Stage II Breast Cancer Treatment Complicated by Scleroderma-Like Skin Changes

What happened, in summary

A 54-year-old woman discovered a movable lump in her right breast in 2023. She underwent breast-conserving surgery with a sentinel lymph node biopsy. Pathology showed Stage II breast cancer that was estrogen-receptor low-positive at 5%, progesterone-receptor negative, and HER2-negative.

She received one cycle of docetaxel after surgery and then 5 cycles of docetaxel, cyclophosphamide, and pembrolizumab. Her cancer remained stable during treatment, but after the combination therapy she developed numbness in her hands, swelling of her legs, and progressive tightening and fibrosis of the skin on both lower legs. Dermatology assessment supported morphea, a localized scleroderma-like condition.

Because of the skin reaction, planned radiotherapy was suspended and docetaxel was replaced with capecitabine. She declined methotrexate and used topical treatment for the skin changes. Six months after docetaxel was stopped, the morphea had improved noticeably.