Stage 4 ER Positive Breast Cancer: 87 Real Stories

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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Metastatic Breast Cancer Presenting With Severe Pulmonary Hypertension

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

Biomarkers: ER-positive; PR-positive.

Metastatic Site: bone; bone marrow

At seven months, she was doing well with a marked response on PET imaging, normalized right-heart pressures, and ongoing systemic treatment with palbociclib.

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Breast cancer recurrence involving the bladder and bones

Patient Info: Anonymized, Female | Stage IV

Biomarkers: Initial breast cancer: ER-positive, PR-positive, HER2-negative. Bladder metastasis: ER-positive, PR-negative, HER2 1+.

Metastatic Site: bladder, bone, rectosigmoid region, anorectal region

She died in October 2016 from pulmonary haemorrhage, 47 months after metastatic disease was diagnosed.

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Breast cancer spreading to the colon, rectum and peritoneal surfaces

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

Biomarkers: Primary tumor: ER >80% positive; PR 50–60% positive; HER2 negative; E-cadherin positive. Later colorectal metastases: ER positive; PR negative; HER2 negative; CK7 positive; CK20 negative; CDX2 negative.

Metastatic Site: colon, rectum, peritoneum, diaphragm, liver, bowel,…

Metastatic breast cancer was subsequently confirmed in the colon and rectum, with later laparoscopic biopsies showing peritoneal and additional intra-abdominal metastatic disease.

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Occult lobular breast cancer presenting as an orbital metastasis

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

Biomarkers: ER positive; PR positive; HER2 negative; CK7 positive; CK CAM5.2 positive; E-cadherin negative

Metastatic Site: left orbit, bone

The orbital metastasis decreased with treatment and systemic disease remained controlled on hormonal therapy during 5 years of clinical follow-up.

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Stage IV Breast Cancer With Long-Term Tumor Regression After Radiation Therapy

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

Biomarkers: HER2 positive

Metastatic Site: 8th thoracic vertebra

Follow-up showed near-complete regression of the breast tumor, resolution of the bone lesion, normal tumor markers, and a 2015 biopsy with no tumor cells. Follow-up showed no further recurrence, and she returned to work with good quality of life.

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Breast cancer returning 21 years later as a solitary parotid metastasis

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

Biomarkers: Parotid metastasis ER positive; PR positive; HER2 borderline by IHC but FISH 1.82

Metastatic Site: left parotid gland

More than 5 months after the parotid metastasis was diagnosed, the tumour had slightly decreased in size and her metastatic disease remained stable on endocrine therapy.

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Breast cancer returning years later in the biceps muscle

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

Biomarkers: ER positive

Metastatic Site: left biceps muscle

Her arm symptoms improved considerably after radiotherapy, and MRI 6 months later showed a significant decrease in the size of the biceps tumour.

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Stage IV ER/PR-positive mucinous breast cancer: long-term no evidence of disease after surgery, AFTV, radiation, CEF, and endocrine therapy

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

Biomarkers: ER-positive; PR-positive; delayed-type hypersensitivity to AFTV became pseudo-positive after vaccination and remained pseudo-positive 5.4 years later

Metastatic Site: Th7 vertebra

More than 6 years after primary surgery, she remained well with no evidence of vertebral metastasis activity, new metastasis, or local recurrence.

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ER-positive breast cancer recurrence with renal metastasis inside angiomyolipoma

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

Biomarkers: ER-positive; mammaglobulin-positive; e-cadherin-positive; GCDFP-15-positive; melan A positive in angiomyolipoma component

Metastatic Site: right subpectoral lymph node, left kidney

At 7 months after nephrectomy, she continued anti-estrogen hormonal therapy with no demonstrable progression of disease; surgical excision of the subpectoral lymph node was offered but declined.

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ER/PR-positive breast cancer with bilateral ovarian metastases controlled after oophorectomy and aromatase inhibitor

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

Biomarkers: ER-positive; PR-positive; HER2-negative; CK7-positive; gross cystic disease fluid protein-15-positive; CK20-negative

Metastatic Site: bilateral ovaries

After bilateral oophorectomies and aromatase inhibitor therapy, pleural effusion resolved, CEA and CA 15-3 decreased below the normal upper limit, and she remained well with no further recurrence for 40 months.

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Metastatic lobular breast cancer to gynecologic sites: disease-free after surgery and chemotherapy

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

Biomarkers: ER-positive; PR-negative; HER2/C-Erb-B2-negative

Metastatic Site: vagina, uterus, ovaries

After treatment of vaginal, uterine, and ovarian metastases from lobular breast cancer, she was free from disease 12 months after completion surgery.

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Metastatic lobular breast cancer to bladder trigone: partial response to tamoxifen

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

Biomarkers: progesterone receptor-positive; genetic testing including BRCA1 negative

Metastatic Site: bladder trigone

As of January 2012, urge incontinence had resolved and PET showed decreased activity in the breast and bladder trigone lesions nearly 10 months after starting tamoxifen, consistent with clinical and partial radiologic remission.

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Lobular breast cancer with extraocular muscle and lung metastases: ocular improvement after radiotherapy and tamoxifen

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

Biomarkers: Original breast cancer: ER-negative; PR-negative. Extraocular muscle metastasis/recurrent disease: ER strongly positive; PR strongly positive.

Metastatic Site: bilateral extraocular muscles, right upper lobe lung,…

At 18 months after presentation with extraocular muscle metastases, PET showed no abnormality, diplopia had resolved, and ocular motility had markedly improved, with mild bilateral ptosis remaining.

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