2017 Volume 42 Issue 6 Pages 923-929
The present case involved a 44-year-old female who presented with a chief complaint of swelling in the left breast. A mass of >10 cm in diameter and skin erythema were confirmed in the left breast, which showed had partial ulceration with exudate. We performed a core needle biopsy and diagnosed an invasive triple-negative carcinoma accordingly. Chemotherapy for a locally advanced left breast cancer, T4bN3M0 Stage Ⅲc, was initiated. After three courses of EC, erythema had faded and the mass had slightly decreased in size; however, the mass rapidly regrew over the next week; therefore, the scheduled fourth course of chemotherapy was not implemented in that week. Despite a switch to DTX-based chemotherapy, the case progressed to PD. On CT scan, the mass was observed to decrease in size during EC and then to regrow and invade the thoracic wall without lymphadenopathy or metastasis to other organ including the lung or the liver. Therefore, in an attempt at curative resection, we performed radical left mastectomy, partial thoracic wall resection, and latissimus dorsi myocutaneous flap reconstruction. The postoperative course was good, and the left thoracic wall was treated with radiation. When chemotherapy is ineffective for locally advanced breast cancer, localized disease control is particularly important. Patient condition must be monitored closely to ensure that the timing window for resection is not missed and the patient is adequately prepared for surgery.
