Metastatic Breast Cancer With Liver Progression Treated Through Multiple Chemotherapy Lines

This breast cancer diagnosis at a glance

Stage at diagnosis
Stage IV
Subtype
Invasive Ductal Carcinoma
Biomarkers
Initial tumor: ER 90%, PgR 90%, HER2 3+, Ki67 15%. Liver metastasis: ER 30%, PgR 25%, HER2 negative, Ki67 35%.
Sex
female
Spread to
pleura, liver
Treatment
surgery, hormone therapy, chemotherapy and targeted therapy
Outcome
Care Ongoing

Treatment course, step by step

  1. She had breast surgery in 1996.
  2. She then received LH-RH analogue therapy and tamoxifen through 2001.
  3. Pleural recurrence in 2004 was treated with 6 cycles of epirubicin and docetaxel.
  4. Letrozole continued afterward.
  5. Liver metastases in 2014 were treated with nab-paclitaxel.
  6. Capecitabine plus vinorelbine followed.
  7. She later received 18 courses of eribulin with a partial liver response before progression.
  8. Letrozole plus palbociclib was used next.
  9. Pegylated liposomal doxorubicin followed after further liver progression.

What happened, in summary

A 45-year-old woman found a roughly 1 cm lump in her right breast in 1996. Surgery showed grade 3 invasive ductal carcinoma with ER 90%, PgR 90%, HER2 3+ and Ki67 15%. She then received an LH-RH analogue and tamoxifen for about 5 years. In 2004, worsening shortness of breath and cough led to detection of pleural recurrence. Six cycles of epirubicin and docetaxel produced a complete response, followed by long-term letrozole. She stopped letrozole in 2011. In 2014, new right-upper-abdominal pain led to discovery of multiple liver metastases. Biopsy showed a changed profile: ER 30%, PgR 25%, HER2 negative and Ki67 35%. Four nab-paclitaxel infusions produced no response. Capecitabine plus vinorelbine was tried next, but capecitabine was stopped after 2 cycles because of grade 3 hand-foot syndrome and the liver cancer progressed. She then started eribulin. After 8 cycles, the largest right-liver lesion had fallen from 39 mm to about 1 cm, and her pain score improved from 7 to 0. She completed 18 courses before new liver lesions appeared in February 2016. After further treatment with letrozole plus palbociclib and additional liver progression, she moved to pegylated liposomal doxorubicin and remained in active care.

Where this story comes from

This is a lay summary of an account first published by PMC / PubMed Central. Read the original in full

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