内容紹介
Summary
A 51-year-old woman came to our hospital complaining of a skin ulcer in the left breast. She had previously undergone cosmetic breast augmentation by placement of a bag prosthesis under each mammary gland. She was diagnosed with StageⅣ(T4bN1M1)breast cancer with multiple bone metastases. Following the diagnosis, 3 regimens of hormonal therapy were sequentially administered. The treatment was then switched to chemotherapy following confirmation of tumor progression in the left breast tumor. After 3 cycles of paclitaxel and bevacizumab as the second-line of chemotherapy, the size of the left breast tumor was remarkably reduced. Mastectomy with axillary lymph node sampling and removal of the implant were scheduled for local control. However, due to gradual exposure of the implant under the left breast, it was spontaneously removed from the original position when the patient was waiting for the surgery. Therefore, only mastectomy with axillary lymph node sampling was performed, followed by 45 Gy/25 times of postmastectomy and locoregional lymph node irradiation. Six months after the surgery, the patient is alive with no signs of local recurrence.
要旨
症例は51歳,女性で過去に両側の豊胸術を受けていた。左乳房皮膚潰瘍形成を主訴に受診された。骨転移を伴う左進行乳癌,T4bN1M1,StageⅣと診断し,ホルモン療法,化学療法を施行した。二次化学療法のパクリタキセル+ベバシズマブにより腫瘍縮小効果が得られたため,局所コントロール目的に乳房切除術,腋窩リンパ節サンプリングおよびインプラント摘出手術を予定していた。しかしその待機中,左乳腺下に挿入されていたインプラントが露出,脱落したため乳房切除術,腋窩リンパ節サンプリングのみを施行した。術後,胸壁,腋窩～鎖骨上窩に放射線照射(45 Gy/25回)を施行し,全身薬物療法は行っていない。術後6か月経過し,局所再発なく生存中である。
目次
A 51-year-old woman came to our hospital complaining of a skin ulcer in the left breast. She had previously undergone cosmetic breast augmentation by placement of a bag prosthesis under each mammary gland. She was diagnosed with StageⅣ(T4bN1M1)breast cancer with multiple bone metastases. Following the diagnosis, 3 regimens of hormonal therapy were sequentially administered. The treatment was then switched to chemotherapy following confirmation of tumor progression in the left breast tumor. After 3 cycles of paclitaxel and bevacizumab as the second-line of chemotherapy, the size of the left breast tumor was remarkably reduced. Mastectomy with axillary lymph node sampling and removal of the implant were scheduled for local control. However, due to gradual exposure of the implant under the left breast, it was spontaneously removed from the original position when the patient was waiting for the surgery. Therefore, only mastectomy with axillary lymph node sampling was performed, followed by 45 Gy/25 times of postmastectomy and locoregional lymph node irradiation. Six months after the surgery, the patient is alive with no signs of local recurrence.
要旨
症例は51歳,女性で過去に両側の豊胸術を受けていた。左乳房皮膚潰瘍形成を主訴に受診された。骨転移を伴う左進行乳癌,T4bN1M1,StageⅣと診断し,ホルモン療法,化学療法を施行した。二次化学療法のパクリタキセル+ベバシズマブにより腫瘍縮小効果が得られたため,局所コントロール目的に乳房切除術,腋窩リンパ節サンプリングおよびインプラント摘出手術を予定していた。しかしその待機中,左乳腺下に挿入されていたインプラントが露出,脱落したため乳房切除術,腋窩リンパ節サンプリングのみを施行した。術後,胸壁,腋窩～鎖骨上窩に放射線照射(45 Gy/25回)を施行し,全身薬物療法は行っていない。術後6か月経過し,局所再発なく生存中である。