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1.
Ninomiya J Horiguchi J Koibuchi Y Yoshida T Iijima K Yoshida M Takata D Yokoe T Iino Y Morishita Y 《Breast cancer (Tokyo, Japan)》2003,10(4):361-365
A 45-year-old woman underwent a modified radical mastectomy for right breast cancer in July 1996. As lymph node metastases were quite advanced, chemotherapy was started with anthracyclines. Four years after surgery, cough and dyspnea appeared. Chest radiograph and CT showed reticular shadows bilaterally and slight pleural effusion, suggesting lymphangitic lung metastasis of breast cancer. Biweekly intravenous docetaxel (TXT,45 mg/m2) was initiated. Four courses of TXT ameliorated her complaints and radiographic findings. A total of 30 continuous courses of TXT suppressed disease exacerbation for 18 months until new lesions manifested in January 2002. The main side effects were grade 2 leukopenia and alopecia. This case report describes a patient with long-term suppression of lymphangitic lung metastasis of breast cancer using biweekly TXT without severe side effects or worsening quality of life. 相似文献
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Kumar L Pokharel YH Dawar R Thulkar S 《Clinical oncology (Royal College of Radiologists (Great Britain))》1999,11(6):414-416
Metastasis to the breast from primary cervical cancer is rare. We describe one such patient, who developed breast metastasis 6 months after diagnosis. She was free of pelvic disease at the time of metastases but had evidence of lung involvement. She died of progressive disease 2 months later. Data on 23 patients collected from the literature via Medline are reviewed. 相似文献
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目的探讨乳腺癌骨髓转移的临床特点、诊治方法及预后。方法报告1例乳腺癌骨髓转移病例,分析其诊疗经过并复习相关文献。结果本例患者就诊时已有明显骨痛和中度贫血,经紫杉醇单药联合最佳支持治疗(BSC),症状明显缓解,至2011年10月已获生存期31个月。结论骨髓转移癌早期易被忽视,当有骨痛并突发原因不明的贫血和血小板减少时(而白细胞多正常),应考虑骨髓转移的可能,骨髓穿刺是简单而有效的确诊手段。在造血因子的支持下,化疗联合BSC能缓解症状,延长生存期。 相似文献
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目的探讨乳腺癌首发肝转移的临床病程、治疗效果及预后影响因素。方法收集2005~2010年中国医学科学院肿瘤医院收治、首发转移部位为肝脏的女性乳腺癌患者的临床病理资料及生存情况,回顾性分析其预后及影响因素。结果全组146例患者,术后中位无病生存期(DFS)19.1个月,转移后中位生存期(MSR)22个月,中位无进展生存期(PFS)9个月。肝转移后1、2、3年生存率分别为69.8%、43.4%和31.7%。整组初始治疗的有效率为59.4%,临床获益率为84.4%。单因素分析显示:原发肿瘤的大小、激素受体状态、是否为三阴性乳腺癌、无病生存期长短、有无其他脏器转移、肝转移灶数目、肝转移时转氨酶、转移后首次治疗方式以及一线治疗疗效与预后有关。多因素分析显示是否三阴性乳腺癌及无病生存期长短是影响乳腺癌肝转移后生存的独立预后因素(P=0.006,P=0.008)。结论乳腺癌肝转移患者经过合理的综合治疗后,其生存期及1、2、3年生存率较前有显著提高,术后无病生存期短以及三阴性亚型的乳腺癌肝转移患者预后较差,需要更精细和个体化的治疗以改善预后。 相似文献
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乳腺癌骨转移内分泌治疗与化疗的对比研究 总被引:10,自引:0,他引:10
目的 对比分析内分泌治疗与化疗对乳腺癌骨转移的疗效。方法 对 138例无内脏转移的乳腺癌骨转移患者 ,行 2 89例次单独内分泌治疗或化疗。结果 内分泌治疗与化疗的一线治疗有效率分别为 35 .4 %和 31.7% ,差异无显著性 (χ2 =0 .16 3,P =0 .6 87) ;全部治疗有效率分别为 2 7.1%和 2 5 .0 % ,差异无显著性 (χ2 =0 .15 9,P =0 .6 90 ) ;临床获益率分别为 4 3.9%和 36 .6 % ,差异无显著性(χ2 =0 .6 0 3,P =0 .4 37)。但内分泌治疗与化疗的二线治疗临床获益率分别为 4 7.8%和 2 4 .2 % ,全部治疗为 4 7.5 %和 2 7.7% ,差异均有显著性 (χ2 =4 .5 37,P =0 .0 33;χ2 =11.2 0 1,P =0 .0 0 1)。内分泌治疗和化疗患者的中位治疗失败时间 (TTF)为 5个月和 2个月 ,中位病变进展时间 (TTP)为 5个月和 2 .5个月 ,差异均有非常显著性 (P均 <0 .0 0 1)。结论 单独内分泌治疗和化疗均为乳腺癌骨转移的有效治疗手段 ,其中内分泌治疗优于化疗。 相似文献
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目的探讨转移性乳腺癌发生脑转移的危险因素.方法采用临床分析的方法对199例转移性乳腺癌病例归纳总结,并采用COX模型单变量和多变量分析法对临床特征进行统计分析.结果肺转移的存在(比值比=4.26,95%,CI:1.9%~9.3%,P=0.0003)和激素受体阴性状态:(比值比=4.15,95%,CI:1.6%~10%,P=0.002),CerbB-2阳性(比值比=4.22,95%,CI:1.5%~11%,P=0.0006)是脑转移发生的预测因素.结论在转移性乳腺癌患者中,肺转移是首发转移位置,激素受体阴性CerbB-2阳性是发生脑转移的危险因素,应在这些患者中进行预防性治疗. 相似文献
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Epididymal metastasis from gastric cancer is extremely rare. We reported one rare case. The 34-year-old male patient was found swelling lumps on his right testicle 6 months after adjuvant chemotherapy. The patient was given another 2 cycles of chemotherapy which followed by DCX regimen after the orchiectomy. The patient is still survival 21 months after radical gastrectomy. Therefore the early correct diagnosis and rational treatment are very important for improving the survival rate of patients. 相似文献
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Bisphosphonates inhibit osteoclastic bone resorption and are being used as treatment for bone metastases from breast cancer. Intravenous bisphosphonate therapy can significantly reduce skeletal related events (SREs) when administered concurrently with chemotherapy or endocrine therapy. In addition, intravenous bisphosphonate monotherapy is also able to alleviate cancer induced bone pain, and to improve bone metastases in some patients. Oral bisphosphonates are not routinely used for the treatment of bone metastases due to their low bioavailability. However, minodronate, a bisphosphonate 100-fold more potent than pamidronate, is now in phase II clinical studies in Japan, and may alter the role of oral bisphosphonates in the treatment of bone metastasis from breast cancer. The ASCO guidelines recommend that patients with osteolytic bone metastases be treated not with bisphosphonate monotherapy, but with concurrent bisphosphonate and systemic therapy. In addition, it is also recommended that current standards of care for cancer pain, analgesics and radiotherapy, should not be replaced with bisphosphonate therapy. 相似文献
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肝脏是乳腺癌常见的转移部位。乳腺癌肝转移的过程包括多个步骤,涉及乳腺癌细胞和肝脏微环境中的多种因素。在本文中,我们综述了与乳腺癌肝转移相关的分子(包括连接蛋白类、蛋白激酶类、miRNAs)、信号转导通路(包括CXCL12-CXCR4轴、Wnt/β-catenin信号通路、AF1q/TCF7/CD44调节轴、层黏连蛋白受体/Akt/ERK信号通路、瘦素/ERK/IL-8信号通路)以及肝脏微环境中的影响因素(包括缺氧诱导因子、肿瘤相关成纤维细胞、脂肪基质干细胞、金属蛋白酶、选择性配体、炎性细胞免疫浸润)。 相似文献
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Fujii H Enomoto K Ikeda T Hojo T Yasuda S Ide M Shohtsu A Kameyama K Kubo A 《Breast cancer (Tokyo, Japan)》2000,7(2):165-168
We report a 48-year-old woman with lymph node (LN) metastases from breast cancer in whom diagnosis was difficult by conventional imaging methods but easy by F-18 fluorodeoxyglucose (FDG) PET. She was given a diagnosis of right breast cancer and then underwent modified radical mastectomy in December 1997. During routine CT and US studies in September 1998, a questionable LN measuring 1 cm in diameter was detected in the right supraclavicular region, but a definitive diagnosis of this LN was difficult by these tests. The patient underwent FDG PET test, which showed strong nodular activity (SUV= 7.1) in the right supraclavicular region, indicating a metastatic lesion. Moreover, an unexpected second metastatic LN lesion (SUV= 5.5) in the medial aspect of the right axillary was diagnosed by PET. The PET results were confirmed by pathological examination of the surgical specimens. FDG PET is a useful tool to detect small malignant lesions that are not easily diagnosed by conventional imaging techniques such as CT and US. It is expected that PET test will be feasible at many institutions. 相似文献
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F. Chen T. Fujinaga K. Sato M. Sonobe T. Shoji H. Sakai R. Miyahara T. Bando K. Okubo T. Hirata M. Toi H. Date 《European journal of surgical oncology》2009
Background and objectives
Metastatic breast cancer has been defined as a systemic disease. The discussion concerning the resection of lung metastases in patients with breast cancer is controversial. To confirm the role of resection of pulmonary metastases from breast cancer and to identify possible prognostic factors, we reviewed our institutional experience.Methods
Between 1991 and 2007, 41 patients with pulmonary metastases from breast cancers underwent complete pulmonary resection. All patients had obtained or had obtainable locoregional control of their primary tumors. Various perioperative variables were investigated retrospectively to confirm the role of metastasectomy and to analyze prognostic factors for overall survival after metastasectomy.Results
All patients were female with a median age of 55 years (range, 35–81 years). The overall survival rate after metastasectomy was 51% at 5 and 10 years. On multivariate analysis, fewer than four pulmonary metastases and a disease-free interval of more than 3 years were significantly favorable prognostic factors for overall survival (p = 0.023 and 0.024, respectively).Conclusions
The current practice of pulmonary metastasectomy for breast cancers in our institution was well justified. Pulmonary metastasectomy in patients with previous breast cancer might be justified when fewer than four pulmonary metastases or a disease-free interval of more than 3 years. 相似文献14.
Baba M Tatsuta M Miya A Ishida H Masutani S Kawasaki T Satomi T Hanai J Kimura F 《Breast cancer (Tokyo, Japan)》2000,7(2):173-175
We describe a case of a 58-year-old woman with right inguinal lymph node swelling and a T1 tumor in the right breast. She was referred with an 18-month history of the former complaint and a six-month history of the latter. Excisional biopsy of the inguinal lymph node revealed breast cancer metastasis. Radiographical examination showed no metastases to the lungs, liver or bone. Modified radical mastectomy was performed. Histological examination revealed solid tubular carcinoma, PT2, PM (axillary lymph node metastases 4/16), stage IV. Estrogen and progesterone receptors were negative. Three cycles of postoperative cyclophosphamide, adriamycin and 5-fluorouracil (CAF) chemotherapy were given, and the right inguinal area was irradiated with 40 Gy. The patient complained of swelling in both legs three years after surgery. Computed tomography revealed marked lymph node swellings in the pelvic cavity. She died six months later. Inguinal lymph node metastasis from breast cancer is very rare, although distant lymph node metastasis in the cervix occurs frequently. This case should help clarify how breast cancer metastasizes to distant lymph nodes. 相似文献
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Shigekawa T Takeuchi H Misumi M Matsuura K Sano H Fujiuchi N Okubo K Osaki A Aogi K Saeki T 《Breast cancer (Tokyo, Japan)》2009,16(1):88-92
We report a case of metastatic breast cancer with leptomeninges and multiple bone metastases that showed an excellent response
to the combination of trastuzumab and capecitabine; therapeutic effect was evaluated by MRI at follow-up. A 44-year-old woman
underwent modified radical mastectomy in February 1997. In April 2003, a tumor at the right basis cerebri and multiple bone
metastases were noted, and in October 2003, she underwent enucleation of the tumor. Histopathologically, the tumor was consistent
with a basal skull metastasis from breast cancer. In March 2004, the patient began to experience pain, weakness, and paresthesia
of both legs. She was diagnosed, with leptomeningeal metastasis (LM) from breast cancer using MRI. In December 2005, the combination
of trastuzumab and capecitabine administered as sixth-line treatment was very effective for LM. Although it is generally very
difficult to diagnose LM and assess the therapeutic effect with MRI, in this case, it was possible. To our knowledge, there
has been no report in the literature describing the combination of trastuzumab and capecitabine for LM from breast cancer.
Although the mechanism underlying the efficacy of this combination is still unknown, the treatment would be worth trying because
of its few side effects in extensively treated patients with LM from breast cancer. To confirm the antitumor efficacy of trastuzumab
and capecitabine, however, further investigations are required. 相似文献
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J. A. Perez-Fidalgo I. Chirivella J. Laforga J. M. Colio M. D. Blanes R. Baydal S. Roselló E. De-la-Morena A. Lluch 《Clinical & translational oncology》2007,9(4):264-265
Abstract Parotid gland metastases from malignant tumors are extremely rare. A 61-year-old woman was diagnosed with an early breast
cancer with no expression of oestrogen and progesterone receptors. Five years later the patient presented a tumour in parotid
gland. After total parotidectomy, microscopic analysis of the gland demonstrated an invasive duct carcinoma (IDC) with positive
expression of oestrogen receptor. The patient was treated with chemotherapy followed by complementary local radiotherapy.
Diagnosis of a metastasic tumour in parotid gland poses a challenge. In our case an immunohistochemical study of oestrogen
receptor was fundamental to establish a diagnosis. 相似文献
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目的 提高对乳腺癌骨转移患者预后影-向因素的进一步认识,指导临床个体化治疗。方法 回顾分析有完整病例资料的乳腺癌骨转移患者68例。结果 68例患者的中位生存期20个月,乳腺癌骨转移合并肝脏和/或肺转移同时存在时,患者的中位生存期13.5个月;乳腺癌骨转移不合并肝脏和/或肺转移患者的中位生存期为26个月;仅有骨转移而不合并其他脏器转移的患者的平均生存时间为44.2个月。结论 乳腺癌转移患者中肝脏和/或肺转移是预后不良指标。骨转移而不合并其他转移的患者生存期较长,其次是骨转移合并肺转移者、合并淋巴结转移、骨转移合并多个脏器转移者及合并肝脏转移者。 相似文献
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Pinar Saip Irfan Cicin Yesim Eralp Hakan Karagol Seden Kucucuk Ruşen Cosar Alas Ekrem Yavuz Maktav Dincer Esra Saglam Erkan Topuz 《Journal of neuro-oncology》2009,93(2):243-251
Background To identify the candidates for prophylactic cranial radiotherapy (PCI) among the patients with early and advanced-stage breast
cancer. Methods The demographic, pathologic and clinical features and survival results of 182 brain metastatic breast cancer patients treated
with cranial radiotherapy were examined. Results Early stage patients who progressed with isolated brain metastasis had longer survival (13 months vs. 4 months P = 0.006). Lobular/mixed type histology (P = 0.033), high nuclear (P = 0.046) and high histological grade (P = 0.034) were the prognostic factors for isolated brain metastases. The most significant factor for the time to brain metastasis
was the number of involved of lymph nodes (P = 0.004). In 60% of 148 patients with metastatic breast cancer, a progression with isolated brain metastasis was developed
while the systemic disease was under control. Isolated brain metastasis progression was related to the presence of the hepatic
metastasis at the
first relapse (P = 0.001) and with ErbB-2 overexpression (P = 0.034). The time to the brain metastasis from the first extracerabral metastasis was associated with the high nuclear grade
(P = 0.040) and with chemoresistance (P = 0.037). The median survival time after the brain metastases in chemosensitive patients was longer than in chemoresistant
patients (8 months vs. 3 months P = 0.044). In chemoresistant patients (P = 0.0028) and/or in triple negative patients (P = 0.05) the development of the brain metastasis was early and the survival after brain metastasis was short. Discussions Since there is a tendency to early brain metastasis in early stage patients with high-grade, lobular/mixed type histology
tumors and with a high number of involved lymph nodes, the value of PCI can be explored in these patients by a well designed
prospective trial. Advanced stage chemosensitive patients with ErbB-2 over-expression and/or with hepatic metastasis at their
first relapse may be candidates for PCI. There is no place for PCI in chemoresistant and triple-negative breast cancer patients. 相似文献