What happened, in summary

A 40-year-old woman underwent breast-conserving surgery in July 2013 for grade 2 infiltrating ductal carcinoma of the right breast. The tumor was ER 90%, PgR 60%, HER2 negative and Ki67 10%. She started tamoxifen and received 25 radiation sessions totaling 50 Gy. After 18 months without disease, imaging in February 2015 found metastases in both lungs. A right-lung lesion was surgically removed and confirmed to be metastatic breast cancer. She then received nab-paclitaxel plus nonpegylated liposomal doxorubicin. Ten cycles produced a sustained partial response, after which she switched to fulvestrant maintenance. In January 2017, the disease progressed in the lungs and spread to bone and brain. She received 30 Gy of whole-brain radiation and then capecitabine. After 6 cycles, the brain lesions had partially responded, but lung and bone disease worsened and new liver metastases appeared. She received radiation to high-risk vertebral disease. Eribulin began in August 2017. Later scans showed stable brain and bone disease with partial liver response. By January 2018, both measured brain lesions had shrunk to about 2 mm and the liver metastases had decreased further. Treatment was still ongoing, and she had no serious toxicity.