HER2-Positive Metastatic Breast Cancer With Recurrent Severe Hypocalcemia - Case 2
This breast cancer diagnosis at a glance
- Stage at diagnosis
- Stage IV
- Subtype
- Invasive Ductal Carcinoma
- Biomarkers
- ER-positive; PR-positive; HER2-positive
- Sex
- female
- Spread to
- bone, liver
- Treatment
- chemotherapy, surgery, endocrine therapy and targeted therapy
- Outcome
- In Memory
Treatment course, step by step
- Received neoadjuvant chemotherapy followed by right partial mastectomy and axillary lymph node dissection.
- Received adjuvant anastrozole and trastuzumab.
- After bone metastases developed 2 years later, received fulvestrant and denosumab followed by letrozole with lapatinib.
- Later received trastuzumab emtansine and then lapatinib with capecitabine, with recurrent episodes of severe hypocalcemia during therapy.
What happened, in summary
A 65-year-old woman was diagnosed with Stage III invasive ductal cancer of the right breast. The tumor was strongly estrogen- and progesterone-receptor positive and HER2-positive. She received neoadjuvant chemotherapy, followed by right partial mastectomy and axillary lymph-node dissection, with a complete response reported after surgery. Adjuvant anastrozole and trastuzumab followed.
Two years after diagnosis, multiple bone metastases developed. She was treated with fulvestrant and denosumab, then later with letrozole and lapatinib as the bone disease progressed. Several treatment changes were complicated by marked falls in calcium levels. Severe hypocalcemia occurred during letrozole plus lapatinib, again during trastuzumab emtansine, and later during lapatinib plus capecitabine. These episodes required calcium and calcitriol treatment and, at times, temporary interruption of therapy.
Trastuzumab emtansine controlled the disease for 26 months before another change was needed. In year 7 after the original breast-cancer diagnosis, her condition deteriorated rapidly because of liver metastases, and she died in hospital. Her documented survival from diagnosis was therefore about 7 years.
Where this story comes from
This is a lay summary of an account first published by PMC / PubMed Central. Read the original in full
How we source and attribute stories Accuracy and limitations
Collections this story belongs to
- Stage 4 Breast Cancer 295 stories
- Stage 4 HER2 Positive Breast Cancer 53 stories
- HER2 Positive Breast Cancer 136 stories
- Anastrozole for Breast Cancer 71 stories
These are lay summaries of published cancer stories, for information only. No two cancers behave the same way, and nothing here predicts your own diagnosis or replaces advice from your oncology team. Read the full disclaimer