Abstract
A 45-year-old woman, who had severe motor and intellectual disabilities (SMID), underwent mastectomy for Stage IIB apocrine cancer of the right breast. The cancer showed ER, 0% ; PgR, 0% ; HER-2, 3+ immunohistochemically. Two years later, computed tomography (CT) findings revealed recurrences at the ipsilateral axillar and supraclavicular lymph nodes. After making diagnosis of the recurrence, 3-weekly administration of trastuzumab was initiated. After 3 months of the therapy, breast CT examination demonstrated reduction in sizes of multiple lymph nodes.
Although pertuzumab, trastuzumab, and docetaxel should have been administrated, rather than trastuzumab alone, in this case, based on the results of the CLEOPATRA trial and recommendation of Japanese clinical guidelines for the breast cancer, it was difficult to assess the tolerability of a combinational chemotherapy in this patient.
There are some barriers to the clinical course for care of breast cancer in SMID persons. It is difficult to estimate the tolerability against the therapies in SMID persons compared with non-handicapped persons. We should plan individually for the planning and treatment of patients with SMID who exhibit breast cancer or recurrence.
