Abstract
Breast cancer is the leading new cancer diagnosis in women in the United States and is the second most lethal cancer in this patient population after lung cancer. Chest wall recurrence after mastectomy poses unique clinical challenges, as such tumors are often not amenable to surgical resection and durable local control with radiation or systemic therapy is challenging. When uncontrolled, chest wall recurrence can lead to severe pain and other morbidity. Herein, we describe a patient with inflammatory breast cancer with a massive, rapidly growing chest wall recurrence treated with a regimen of hypofractionated concurrent chemoradiation resulting in a complete chest wall response with durable local control.
Highlights
Breast cancer is the leading new cancer diagnosis in women in the United States (US) comprising 29% of all female cancer diagnoses and is the second most lethal cancer in this patient population after lung cancer [1,2]
We describe a patient with inflammatory breast cancer treated initially with neoadjuvant chemotherapy and mastectomy with a rapidly growing, massive chest wall tumor recurrence treated with concurrent chemoradiation (CRT) with durable local control
A hypofractionated radiotherapy regimen was employed with concurrent full-dose carboplatin/paclitaxel to control a massive, rapidly growing chest wall recurrence
Summary
Breast cancer is the leading new cancer diagnosis in women in the United States (US) comprising 29% of all female cancer diagnoses and is the second most lethal cancer in this patient population after lung cancer [1,2]. In hopes of enrolling on clinical trial, the patient had repeat tumor testing done by a certified lab that revealed the tumor to be, in contrast to the initial pathology, ER positive, and the patient initiated endocrine therapy with letrozole Her disease remained well-controlled for 10 months on endocrine therapy when surveillance PET/CT showed low-volume systemic disease progression with small pulmonary and liver nodules and increase in size and fluorodeoxyglucose (FDG) avidity of left axillary lymph nodes without associated chest wall progression. At the time of her death, her chest wall disease remained well-controlled, she required an additional course of palliative RT for a growing axillary node outside the initial RT field 17 months after her initial RT course
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