A Story of Resilience and Triumph Against Cancer

In September 2015, a 34-year-old premenopausal woman was diagnosed with stage III invasive ductal carcinoma of the right breast. Her cancer was classified as estrogen receptor (ER)-negative, progesterone receptor (PR)-negative, and HER2-positive. She sought treatment at MD Anderson Cancer Center in Houston, Texas, and began an aggressive battle against the disease.

The Treatment Journey: A Path of Challenges and Victories
Her journey began with a right mastectomy and axillary lymph node dissection, followed by chemotherapy and targeted therapy with Trastuzumab. Unfortunately, she developed symptomatic cardiomyopathy, leading to the temporary discontinuation of Trastuzumab in June 2016. After several months of cardiac monitoring, her heart function improved, allowing her to resume treatment.

In October 2017, follow-up scans revealed lung and mediastinal lymph node metastases, marking a recurrence of her disease. She switched to second-line therapy with ado-Trastuzumab Emtansine (TDM-1), which showed promising results. However, due to severe fatigue and liver toxicity, she transitioned to dual-antibody therapy with Trastuzumab-Pertuzumab in February 2018. Though she faced periodic interruptions due to cardiac concerns, her scans continued to show no evidence of disease.

In January 2020, her treatment was paused due to another drop in heart function, but she resumed Trastuzumab-Pertuzumab after recovery. Throughout 2021 and 2022, she remained on treatment, though with occasional delays due to personal reasons.

An Unexpected Turn: Pregnancy Amidst Cancer Treatment
In December 2022, the patient discovered she was pregnant, just 12 days after her last Trastuzumab-Pertuzumab cycle. Despite medical advice warning of potential complications, she chose to continue the pregnancy. Close monitoring at the Maternal Fetal Medicine Clinic showed positive fetal development, with no congenital abnormalities detected.

At 38 weeks, she had a spontaneous vaginal delivery of a healthy baby boy. Postpartum evaluations, including PET-CT and echocardiography, showed no evidence of cancer recurrence, and her cardiac function remained stable.
Three weeks after childbirth, she returned for an oncology consultation and was offered options to resume treatment. She chose to wait three months to focus on breastfeeding before making a decision.