Abstract
Background. Breast cancer ranks as the second most common cancer (14.9 %) and the most common female cancer (20.9 %) in Russia. at the time of diagnosis, 11.0 % of patients have already developed metastases, and 10.3 % of patients die within the first year of diagnosis from disease progression. distant metastasis is the leading cause of death from breast cancer, and brain metastasis is a significant prognostic factor for poor survival.Case description. We report the case of a long-lasting control of advanced breast cancer with brain metastases in a 32-year-old woman. low grade tubular breast carcinoma was histologically confirmed. immunohistochemical study: eR-ts-4 points, PR-ts – 3 points, Her-2 positive, Ki67 – 35.0 %. BRCa1 5382ins C mutation was not detected. the long-term use of therapy with lapatinib and capecitabine was described.Conclusion. this case demonstrates the feasibility of long-term (31 months) control over Her-2 positive disseminated breast cancer with multiple metastases to the brain and bones, while maintaining the quality of life and social activity of a young patient. despite the risks associated with whole brain radiotherapy, no cognitive impairment was observed. therapy with lapatinib and capecitabine was effective for 28 months with good tolerance.
Highlights
Breast cancer ranks as the second most common cancer (14.9 %) and the most common female cancer (20.9 %) in Russia
At the time of diagnosis, 11.0 % of patients have already developed metastases, and 10.3 % of patients die within the first year of diagnosis from disease progression
We report the case of a long-lasting control of advanced breast cancer with brain metastases in a 32-year-old woman
Summary
У 11,0 % больных к моменту постановки диагноза имеются отдаленные метастазы, 10,3 % пациенток умирают в течение первого года жизни от прогрессирования заболевания. Наиболее частая причина гибели больных раком молочной железы – отдаленные метастазы, наиболее опасным считается поражение головного мозга. Приводим клиническое наблюдение длительного лечения диссеминированного рака молочной железы с метастазами в головной мозг у пациентки 32 лет. Гистологическое заключение: тубулярная карцинома молочной железы, низкой степени злокачественности G1. Представленный случай демонстрирует возможность длительного (31 мес) контроля над Her-2 позитивным раком молочной железы с множественными метастазами в головной мозг и кости с сохранением качества жизни и социальной активности пациентки молодого возраста. Ключевые слова: диссеминированный рак молочной железы, гиперэкспрессия Her-2 neu, метастатическое поражение головного мозга, лучевая терапия на головной мозг, таргетная терапия, качество жизни
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