm and enlarged lymph nodes in the left axillary region. Core needle biopsy revealed Luminal B invasive ductal carcinoma(scirrhous type). The estrogen receptor(ER)positivity was 95%, progesterone receptor(PgR)positivity was 60%, human epidermal growth factor receptor type 2(HER2)score was 2+, fluorescence in situ hybridization(FISH)showed no amplification, and Ki-67 index was 60%. Clinical T1N1M0, StageⅡA cancer was thus diagnosed. As preoperative chemotherapy, the patient received 4 courses of treatment containing epirubicin(100 mg/m2), 5-fluorouracil(500 mg/m2), and cyclophosphamide(500 mg/m2; FEC100), and 4 courses of treatment containing docetaxel and cyclophosphamide(TC). Clinical complete response(cCR)was confirmed on imaging studies. The patient was explained about the need for surgery, but she refused to undergo surgery. The patient is being followed up while receiving endocrine therapy, and there has been no recurrence or metastasis as of 2 years. We described our encounter with a patient with breast cancer who refused surgery after preoperative chemotherapy and has had no recurrence or metastasis during follow-up.
要旨
症例は53歳,女性。主訴は左乳房腫瘤。左乳房C領域に2 cm大の腫瘤を触知した。マンモグラフィ(MMG)では石灰化を伴う腫瘤,乳房超音波検査では18×16×14 mmの腫瘤を認め,左腋窩にリンパ節腫大を認めた。乳房腫瘤の針生検にて浸潤性乳管癌(硬性型),ER 95%,PgR 60%,HER2 2+,FISH増幅なし,Ki-67 60%,Luminal Bであった。cT1N1M0,cStageⅡAと診断した。術前化学療法はFEC100,TC(4コースずつ)を施行し,画像上臨床的完全奏効(clinical complete response: cCR)を得た。患者は手術の必要性を説明するも拒否した。ホルモン療法にて経過観察し,2年経過した時点で再発・転移は認めていない。今回,腋窩リンパ節転移を伴うLuminal B乳癌の術前化学療法後cCR症例で,2年再発・転移なく経過している症例を経験した。