Metastatic Breast cancer Case Report

General information Name: WU ChunHong Age: 40y Sex: Female Date of admission: February 9th,2011 Date of discharge: April 23th,2011

Chief complaint She got hypoesthesia of lower limbs and inability to walk for more than a month

History of present illness The patient felt pain on the back by no obvious incentives in June 2010 The pain was tingling, especially in night-time The patient took orally traditional Chinese medicine , but had not tangible effects

Past, Personal & Family History No hepatitis, hypertension, or diabetes No smoking, alcohol or drug abuse No inherited diseases No history of drug allergy Normal menstruation

Clinical findings The left breast presented with diffused erythema and edema , induration about size of 3.0cm*3.0cm

Ultrasound examination a 3 cm left breast mass and a normal right breast

Thoracic MRI examination

Thoracic MRI examination Enhanced MRI High-density mass was shown on the seventh thoracic, and bone destruction also had been found.

Laboratory examination 2011-02-09 1.Hepatic functions ALT 40 U/L AST 20 U/L TB Normal 3.Tumor markers CA19-9 Normal 2. Blood routine test Hb 82 g/L RBC 4.54×1012 /L WBC 6.1×109 /L PLT 201 ×109 / L

puncture biopsy She received ultrasound guided breast core needle puncture biopsy Puncture tissue pathology :The left breast invasive ductal carcinoma

Breast cancer with bone metastasis Primary diagnosis Breast cancer with bone metastasis

Treatment On February 11, 2011 in orthopedic department, The Patient received "the seventh thoracic tumor resection and pedicle screw fixation"

Histological examination Seventh thoracic tumors was identified as metastatic carcinoma, and the immunohistochemistry results showed the possibility of breast cancer bone metastasis was very large

IMMUNOHISTOCHEMICAL results ER++ PR++ CerbB2- CK20- EMA++,Ckpan+++,CK5/6-

Treatment The patient recovered well , and then transferred into our department Chemotherapy two times before operation: February 23 ,2011 March 20 ,2011 The chemotherapy plan was TEC

Treatment The lesions area of left breast showed no reduction After the chemotherapy The lesions area of left breast showed no reduction

Treatment Modified radical mastectomy on march 31,2011 On the same day Bilateral oophorectomy On the same day

Histological examination The left breast invasive ductal carcinoma The basal resection margin of tumor was close to the surrounding normal tissue The axillary lymph nodes metastasis (13/15)

Immunohistochemical ER++ PR++ CerbB2- E-cad+++,Ki6750%+,P53+,Ck5/6-

Treatment After operation, the patient continued to receive chemotherapy and radiotherapy.

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