A Case of Hormone Receptor-positive Recurrent Breast Cancer in which Stable Disease Condition was Achieved by Olaparib

Abstract

We have experienced a case of recurrent breast cancer with liver, brain and lung metastases in which stable disease condition could be achieved by olaparib administration. The patient had left breast cancer, T1N1M0 and luminal type, at the age of 39, right breast cancer, T1N0M0 and luminal type, at the age of 43, and right axillary lymph node metastasis at the age of 45. Further two years later, liver and parasternal lymph node metastases were confirmed. The patient received two hormone therapy regimens, but one year and nine months after the recurrence, brain and lung metastases appeared and the liver metastasis enlarged in size. Radiation therapy was conducted for the brain metastasis and oral anti-cancer drug was administered. BRCA2 mutation was confirmed, and olaparib was administered as the fourth-line chemotherapy. During the therapy, she developed nausea, appetite loss, fatigue (Grade 1) and neutropenia (Grade 2), but she did not need to decrease the dose. She needed only once a month medical treatment as an outpatient and she can keep her domestic duties and child care at home as before. No aggravation of the metastatic lesions has occurred until now when one year and 2 months elapsed after the metastases. Olaparib is a promising treatment choice with high tolerability to long-term administration. In the treatment of recurrent breast cancer, we should actively survey the presence of BRCA1/2 mutation and consider the administration of olaparib, even though the disease is in an advanced stage.