UNASSIGNED: A 46 years-old woman presented as an aggressive colloid breast carcinoma showing skin ulceration, enlargement of multiple axillary lymph nodes and a metastasis in the pleura at diagnosis. The primary tumor showed strong positive expression of estrogen, progesterone as well as Her-2 receptors. The patient was treated with 6 cycles of paclitaxel and carboplatin followed by mastectomy, radiotherapy, and hormonal therapy. Patient tolerated the treatment course and showed improvement both in the locoregional control and pleural metastasis.
CONCLUSIONS: Colloid breast carcinoma with aggressive clinical course is rarely found. Nodal involvement as a sign of poor prognosis in colloid breast carcinoma ranges only between 12 and 19%. Therefore, axillary node clearance is usually excluded during the surgery of colloid breast carcinomas. However, in the presence of high-risk characteristics, mastectomy involving axillary lymph node dissection is still contentious. In patients with Her-2 overexpression, treatment using anti-Her2 (trastuzumab) is also still disputed in colloid breast carcinoma because of the higher resistance rates.
CONCLUSIONS: Although clinically aggressive colloid breast carcinoma is rare, thorough clinical assessment and immediate treatment initiation will be beneficial for patients with high risk of relapse and metastatic spread.
一名46岁女性表现为侵袭性胶体乳腺癌,表现为皮肤溃疡,诊断时腋窝多发淋巴结肿大和胸膜转移。原发肿瘤显示雌激素强阳性表达,孕激素以及Her-2受体.患者接受了6个周期的紫杉醇和卡铂治疗,然后进行乳房切除术。放射治疗,和激素治疗。患者耐受治疗过程,并且在局部区域控制和胸膜转移方面均显示出改善。
结论:很少发现具有侵袭性临床病程的胶体乳腺癌。在胶体乳腺癌中,淋巴结受累是预后不良的标志,范围仅为12%至19%。因此,在胶体乳腺癌的手术中,腋窝淋巴结清除通常被排除。然而,在存在高风险特征的情况下,涉及腋窝淋巴结清扫的乳房切除术仍有争议。在Her-2过度表达的患者中,使用抗Her2(曲妥珠单抗)的治疗在胶体乳腺癌中也存在争议,因为其耐药率较高.
结论:尽管临床上侵袭性乳腺胶体癌很少见,全面的临床评估和立即开始治疗将有利于复发和转移扩散风险高的患者.