A Case of Breast Cancer Diagnosed as Anemia due to Bone Marrow Metastasis

Abstract

A 75-year-old woman was referred to our hospital for a detailed examination of anemia and a mass in the right breast. On examination, breast cancer (4 cm) was revealed in the right C area ; however, no distant metastasis was observed. Bone marrow aspiration was inadequate, and right mastectomy and axillary lymph node dissection were performed. Pathological examination revealed triple-negative invasive lobular carcinoma. Postoperative bone marrow biopsy revealed bone marrow metastasis of breast cancer. The postoperative staging was T2, N1, M1 (MAR), stage IV. Postoperative bone scintigraphy revealed widespread bone marrow metastasis. The patient was treated with epirubicin + endoxan^® → weekly paclitaxel. Bone marrow metastasis is associated with disseminated intravascular coagulation (DIC) and can lead to worsening of the patient's condition. Bone marrow metastasis has a poor prognosis ; thus, immediate therapeutic intervention is crucial. When breast cancer is characterized by anemia or thrombocytopenia, emphasis should be given to the risk of bone marrow metastases. However, no chemotherapy regimen for bone marrow metastases has yet been determined.