Abstract
It has recently been found that the biologic mechanisms responsible for early recurrence in breast cancer differ from those for late recurrence in breast cancer and that estrogen receptor (ER)-positive breast cancer often recurs more than 5 years after the initial surgery. Patients who have ER-positive breast cancer with longer disease-free intervals usually respond to endocrine therapy after relapse and have longer post-relapse survival. We report here a rare case of ER-positive breast cancer that recurred 10 years after the initial operation ; it advanced rapidly and the patient died. A 65-year-old woman was admitted to our hospital with backache and headache. She had undergone right mastectomy and axial lymph node dissection for early breast cancer when she was 55 years old. Pathologically, the tumor was classified as pT1 pN0 M0 Stage I and was ER-positive (80-90%), progesterone receptor-negative, and HER2-negative. She received adjuvant endocrine therapy with an aromatase inhibitor for 5 years. At 10 years 2 months after surgery, she developed back pain and headache and was diagnosed with multiple bone metastases, multiple brain metastases, and carcinomatous meningitis. Despite endocrine therapy and radiation therapy for her recurrent breast cancer, she died following rapid exacerbation of carcinomatous meningitis 3 months after relapse.
