Abstract:
A 53-year-old post-menopausal Indian female presented with invasive ductal carcinoma, treated with neoadjuvant chemotherapy and pembrolizumab due to a PD-L1 combined positive score of 5. Following a right mastectomy and axillary dissection, she received a breast expander and AlloDerm™ graft. After resuming pembrolizumab and paclitaxel postoperatively, she developed severe breast redness and high-grade fever, necessitating expander removal due to suspected pembrolizumab-induced complications. This case underscores the unique and severe adverse effects of pembrolizumab on breast reconstruction, highlighting the need for careful monitoring and management in patients undergoing similar treatments.
CONCLUSIONS: Among patients with early triple-negative breast cancer, the combination of pembrolizumab with neoadjuvant chemotherapy enhances outcomes compared to chemotherapy alone.Early recognition is essential for managing pembrolizumab-induced complications, as demonstrated by the need for expander removal and debridement in this case.The unique adverse effects observed in this case underscore the importance of tailoring cancer treatment plans to individual patients, taking into account the potential risks associated with immunotherapy in the context of reconstructive surgery.
摘要:
一名53岁的绝经后印度女性患有浸润性导管癌,由于PD-L1联合阳性得分为5,接受新辅助化疗和派姆单抗治疗。在右乳房切除术和腋窝解剖之后,她接受了乳房扩张器和AlloDerm™移植。术后恢复pembrolizumab和紫杉醇,她出现了严重的乳房红肿和高烧,由于怀疑派姆单抗引起的并发症,需要移除扩张器。该病例强调了pembrolizumab对乳房重建的独特和严重的不良反应,强调需要对接受类似治疗的患者进行仔细的监测和管理。
结论:在早期三阴性乳腺癌患者中,与单纯化疗相比,pembrolizumab联合新辅助化疗可提高预后.早期识别对于管理pembrolizumab引起的并发症至关重要,在这种情况下,需要去除扩张器和清创术。在这种情况下观察到的独特不良反应强调了为个体患者量身定制癌症治疗计划的重要性。考虑到重建手术中与免疫治疗相关的潜在风险。