Can we cure stage IV triple-negative breast carcinoma?: Another case report of long-term survival (7 years).

RATIONALE: Triple-negative breast cancer has a dismal prognosis, especially once it has spread to other organs, due to the lack of effective treatments available at this time. Finding an effective treatment for metastatic triple-negative breast cancer remains an unmet medical need. PATIENT CONCERNS: A 60-year-old woman was diagnosed with stage IIIC triple-negative breast cancer after undergoing a mastectomy. Her mastectomy was followed by adjuvant chemotherapy and radiation therapy. Approximately 1 year later, the patient presented with enlarging lymph nodes in her neck. A biopsy of a left supraclavicular lymph node was positive for recurrent disease. Positron emission tomography and computed tomography scans performed after the biopsy showed metabolic activity in the T6 vertebral body and the right level IIB lymph nodes. DIAGNOSES: The patient was diagnosed with recurrent metastatic triple-negative breast carcinoma with metastases to the bone and lymph nodes. INTERVENTIONS: The patient was treated with weekly metronomic chemotherapy, sequential chemotherapy regimens, and immunotherapy. OUTCOMES: The patient is now 68 years old and 7 years out from her diagnosis of metastatic disease. She achieved a complete response to her treatment and routine scans continue to show no evidence of recurrent disease. LESSONS: Utilizing sequential weekly metronomic chemotherapy regimens in combination with immunotherapy looks to be a promising treatment option for patients with metastatic triple-negative breast carcinoma. This is a second case where we were able to achieve long-term remission by using the above treatment strategy. These exciting results warrant further investigation of this treatment methodology. We hope that the treatment strategy described in this article can provide an outline for researchers and give patients with this disease more treatment options.

Case report of long-term survival with metastatic triple-negative breast carcinoma: Treatment possibilities for metastatic disease.

RATIONALE: Breast cancer is the most common as well as one of the most devastating cancers among women in the United States. Prognosis is poor for patients with metastatic breast cancer, especially for patients with so-called "triple-negative" disease. The lack of effective therapies for metastatic triple-negative breast cancer outlines the need for novel and innovative treatment strategies. PATIENT CONCERNS: A 58-year-old underwent a mastectomy which revealed a recurrent triple-negative breast carcinoma. Afterward, she presented with a growing mass in her left axilla and chest wall. A computed tomography scan showed axillary and supraclavicular adenopathy, nodules in the left upper and lower lobe of the lungs, and 2 areas of disease in the liver. A bone scan showed lesions in the ribs. DIAGNOSIS: The patient was diagnosed with a recurrent metastatic triple-negative breast carcinoma that spread to the lung, liver, and bones. INTERVENTIONS: The patient was treated with metronomic chemotherapy, sequential chemotherapy regimens, and immunotherapy. OUTCOMES: The patient is now over 15 years out from her diagnosis of metastatic disease without any evidence of recurrent disease, likely due to the patient's treatment strategy which included sequential metronomic chemotherapy regimens and immunotherapy. LESSONS: Sequential metronomic chemotherapy regimens in combination with immunotherapy might be an effective treatment option for patients with metastatic triple-negative breast cancer. We hope that this case can provide some guidance for the treatment of metastatic triple-negative breast cancer and motivate research that can potentially lead to more cases of long-term survival for patients who develop this dismal disease.