浅谈骨转移性乳腺癌.pptx

Metastatic Breast cancer Case ReportGeneral informationName:WU ChunHongAge:40y Sex:FemaleDate of admission:February 9th,2011Date of discharge:April 23th,2011Chief complaintShe got hypoesthesia of lower limbs and inability to walk for more than a monthHistory of present illnessThe patient felt pain on the back by no obvious incentives in June 2010The pain was tingling,especially in night-timeThe patient took orally traditional Chinese medicine,but had not tangible effectsPast,Personal&Family HistoryNo hepatitis,hypertension,or diabetesNo smoking,alcohol or drug abuseNo inherited diseasesNo history of drug allergyNormal menstruationClinical findingsThe left breast presented with diffused erythema and edema,induration about size of 3.0cm*3.0cmUltrasound examinationa 3 cm left breast mass and a normal right breast Thoracic MRI examination Thoracic MRI examinationHigh-density mass was shown on the seventh thoracic,and bone destruction also had been found.Enhanced MRIEnhanced MRILaboratory examination2011-02-09 1.Hepatic functions ALT 40 U/L AST 20 U/L TB Normal3.Tumor markers CA19-9 Normal2.Blood routine test Hb 82 g/L RBC 4.541012/L WBC 6.1109/L PLT 201 109/L puncture biopsyShe received ultrasound guided breast core needle puncture biopsy Puncture tissue pathology:The left breast invasive ductal carcinomaPrimary diagnosis Breast cancer with bone metastasisTreatmentOn February 11,2011 in orthopedic department,The Patient receivedthe seventh thoracic tumor resection and pedicle screw fixationHistological examinationSeventh thoracic tumors was identified as metastatic carcinoma,and the immunohistochemistry results showed the possibility of breast cancer bone metastasis was very largeIMMUNOHISTOCHEMICAL resultsER+PR+CerbB2-CK20-EMA+,Ckpan+,CK5/6-TreatmentThe patient recovered well,and then transferred into our departmentChemotherapy two times before operation:February 23,2011 March 20,2011 The chemotherapy plan was TECTreatmentAfter the chemotherapyThe lesions area of left breast showed no reduction TreatmentModified radical Modified radical mastectomy on marchmastectomy on march31,201131,2011Bilateral oophorectomyBilateral oophorectomyOn the same dayOn the same dayHistological examinationThe left breast invasive ductal carcinomaThe basal resection margin of tumor was close to the surrounding normal tissueThe axillary lymph nodes metastasis(13/15)ImmunohistochemicalER+PR+CerbB2-E-cad+,Ki6750%+,P53+,Ck5/6-TreatmentAfter operation,the patient continued to receive chemotherapy and radiotherapy.Thank you