1. Metastatic Breast cancer
Case Report

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

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

4. 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

5. 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

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

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

8. Thoracic MRI examination

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

10. Laboratory examination
1.Hepatic functions
ALT 40 U/L
AST 20 U/L
TB Normal
3.Tumor markers
CA Normal
2. Blood routine test Hb g/L RBC 4.54×1012 /L WBC 6.1×109 /L
PLT ×109 / L

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

12. Breast cancer with bone metastasis
Primary diagnosis
Breast cancer with bone metastasis

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

14. 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

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

16. 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

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

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

19. 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)

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

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

22. Thank you