Breast Cancer Recurrence Treated With Radiation Despite a Chronic Skin Condition

Patient Info: Anonymized, Female, 50s

Biomarkers: ER-positive; PR-positive; HER2-negative

After treatment of a chest-wall recurrence and a radiographically suspicious ischial lesion, she completed chest-wall radiation, her skin healed within 5 weeks, and she remained under surgical, radiation-oncology, and dermatology review.

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Occult lobular breast cancer first discovered through colon metastases

Patient Info: Anonymized, Female, 70+ | Stage IV

Biomarkers: ER-positive; PR-negative; HER2-negative; E-cadherin-negative

Metastatic Site: colon

Her tumour marker decreased during letrozole and palbociclib treatment, but recurrent infections interrupted therapy, and she died from urosepsis 2 years after diagnosis.

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Male breast cancer found after persistent nipple discharge without a lump

Patient Info: Anonymized, Male, 60s | Stage 0

Biomarkers: ER-positive; PR-positive

Six months after mastectomy, surveillance examination found no clinical evidence of recurrence.

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HER2-positive breast cancer diagnosed during pregnancy and later spread to bone and brain

Patient Info: Anonymized, Female, Under 40 | Stage IV

Biomarkers: Initial tumour: ER 0%, PR <1%, HER2 3+

Metastatic Site: bone (L3)|brain

After treatment and surveillance without new lesions, she developed a large symptomatic occipital brain metastasis 14 months after completing paclitaxel and radiation and died after rapid neurological deterioration.

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A New Breast Cancer Arising Beneath an Accessory Nipple

Patient Info: Anonymized, Female, 40s

Biomarkers: ER 5%; PR 5–10%; HER2-negative.

After chemotherapy, surgery, endocrine therapy, proton radiation, and later reconstruction revision, she was currently without evidence of disease.

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A Rare Metaplastic Breast Cancer With Bone-Like Tissue Formation

Patient Info: Anonymized, Female, 70+

Biomarkers: ER weakly positive; PR-negative; HER2-negative; BRCA mutation not detected; described as triple-negative

One year after left mastectomy, she was alive without notable complications or evidence of recurrence.

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Recurrent Breast Cancer With a Benign-Appearing Chest-Wall Rash

Patient Info: Anonymized, Female | Stage IV

Biomarkers: Initial tumor: ER-positive; PR-negative; HER2-negative.

Metastatic Site: mediastinal lymph nodes

She had recurrent chest-wall and mediastinal metastatic disease; a later rash biopsy showed dermatitis rather than another skin recurrence.

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Heart Failure and Electrical Conduction Changes During Trastuzumab Treatment

Patient Info: Anonymized, Female, 70+

Biomarkers: HER2-positive; ER-positive

Trastuzumab was suspended after acute heart failure and electrical conduction abnormalities; 4 weeks later, left ventricular function recovered and the ECG returned to normal during cardio-oncology follow-up.

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Young woman with ductal breast cancer and bleeding gastric metastases

Patient Info: Anonymized, Female, Under 40 | Stage IV

Biomarkers: ER-positive; PR-negative; HER2-negative

Metastatic Site: pancreas|liver|kidney|stomach

After rapid progression to the pancreas, liver, kidney and stomach, she chose palliative care and died 1 month after presenting with gastrointestinal bleeding.

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Lobular breast cancer later spread to the stomach, bone, neck and mediastinum

Patient Info: Anonymized, Female, 70+ | Stage IV

Biomarkers: ER-positive; PR-positive; HER2-negative

Metastatic Site: stomach|bone|neck|mediastinum

After gastric metastasis was diagnosed and later imaging showed bone, neck and mediastinal spread, her oral intake and health declined; she chose palliative care and died 7 months after the diagnostic endoscopy.

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Stage II HR-Positive Invasive Ductal Carcinoma: Caitlin's Patient Story

Patient Info: Caitlin J., Female, Under 40 | Stage II

Biomarkers: ER-positive; PR-positive; BRCA-negative

As of July 2020, Caitlin had completed lumpectomy, AC chemotherapy, Taxol, and 33 radiation treatments for Stage IIB ER-positive, PR-positive IDC and was continuing monthly Lupron plus daily anastrozole.

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Lobular Breast Cancer Spread Into a Nasal Tumor

Patient Info: Anonymized, Female, 60s | Stage IV

Biomarkers: Metastatic lobular focus: ER 8/8; PR 8/8; HER2-negative; E-cadherin-negative.

Metastatic Site: liver; bone; right nasal cavity within an olfactory…

The nasal lesion was removed with no residual local disease on imaging, and capecitabine was restarted while oncology follow-up continued for metastatic breast cancer.

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Fatal Bowel Infection After the First Chemotherapy Cycle for Early HER2-Positive Breast Cancer

Patient Info: Anonymized, Female, 70+

Biomarkers: ER-positive; PR-positive; HER2-amplified

Nine days after the first TCH cycle, she developed fulminant febrile neutropenia and Clostridium septicum sepsis with extensive bowel ischaemia; despite emergency treatment and resuscitation, she died 4 hours after hospital arrival.

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Occult breast cancer found in the axillary lymph nodes during diagnosis of four cancers

Patient Info: Anonymized, Female, 70+

Biomarkers: ER 90% positive; HER2 overexpression; CK19-positive; mammaglobin-positive.

Almost four years after the synchronous cancer diagnoses, she was alive without recurrence and continued letrozole and oncology follow-up.

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Stage IV Breast Cancer: Kirby's Patient Story

Patient Info: Kirby Lewis, Male | Stage IV

Biomarkers: ER-positive, PR-positive, HER2-negative

Metastatic Site: lung|spine

Kirby was living with metastatic breast cancer, and his most recent scans showed the right-lung tumor was stable with no signs of progression while he continued fulvestrant and palbociclib.

Rapidly enlarging breast cancer with suspected metaplastic features

Patient Info: Anonymized, Female, 40s

Biomarkers: ER 95% positive; PR 95% positive; HER2 negative; Ki-67 11–50%; p53 negative for overexpression

Further biopsy was pending, with neoadjuvant chemotherapy planned before definitive breast surgery.

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A second breast cancer arising in a previously known cyst

Patient Info: Anonymized, Female, 70+

Biomarkers: ER >95% positive; PR >95% positive; HER2 negative; Ki-67 11–50%; p53 negative for overexpression

She completed right-breast radiation and was continuing anastrozole 1 mg daily as adjuvant endocrine therapy.

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Small hormone-receptor-positive breast cancer found incidentally on chest CT

Patient Info: Anonymized, Female, 70+

Biomarkers: ER 95% positive; PR 70% positive; HER2 negative; Ki-67 11–50%; p53 negative for overexpression

She was receiving adjuvant breast radiation, with at least 5 years of anastrozole planned afterward.

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Multifocal ductal carcinoma in situ presenting with breast discharge and a lump

Patient Info: Anonymized, Female, 50s

Biomarkers: ER >80% positive and PR >80% positive on initial biopsy; ER >95% positive on mastectomy specimen; p53 negative for overexpression

She was recovering after mastectomy with clear margins and 0/2 nodes involved, with endocrine therapy still to be discussed.

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Encapsulated papillary breast cancer in a 62-year-old man

Patient Info: Anonymized, Male, 60s

Biomarkers: ER 95% positive; PR 95% positive; HER2 negative; Ki-67 11–50%; p53 negative for overexpression; hereditary cancer panel negative for reported pathogenic mutations including BRCA1 and PALB2

Mastectomy removed a 2.4 cm encapsulated papillary carcinoma with clear margins and 0/3 sentinel nodes involved; systemic adjuvant therapy was not recommended.

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Early breast cancer followed 19 years later by a radiation-related breast sarcoma

Patient Info: Anonymized, Female, 70+ | Stage I

Biomarkers: Strongly ER-positive; strongly PR-positive.

The stage IA breast carcinoma remained disease-free for 19 years; a later right-breast mass was a separate radiation-induced sarcoma rather than recurrent carcinoma.

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Metastatic ER-positive breast cancer complicated by osteonecrosis of the jaw

Patient Info: Anonymized, Female, 70+ | Stage IV

Biomarkers: ER-positive.

Metastatic Site: bone (sternum, spine, pelvis, and proximal femur)

After progressive metastatic bone disease and severe medication-related osteonecrosis of the jaw, she entered end-of-life care and died three weeks after discharge to a nursing home.

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Breast Cancer Recurrence in the Liver Mimicking Cirrhosis

Patient Info: Anonymized, Female, 60s | Stage IV

Biomarkers: Original cancer: HER2-negative and PR-positive. Liver recurrence: ER-positive.

Metastatic Site: liver

The breast cancer recurred in the liver after 14 years, produced pseudocirrhosis and portal-hypertension complications, and she died from hepatorenal syndrome five weeks after presentation.

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Breast Cancer Recurrence in the Parotid Gland Eight Years Later

Patient Info: Anonymized, Female, 50s | Stage IV

Biomarkers: Primary breast tumor: ER-positive and HER2-positive. Parotid metastasis: ER-positive, PR-negative, and HER2-positive.

Metastatic Site: left parotid gland

The isolated parotid metastasis was completely resected, one-month PET-CT showed no significant abnormality, and endocrine therapy continued with exemestane.

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