A Decade of Triumph Over Metastatic Breast Cancer

In 2010, a 42-year-old woman sought medical attention after experiencing worsening swelling, tenderness, and redness in her left breast over several days. Upon examination, doctors noted an enlarged breast with peau d’orange skin changes, nipple retraction, and swollen axillary lymph nodes. A core needle biopsy confirmed invasive ductal carcinoma, which tested negative for hormone receptors but strongly positive for HER2 (FISH ratio 8.3). Further scans revealed numerous small lung nodules, later confirmed to be metastatic HER2-positive breast cancer.

The Treatment Journey

The patient immediately began treatment with paclitaxel and trastuzumab, a targeted therapy designed for HER2-positive cancers. She later transitioned to a combination of docetaxel, carboplatin, and trastuzumab, completing six cycles (18 weeks) of treatment. Follow-up imaging revealed a complete response in the lungs, though some skin thickening remained in the affected breast.

Given the concern for residual disease, doctors proceeded with local radiation therapy, delivering 5,000 cGy to the breast and 4,600 cGy to the regional lymph nodes. Meanwhile, trastuzumab monotherapy was continued as maintenance treatment. After two months, her breast showed a significant response, allowing her to undergo a left modified radical mastectomy. Pathology reports revealed a complete pathological response—no remaining invasive cancer in the breast or lymph nodes.

The Outcome

Now, more than 10 years and 10 months since her initial diagnosis, the patient remains on trastuzumab therapy with no evidence of disease recurrence. Her case highlights the effectiveness of targeted HER2 treatments, radiation, and surgery in achieving long-term remission for advanced breast cancer.