Paclitaxel-Related Macular Edema During Treatment for Metastatic Breast Cancer

This breast cancer diagnosis at a glance

Stage at diagnosis
Stage IV
Biomarkers
ER-positive, HER2-negative
Sex
Female
Treatment
endocrine therapy, chemotherapy and radiation
Outcome
Care Ongoing

Treatment course, step by step

  1. Received anastrozole, exemestane, epirubicin, capecitabine, and breast/chest wall radiation between 2017 and 2020.
  2. Started weekly paclitaxel in June 2020 as the cancer continued to progress.
  3. Paclitaxel was stopped after about 6 months because of severe bilateral macular edema, and eribulin chemotherapy was started in February 2021.

What happened, in summary

A 69-year-old woman had been living with ER-positive, HER2-negative metastatic breast cancer since 2017. Between 2017 and 2020 she received several lines of palliative treatment, including endocrine therapy with anastrozole and exemestane, chemotherapy with epirubicin and capecitabine, and radiation to the breast and chest wall. Because the cancer continued to progress slowly, she began weekly paclitaxel in June 2020.

After about 6 months of paclitaxel, she noticed gradually worsening vision in both eyes. Eye examination showed cystoid macular edema, a rare treatment-related problem. Initial treatment with anti-inflammatory eye drops did not help and her vision worsened further. After discussion between the ophthalmology and oncology teams, paclitaxel was stopped.

The eye problem then improved steadily. Eight weeks after stopping paclitaxel, the macular edema had fully resolved. Her cancer treatment continued with eribulin chemotherapy starting in February 2021.

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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