A case of HER-2-positive advanced inflammatory breast cancer with invasive micropapillary component showing a clinically complete response to concurrent trastuzumab and paclitaxel treatment.
We report a case of HER-2-positive advanced inflammatory breast cancer with invasive micropapillary component showing a complete response to trastuzumab and paclitaxel treatment. A 37-year-old woman was referred to our hospital for right breast swelling with broad skin redness and right axillary tumor. Ipsilateral infraclavicular and contralateral axillary lymph nodes swelling were also recognized. The histopathological findings of core-needle biopsy specimens from primary breast tumor and ipsilateral axillary lymph node were invasive ductal carcinoma with a micropapillary component. Immunohistochemical examination gave a negative result for estrogen receptor (ER)/progesterone receptor (PgR), and overexpression of HER-2 (Hercep Test 3+). Advanced inflammatory breast cancer with an invasive micropapillary component was diagnosed (T4d N3 M1 (LYM), stage IV). The patient was treated with combination chemotherapy using weekly paclitaxel and trastuzumab. After administration of three courses, the breast swelling, skin redness, and lymph node swelling disappeared completely. She maintained complete remission of disease for 12 months and was judged to have a clinically complete response by the RECIST criteria. Invasive micropapillary carcinoma is known to be an aggressive histological type associated with a high incidence of lymph node metastasis and poor prognosis. This is the first reported case of advanced inflammatory breast cancer with an invasive micropapillary component showing a clinically complete response to trastuzumab-containing treatment. This report suggests trastuzumab-containing chemotherapy is a promising therapy for HER-2-positive advanced invasive micropapillary carcinoma.
Shigematsu
Hideo
H
Department of Breast Oncology, National Kyushu Cancer Center, 3-1-1 Notame, Minami-ku, Fukuoka 811-1395, Japan. shigematu1330@yahoo.co.jp
Nakamura
Yoshiaki
Y
Tanaka
Kimihiro
K
Shiotani
Satoko
S
Koga
Chinami
C
Kawaguchi
Hidetoshi
H
Nishimura
Sumiko
S
Taguchi
Kenichi
K
Nishiyama
Kenichi
K
Ohno
Shinji
S
D000328:Adult; D000911:Antibodies, Monoclonal / Q000008:administration & dosage; D061067:Antibodies, Monoclonal, Humanized; D000971:Antineoplastic Combined Chemotherapy Protocols / Q000627:therapeutic use*; D001943:Breast Neoplasms / Q000188:drug therapy* / Q000378:metabolism / Q000473:pathology; D018270:Carcinoma, Ductal, Breast / Q000188:drug therapy* / Q000378:metabolism / Q000473:pathology; D002291:Carcinoma, Papillary / Q000188:drug therapy* / Q000378:metabolism / Q000473:pathology; D005260:Female; D006801:Humans; D058922:Inflammatory Breast Neoplasms / Q000188:drug therapy* / Q000378:metabolism / Q000473:pathology; D008207:Lymphatic Metastasis; D017239:Paclitaxel / Q000008:administration & dosage; D018719:Erb-b2 Receptor Tyrosine Kinases / Q000378:metabolism*; D000068878:Trastuzumab; D016896:Treatment Outcome
D000911:Antibodies, Monoclonal; D061067:Antibodies, Monoclonal, Humanized; D017239:Paclitaxel; D018719:Erb-b2 Receptor Tyrosine Kinases; D000068878:Trastuzumab
Clin Transl Oncol. 2006 Oct;8(10):761-3
17074677
Histopathology. 2004 Apr;44(4):332-8
15049898
Gan To Kagaku Ryoho. 2007 Jan;34(1):65-8
17220672
Ann Diagn Pathol. 2009 Jun;13(3):151-7
19433292
J Clin Oncol. 2005 Aug 1;23(22):5117-25
15955906
Am J Clin Pathol. 2006 Nov;126(5):740-6
17050071
Histopathology. 2004 Jan;44(1):18-23
14717664
Int J Surg Pathol. 2008 Apr;16(2):155-63
18417672
N Engl J Med. 2005 Oct 20;353(16):1673-84
16236738
Am J Clin Pathol. 2004 Jun;121(6):857-66
15198358
Pathol Res Pract. 1994 Aug;190(7):668-74
7808965
Arch Pathol Lab Med. 2005 Oct;129(10):1277-82
16196516
N Engl J Med. 1998 Oct 1;339(14):974-84
9753714
Pathol Int. 2004 Feb;54(2):90-6
14720138
J Clin Oncol. 2005 Jul 1;23(19):4247-50
15911863
N Engl J Med. 2005 Oct 20;353(16):1659-72
16236737
Hum Pathol. 1999 Dec;30(12):1459-63
10667424
N Engl J Med. 2001 Mar 15;344(11):783-92
11248153