A Case Report of an 82-year-old Breast Cancer Patient who Achieved a Pathological Complete Response by Neoadjuvant Hormone Therapy

Abstract

We have experienced an elderly patient with breast cancer who achieved a pathological complete response by neoadjuvant hormone therapy.

An 82-year-old woman who was diagnosed with genital Paget's disease was referred to our department for a 14-mm left breast tumor in the region-A, which was found on a preoperative CT scan. A Core-needle biopsy revealed that the tumor was estrogen and progesterone receptor-positive invasive ductal carcinoma (HER2/2+, cT1cN0M0, Stage I). We scheduled to precede her treatment with operation for genital Paget's disease, and started neoadjuvant hormone therapy with anastrozole for breast cancer. Although the tumor regressed to 11 mm in diameter on ultrasonography seven months after the initiation of the therapy, it remained unchanged at 13 months. Therefore, we performed left mastectomy and sentinel node biopsy 14 months after the initiation. Pathohistological examination revealed no residual cancer cells (pathological complete response). She was maintained on anastrozole regimen without recurrence, as of 1 year after the surgery. Although optimum duration of hormone therapy remains unclear, several authors have reported that high response rate can be expected when it is administered for more than six months. Neoadjuvant hormone therapy is a treatment option for elderly patients with medical complications. It is important to monitor the response to the treatment and to adequately decide the timing of operation.