HER2-Positive Breast Cancer That Spread to the Cervix

What happened, in summary

In November 2020, this woman underwent a modified radical mastectomy for a new invasive cancer in her left breast. Pathology showed extensive lymph-node involvement, with cancer in all 35 sampled nodes. The tumor was HER2-positive, while estrogen and progesterone receptor staining was less than 1%.

From December 2020 through December 2021, she received 19 cycles of paclitaxel, pertuzumab, and trastuzumab. Maintenance systemic treatment continued into September 2022. Later that year, she developed abnormal vaginal discharge and a cervical mass that was initially thought to be a primary cervical cancer. Additional pathology instead supported metastatic breast cancer involving the cervix. Imaging also showed systemic spread, including the esophagus and mediastinal lymph nodes.

Because the cervical disease was not considered surgically removable, she received 6 rounds of brachytherapy. The cervical tumor largely disappeared, producing a local complete response. She continued systemic treatment, but the disease later progressed in the esophagus and restricted her ability to eat. After 4 months of nutritional support and palliative treatment, she died.