A Case of pT1a Breast Cancer with Distant Recurrence

Abstract

A 56-year-old woman was diagnosed with left breast cancer at the age of 53 years and underwent left mastectomy and sentinel lymph node biopsy. The histopathological diagnosis was invasive ductal carcinoma of the left breast, pT1a (2×1 mm) N0M0, pStage IA, ER (60%), PgR (70%), HER2 (2+), Ki67 (40%), and adjuvant therapy was performed with tamoxifen.

Two years and five months after surgery, she developed respiratory distress. A chest CT scan showed multiple bone metastases and multiple lung metastases. A sternum biopsy was performed. The histopathological diagnosis was metastasis of breast cancer, ER (0%), PgR (0%), HER2 (2+) (FISH negative), and Ki67 (30%). It showed the discordance of ER expression between the primary and metastatic lesions. One month later, she had worsening respiratory distress. The tumor markers were increased significantly and the metastases CT showed were rapidly progressed. We initiated paclitaxel plus bevacizumab therapy. After 3 courses of the therapy, the lesions were significantly reduced and the markers also decreased. For 8 months after the recurrence, the treatment was effective for the lesion. In following the postoperative patient with pT1a breast cancer, we must bear in mind that the neoplasm can recur.