IV期乳腺癌难以治愈,主要采用全身治疗。然而,当远处转移是寡转移时,据报道,包括针对原发病灶和远处转移灶的局部治疗在内的积极治疗可改善预后.我们遇到了一名患有同侧颈淋巴结转移的乳腺癌患者。转移是寡转移,我们对他们进行了治疗。该患者是50多岁的女性,几年来一直意识到左乳房的下内象限有肿块。进行活检,病理诊断为左乳腺癌。放射学检查显示同侧腋窝和颈部淋巴结转移。颈淋巴结转移是寡转移,提示包括局部治疗在内的多模式治疗可能改善预后。在这种情况下,多模式治疗包括乳房切除术和I级和II级腋窝淋巴结清扫术,全身治疗(包括化疗,内分泌治疗,和分子靶向治疗),和乳房切除术后的放射治疗.左胸壁及左锁骨上淋巴结区照射。此外,乳房切除术后的放射治疗后,颈淋巴结转移患者接受根治性放射治疗。治愈了,放射治疗完成后,无复发状态维持两年零四个月。这个案例表明,对于颈淋巴结寡转移受累的乳腺癌,作为多模态治疗的一部分,采用根治性放疗对这些远处转移性病变进行局部治疗是有益的.
Stage IV breast cancer is difficult to cure and is mainly treated with systemic therapy. However, when distant metastasis is oligometastatic, proactive treatment including local therapies for the primary lesion and distant metastases has been reported to improve prognosis. We encountered a patient who had left breast cancer with ipsilateral cervical lymph node metastases. The metastases were oligometastatic, and we treated them curatively. The patient was a female in her 50s who had been aware of a lump in the lower inner quadrant of the left breast for a few years. A biopsy was performed and left breast cancer was diagnosed pathologically. Radiological examination showed metastasis to ipsilateral axillary and cervical lymph nodes. The cervical lymph node metastases were oligometastatic, suggesting possible improvement in prognosis by multimodality treatment including local therapy. The multimodality treatment in this
case comprised mastectomy with levels I and II axillary lymph node dissection, systemic therapy (including chemotherapy, endocrine therapy, and molecular targeted therapy), and postmastectomy radiation therapy. The left chest wall and left supraclavicular lymph node region were irradiated. Furthermore, following the postmastectomy radiation therapy, the cervical lymph node metastases were treated with radical radiation therapy. The cure was achieved, with recurrence-free status maintained for two years and four months after the completion of radiation therapy. This
case suggests that, for breast cancer with oligometastatic involvement of cervical lymph nodes, locally treating these distant metastatic lesions with radical radiation therapy as part of multimodality treatment is beneficial.