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.
Subject(s)
Brain Neoplasms/therapy , Breast Neoplasms/therapy , Carcinoma, Ductal, Breast/therapy , Liver Neoplasms/therapy , Antineoplastic Combined Chemotherapy Protocols/therapeutic use , Brain Neoplasms/secondary , Breast Neoplasms/chemistry , Breast Neoplasms/pathology , Combined Modality Therapy , Fatal Outcome , Female , Humans , Liver Neoplasms/secondary , Mastectomy , Middle Aged , Receptor, ErbB-2/analysisABSTRACT
We report a case of patient who underwent resection for local recurrent gastric cancer at the anastomotic site curatively. The patient was a 72 years old male with a history of undergoing total gastrectomy for gastric cancer located at the gastric cardia in February 2005. The histological findings of the resected tumor showed a Type 3 advanced gastric cancer invaded into subserosa in the cardia of the stomach with positive lymphatic and venous invasion and lymph node metastasis. The histological diagnosis was moderately differentiated tubular adenocarcinoma. Both the proximal and distal margins were negative for cancer. Endoscopy, 4 years after the first operation, showed a recurrent tumor at the site of esophago-jejunal anastomosis. A resection of the tumor was carried out curatively through the left thoraco-abdominal approach in June 2009. We recommend a resection of anastomotic recurrence especially if it occurs from the first operation in the long interval.
