Abstract
A woman in her 40s had been receiving treatment at a nearby clinic for alcoholic cirrhosis since 5 years earlier. One month earlier, she became aware of tenderness, pain, and a lump in the left breast, and visited our department. At the first visit, a tumor in the left breast measuring 7 cm was identified, with redness, edema, and retraction of the nipple. Needle biopsy showed invasive ductal carcinoma with estrogen receptor : 0, progesterone receptor : 0, HER2 : 0, Ki-67 : 65.7%. This tumor was diagnosed as locally advanced breast carcinoma, T4dN1M0, Stage IIIB. At the first visit, liver function was Child A, but platelet count was low at 3.8 × 104/μL, so splenectomy was performed. A rapid rise in platelets was confirmed, following which we administered nine courses of weekly PTX as preoperative chemotherapy, achieving cCR. After 11 months, pectoral muscle-conserving mastectomy and axillary lymph node dissection were performed. Pathological examination found only remnants of ductal carcinoma in situ (DCIS) : pCR. In cases with complicating cirrhosis that require chemotherapy, splenectomy may offer an effective auxiliary means for implementing safe chemotherapy administration.
