Breast Cancer and a Separate Intrahepatic Cholangiocarcinoma in a 35-Year-Old Woman

What happened, in summary

A 35-year-old woman presented with a left breast mass in September 2021. Initial breast surgery showed invasive ductal carcinoma with estrogen- and progesterone-receptor positivity and CerbB-2 positivity. She later underwent a left radical mastectomy with sentinel lymph node biopsy. Only a small amount of residual lobular carcinoma in situ was found in the breast specimen, and the sentinel lymph node was negative. She received goserelin plus letrozole as postoperative endocrine maintenance.

At the same time, imaging showed multiple masses in the right side of the liver and enlarged abdominal lymph nodes. These findings were initially suspected to represent metastatic breast cancer. A liver operation in December 2021 changed the picture: pathology showed a separate primary intrahepatic cholangiocarcinoma rather than breast-cancer spread.

The liver cancer later recurred and required its own treatment, including capecitabine, immunotherapy, and liver-artery embolization. The liver cancer later recurred and required additional treatment. Her breast-cancer care continued with surgery and endocrine maintenance, without confirmed distant breast-cancer spread.