Abstract
A 68-year-old woman diagnosed with T4cN3cM1 (OSS) Stage IV (solid tubular carcinoma, ER+, PgR+, HER2-, Ki67 labeling index : < 14%) left breast cancer was started on weekly paclitaxel plus bevacizumab (BEV) plus zoledronic acid. Although a favorable response was obtained from an early stage of treatment, the patient developed hypertension and proteinuria, thought to be adverse events associated with BEV. She developed sudden, severe back pain during the 5th course and visited the outpatient emergency department. The cause of the pain could not be identified on plain computed tomography (CT) performed during this visit, but the symptoms improved with analgesics and rest. Subsequently, on contrast-enhanced CT performed at the completion of the 9th course, aortic dissection (DeBakey IIIb) was incidentally detected. Because the possibility of this finding being an adverse event associated with BEV could not be ruled out, BEV was discontinued, an antihypertensive agent was started, and serious outcomes were prevented with conservative treatment. This is the first report of a case of aortic dissection occurring during administration of BEV for breast cancer as part of the postmarketing surveillance of BEV in Japan.
