Abstract

A 45-year-old woman visited our department due to enlargement and ulceration of the right breast. Core needle biopsy and pathological examination revealed invasive ductal carcinoma of right breast (grade II). Immunohistochemistry showed that tissues were negative for estrogen receptor (ER) and progesterone receptor (PR), but positive for epidermal growth factor receptor-2 (Her-2) (+++) and vascular endothelial growth factor (VEGF) (+). Whole body positron emission tomography (PET) scan indicated multiple lymph node metastases and bone metastases. On examination, the performance status scored 1 (Eastern Cooperative Oncology Group (ECOG) score system). Salvage therapy was performed with bevacizumab and taxotere, carboplatin and herceptin (TCH) regimen (Taxol: 130 mg [d1, 8 and 15] + carboplatin: 160 mg [d1, 8 and 15] + herceptin: [first dose: 220 mg] 110 mg once weekly, 28 days as a course of chemotherapy). Bevacizumab (Avastin; 500 mg) was administered four times (once every two weeks). If necessary, zoledronic acid (Zometa) was given at 4 mg once monthly. Nine days after treatment, the tumor significantly shrunk and the ulcered tissues fell off. After 4 courses of treatment, positron emission tomography-computed tomography (PET-CT) showed that the cancer disappeared.

Key words: Metastatic breast cancer, pathological complete remission, partial remission, avastin, trastuzumab.