Open Access

Multiple metastases of human epidermal growth factor receptor 2‑positive, hormone receptor‑positive, pT1a pN0 breast cancer within 1 year after surgery: A case report

  • Authors:
    • Takafumi Suzuki
    • Takahiro Einama
    • Miki Takushima
    • Yakumo Araki
    • Katsuyuki Wakamatsu
    • Kazuki Kobayashi
    • Hiroki Ohno
    • Makiko Fukumura‑koga
    • Tamio Yamasaki
    • Hideki Ueno
    • Hitoshi Tsuda
    • Yoji Kishi
  • View Affiliations

  • Published online on: June 12, 2024     https://doi.org/10.3892/ol.2024.14498
  • Article Number: 365
  • Copyright: © Suzuki et al. This is an open access article distributed under the terms of Creative Commons Attribution License.

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Abstract

Adjuvant chemotherapy is usually not considered for pT1a pN0 human epidermal growth factor receptor 2 (HER2)‑positive breast cancer due to its low recurrence rate. The present report describes a case of pT1a hormone receptor‑positive HER2‑positive breast cancer with multiple recurrences in the axillary lymph nodes and liver within 1 year after radical surgery. A 58‑year‑old woman underwent left total mastectomy and sentinel lymph node biopsy for left breast cancer with pathological stage IA (pT1a pN0). The subtype corresponded to luminal B‑like breast cancer with a nuclear grade of 3 and a Ki‑67 labeling index of 37%. An aromatase inhibitor (letrozole) was planned to be administered for 5 years after surgery, but the patient was diagnosed with multiple liver and axillary lymph node metastases 11 months after surgery. After 1 year of chemotherapy (paclitaxel) in combination with anti‑HER2 therapy (pertuzumab and trastuzumab), liver metastases resolved. A complete response of the liver lesion has been maintained 4 years after the anti‑HER2 therapy initiation. The present case exhibited two poor prognostic factors: High Ki‑67 labeling index and nuclear grade 3. Based on the ‘Predict’ tool, the present case would be expected to have a cancer‑related mortality rate of 6% 10 years after surgery with adjuvant endocrine therapy. Although this value may be controversial for postoperative anti‑HER2 therapy, the present case should not be considered to be a low‑risk case. When the identification of high‑risk pT1a pN0 HER2‑positive breast cancer is possible, postoperative anti‑HER2 therapy plus chemotherapy would be effective in decreasing the rate of recurrence.
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August-2024
Volume 28 Issue 2

Print ISSN: 1792-1074
Online ISSN:1792-1082

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Spandidos Publications style
Suzuki T, Einama T, Takushima M, Araki Y, Wakamatsu K, Kobayashi K, Ohno H, Fukumura‑koga M, Yamasaki T, Ueno H, Ueno H, et al: Multiple metastases of human epidermal growth factor receptor 2‑positive, hormone receptor‑positive, pT1a pN0 breast cancer within 1 year after surgery: A case report. Oncol Lett 28: 365, 2024.
APA
Suzuki, T., Einama, T., Takushima, M., Araki, Y., Wakamatsu, K., Kobayashi, K. ... Kishi, Y. (2024). Multiple metastases of human epidermal growth factor receptor 2‑positive, hormone receptor‑positive, pT1a pN0 breast cancer within 1 year after surgery: A case report. Oncology Letters, 28, 365. https://doi.org/10.3892/ol.2024.14498
MLA
Suzuki, T., Einama, T., Takushima, M., Araki, Y., Wakamatsu, K., Kobayashi, K., Ohno, H., Fukumura‑koga, M., Yamasaki, T., Ueno, H., Tsuda, H., Kishi, Y."Multiple metastases of human epidermal growth factor receptor 2‑positive, hormone receptor‑positive, pT1a pN0 breast cancer within 1 year after surgery: A case report". Oncology Letters 28.2 (2024): 365.
Chicago
Suzuki, T., Einama, T., Takushima, M., Araki, Y., Wakamatsu, K., Kobayashi, K., Ohno, H., Fukumura‑koga, M., Yamasaki, T., Ueno, H., Tsuda, H., Kishi, Y."Multiple metastases of human epidermal growth factor receptor 2‑positive, hormone receptor‑positive, pT1a pN0 breast cancer within 1 year after surgery: A case report". Oncology Letters 28, no. 2 (2024): 365. https://doi.org/10.3892/ol.2024.14498