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Preoperative therapy with trastuzumab and paclitaxel in a stage IV advanced breast cancer with complete pathologic response
Authors:Rai Yoshiaki  Sagara Yoshiaki  Sagara Yasuaki  Takahama Tetsuya  Matsuyama Yoshito  Ando Mitsutake  Sagara Yoshiatsu  Ooi Yasuyo  Inoue Kenichi  Kurosumi Masafumi
Institution:Dept. of Breast Surgery, Saitama Cancer Center.
Abstract:A 53-year-old woman had a 105x100 mm tumor on her right breast with a 55x36 mm-sized bleeding ulcer of the skin and ipsilateral axillary and cervical lymph nodes swelling (T4bN3cM1, Stage IV). Core needle biopsy and immunohistochemistry of breast tumor showed invasive ductal carcinoma with negative hormone receptor (ER-, PgR-) and overexpression of HER 2 (Hercep Test score 3+). She was treated with weekly trastuzumab (initially 4 mg/kg followed by 2 mg/kg every week), and a combination of tri-weekly paclitaxel (175 mg/m(2), 6 courses). After 3 courses of administration, the breast tumor subsided, the ulcer became flat, and axillary and cervical nodes completely disappeared. Clinical CR was obtained after 6 courses of treatment, and mastectomy with axillary clearance was then performed. Histopathology of the breast and lymph nodes showed complete disappearance of cancer cells (pCR, Grade 3+3 (d) +3 (n)). The combination of trastuzumab and paclitaxel is a promising regimen for HER 2 positive advanced breast cancer.
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