title: [HER2-Positive T1a Breast Cancer Metastatic to the Liver and Brain in a Patient Who Died Four Years and Three Months after Mastectomy--A Case Report].
abstract: The prognosis of patients with T1a breast cancer is generally good, with a 5-year overall survival rate of 95%. However, HER2 overexpression is a risk factor for recurrence. A 46-year-old woman with left breast cancer underwent a total breast resection. The resected specimen showed invasive ductal carcinoma (T1a, NX, MX, g, ly0, v0, ER [-], PgR [-], HER2 [3+], Ki-67 20%). The patient did not receive adjuvant chemotherapy based on treatment guidelines. Nine months after the mastectomy, multiple liver metastases and severe acute hepatic insufficiency were found. The patient received chemotherapy with trastuzumab and paclitaxel, and a complete response was observed with disappearance of the liver metastases. One year and 11 months after the mastectomy, multiple brain metastases appeared. The patient received whole brain radiation therapy, Gamma Knife radiosurgery, and Cyber Knife radiosurgery. However, the brain metastasis could not be controlled, and the patient died 4 years and 3 months after mastectomy. HER2 positive T1a breast cancer should be observed carefully, and treatment with trastuzumab should be considered.
authors.affiliation: Dept. of Surgery, Toshiba General Hospital.
authors.forename: Ayumi
authors.initials: A
authors.lastname: Takaoka
authors.forename: Tsuyoshi
authors.initials: T
authors.lastname: Nakagawa
authors.forename: Norihito
authors.initials: N
authors.lastname: Ogawa
authors.forename: Mikiko
authors.initials: M
authors.lastname: Hayashi
authors.forename: Sonjin
authors.initials: S
authors.lastname: Park
authors.forename: Hideaki
authors.initials: H
authors.lastname: Iseki
authors.forename: Yuan
authors.initials: Y
authors.lastname: Bei
mesh_terms: D000971:Antineoplastic Combined Chemotherapy Protocols / Q000627:therapeutic use; D001932:Brain Neoplasms / Q000556:secondary / Q000628:therapy*; D001943:Breast Neoplasms / Q000737:chemistry / Q000473:pathology / Q000628:therapy*; D018270:Carcinoma, Ductal, Breast / Q000628:therapy*; D003131:Combined Modality Therapy; D017809:Fatal Outcome; D005260:Female; D006801:Humans; D008113:Liver Neoplasms / Q000556:secondary / Q000628:therapy*; D008408:Mastectomy; D008875:Middle Aged; D018719:Erb-b2 Receptor Tyrosine Kinases / Q000032:analysis
chemical_list: D018719:Erb-b2 Receptor Tyrosine Kinases; C508053:ERBB2 protein, human