title: [A Patient with a Pathological Complete Response to Neo-Adjuvant Chemotherapy for Triple-Negative Breast Cancer Followed by Recurrence after Six Months].
abstract: The patient was a 68-year-old woman who received neo-adjuvant chemotherapy(4 courses of weekly paclitaxel plus bevacizumab and 4 courses of 5-fluorouracil epirubicin, and cyclophosphamide)for cT1N1M0, Stage II A right-sided triplenegative breast cancer(TNBC). Right breast-conserving surgery with axillary lymph-node dissection was performed. The postoperative pathological diagnosis was a complete response. Six months after surgery, the patient developed lower and right-sided back pain. Detailed examination revealed multiple metastases to the liver, bone, lymph nodes of the mediastinum, and bile duct. The recurrence was treated with biweekly paclitaxel plus bevacizumab. The patient's pain dramatically improved. However, the duration of the response was only 3 months. The patient received eribulin as a second-line treatment, but did not respond and subsequently died. TNBC is considered to have relatively good outcomes if a pathological complete response(pCR)is obtained after preoperative chemotherapy. However, recurrence occurred after only 6months in our patient. In patients with TNBC, physical examinations and simple laboratory tests should be performed every 1 to 2 months after surgery, even if a pathological complete response is obtained. We used paclitaxel plus bevacizumab to treat recurrence of TNBC. Although this treatment did not prolong overall or disease-free survival, the patient temporarily responded, and her quality of life was maintained. Further studies are needed to elucidate the pathogenesis of TNBC and to develop more effective treatments.
authors.affiliation: Dept. of Surgery, Japan Community Health care Organization Sagamino Hospital.
authors.forename: Keiko
authors.initials: K
authors.lastname: Hayashi
authors.forename: Mina
authors.initials: M
authors.lastname: Waraya
authors.forename: Takeyoshi
authors.initials: T
authors.lastname: Habiro
authors.forename: Satoshi
authors.initials: S
authors.lastname: Hosoya
authors.forename: Norihiko
authors.initials: N
authors.lastname: Sengoku
authors.forename: Hirokazu
authors.initials: H
authors.lastname: Tanino
authors.forename: Kazushige
authors.initials: K
authors.lastname: Hayakawa
authors.forename: Madoka
authors.initials: M
authors.lastname: Inukai
authors.forename: Makoto
authors.initials: M
authors.lastname: Saegusa
authors.forename: Masahiko
authors.initials: M
authors.lastname: Watanabe
mesh_terms: D000368:Aged; D000971:Antineoplastic Combined Chemotherapy Protocols / Q000627:therapeutic use; D017809:Fatal Outcome; D005260:Female; D006801:Humans; D015412:Mastectomy, Segmental; D020360:Neoadjuvant Therapy; D012008:Recurrence; D064726:Triple Negative Breast Neoplasms / Q000000981:diagnostic imaging / Q000188:drug therapy* / Q000601:surgery