A Case of Stage Ⅳ Breast Cancer Invaded Chest Wall Successfully Resected with Local and Systemic Therapy

A 54-year-old woman with massive exudates and bleeding in her huge right breast tumor had diagnosed Stage Ⅳ breast cancer, T4cN1M1(PUL, BRA, LYM), with ER positive and HER2 negative subtype confirmed with biological testing. She was treated with stereotactic radio surgery(SRS)for metastatic brain tumors before chemotherapy. Primary systemic chemotherapy, the regimen was EC followed by docetaxel effectively decreased the breast tumor, chest wall invasion, and other metastatic sites. After adding SRS for a new brain tumor lesion, mastectomy with a skin graft and lymphadenectomy were performed. Histological assessment showed free margins, decreased Ki-67 labeling index, ypN0, and histological Grade 1b breast tumor. After the surgery, PMRT and hormonal therapy were applied. The patient remained disease-free after surgery. Locally advanced breast cancer with brain metastasis that could be significantly reduced by sufficient therapeutic dose intensity. Aggressive radiation therapy for brain metastasis may improve local control in patients with Stage Ⅳ breast cancer.