骨转移性乳腺癌

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 RBC WBC • PLT 82 g/L 4.54×1012 /L 6.1×109 /L 201 ×109 / L
Chief complaint
• She got hypoesthesia of lower limbs and inability to walk for more than a month
present 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
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
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
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
puncture biopsy
• She received ultrasound guided breast core needle puncture biopsy • Puncture tissue pathology :The left breast invasive ductal carcinoma
Thoracic MRI examination
Thoracic MRI examination
Enhanced MRI
HighHigh-density mass was shown on the seventh thoracic, and bone destruction also had been found.
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
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"
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)
Thank you
Treatment
After the chemotherapy
The lesions area of left breast 来自百度文库howed no reduction
Treatment
Modified radical mastectomy on march 31,2011
Bilateral oophorectomy
IMMUNOHISTOCHEMICAL results
ER++ PR++ CerbB2- CK20EMA++,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
Immunohistochemical
ER++ PR++ CerbB2E-cad+++,Ki6750%+,P53+,Ck5/6-
Treatment
• After operation, the patient continued to receive chemotherapy and radiotherapy.