MetastaticBreastcancerCaseReportGeneralinformation•Name:WUChunHong•Age:40y•Sex:Female•Dateofadmission:February9th,2011•Dateofdischarge:April23th,2011Chiefcomplaint•ShegothypoesthesiaoflowerlimbsandinabilitytowalkformorethanamonthHistoryofpresentillness•ThepatientfeltpainonthebackbynoobviousincentivesinJune2010•Thepainwastingling,especiallyinnight-time•ThepatienttookorallytraditionalChinesemedicine,buthadnottangibleeffectsPast,Personal&FamilyHistory•Nohepatitis,hypertension,ordiabetes•Nosmoking,alcoholordrugabuse•Noinheriteddiseases•Nohistoryofdrugallergy•NormalmenstruationClinicalfindingsTheleftbreastpresentedwithdiffusederythemaandedema,indurationaboutsizeof3.0cm*3.0cmUltrasoundexaminationa3cmleftbreastmassandanormalrightbreastThoracicMRIexaminationThoracicMRIexaminationHigh-densitymasswasshownonthesevenththoracic,andbonedestructionalsohadbeenfound.EnhancedMRILaboratoryexamination•2011-02-091.Hepaticfunctions–ALT40U/L–AST20U/L–TBNormal3.Tumormarkers–CA19-9Normal•2.BloodroutinetestHb82g/LRBC4.54×1012/LWBC6.1×109/L•PLT201×109/Lpuncturebiopsy•Shereceivedultrasoundguidedbreastcoreneedlepuncturebiopsy•Puncturetissuepathology:TheleftbreastinvasiveductalcarcinomaPrimarydiagnosisBreastcancerwithbonemetastasisTreatmentOnFebruary11,2011inorthopedicdepartment,ThePatientreceived"thesevenththoracictumorresectionandpediclescrewfixation"HistologicalexaminationSevenththoracictumorswasidentifiedasmetastaticcarcinoma,andtheimmunohistochemistryresultsshowedthepossibilityofbreastcancerbonemetastasiswasverylargeIMMUNOHISTOCHEMICALresultsER++PR++CerbB2-CK20-EMA++,Ckpan+++,CK5/6-TreatmentThepatientrecoveredwell,andthentransferredintoourdepartmentChemotherapytwotimesbeforeoperation:February23,2011March20,2011ThechemotherapyplanwasTECTreatmentAfterthechemotherapyThelesionsareaofleftbreastshowednoreductionTreatmentModifiedradicalmastectomyonmarch31,2011BilateraloophorectomyOnthesamedayHistologicalexaminationTheleftbreastinvasiveductalcarcinomaThebasalresectionmarginoftumorwasclosetothesurroundingnormaltissueTheaxillarylymphnodesmetastasis(13/15)ImmunohistochemicalER++PR++CerbB2-E-cad+++,Ki6750%+,P53+,Ck5/6-Treatment•Afteroperation,thepatientcontinuedtoreceivechemotherapyandradiotherapy.Thankyou
