乳癌肺再発巣切除後10年無再発生存している1例
症例は右乳癌（T2N1M0=Stage IIB）にて両胸筋温存乳房切除術+腋窩リンパ節郭清（Bt+Ax）を施行した．病理は硬癌，エストロゲン受容体（ER）/プロゲステロン受容体（PgR）/HER2=-/-/0，n=2/35にて術後5FU+epirubicin+cyclophosphamide（FEC）を施行した．術後1年に右肺に孤立性腫瘍を指摘．原発性肺癌との鑑別のため右肺部分切除術を施行し，転移性乳癌（ER/PgR/HER2=-/-/1+）であった．術後はpaclitaxel，S-1を施行後，5年以上drug freeにて無再発生存中である．考察:再発乳癌は薬物療法が中心である．本症例は切除...
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| Published in | 日本臨床外科学会雑誌 Vol. 76; no. 7; pp. 1595 - 1598 |
|---|---|
| Main Author | |
| Format | Journal Article |
| Language | Japanese |
| Published |
日本臨床外科学会
2015
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| Subjects | |
| Online Access | Get full text |
| ISSN | 1345-2843 1882-5133 |
| DOI | 10.3919/jjsa.76.1595 |
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| Abstract | 症例は右乳癌（T2N1M0=Stage IIB）にて両胸筋温存乳房切除術+腋窩リンパ節郭清（Bt+Ax）を施行した．病理は硬癌，エストロゲン受容体（ER）/プロゲステロン受容体（PgR）/HER2=-/-/0，n=2/35にて術後5FU+epirubicin+cyclophosphamide（FEC）を施行した．術後1年に右肺に孤立性腫瘍を指摘．原発性肺癌との鑑別のため右肺部分切除術を施行し，転移性乳癌（ER/PgR/HER2=-/-/1+）であった．術後はpaclitaxel，S-1を施行後，5年以上drug freeにて無再発生存中である．考察:再発乳癌は薬物療法が中心である．本症例は切除術を施行したところ，転移性乳癌の診断となった．再発乳癌でもoligometastasesであれば治癒を目指せると考えられた．結語:乳癌肺再発切除後10年以上無再発生存している稀な症例を経験した． |
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| AbstractList | 症例は右乳癌（T2N1M0=Stage IIB）にて両胸筋温存乳房切除術+腋窩リンパ節郭清（Bt+Ax）を施行した．病理は硬癌，エストロゲン受容体（ER）/プロゲステロン受容体（PgR）/HER2=-/-/0，n=2/35にて術後5FU+epirubicin+cyclophosphamide（FEC）を施行した．術後1年に右肺に孤立性腫瘍を指摘．原発性肺癌との鑑別のため右肺部分切除術を施行し，転移性乳癌（ER/PgR/HER2=-/-/1+）であった．術後はpaclitaxel，S-1を施行後，5年以上drug freeにて無再発生存中である．考察:再発乳癌は薬物療法が中心である．本症例は切除術を施行したところ，転移性乳癌の診断となった．再発乳癌でもoligometastasesであれば治癒を目指せると考えられた．結語:乳癌肺再発切除後10年以上無再発生存している稀な症例を経験した． |
| Author | 上原, 正弘 |
| Author_xml | – sequence: 1 fullname: 上原, 正弘 organization: 京都桂病院乳腺科 |
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| References | 11) Chen F, Fujinaga T, Sato K, et al : Clinical features of surgical resection for pulmonary metastasis from breast cancer. Eur J Surg Oncol 2009 ; 35 : 393-397 3) Diaz-Canton EA, Valero V, Rahman Z, et al : Clinical course of breast cancer patients with metastases confined to the lungs treated with chemotherapy. The University of Texas M. D. Anderson Cancer Center experience and review of the literature. Ann Oncol 1998 ; 9 : 413-418 1) Bergh J, Jönsson PE, Glimelius B, et al : A systemic overview of chemotherapy effects in breast cancer. Acta Oncol 2001 ; 40 : 253-281 8) Ludwig C, Stoelben E, Hasse J : Disease-free survival after resection of lung metastases in patients with breast cancer. Eur J Surg Oncol 2003 ; 29 : 532-535 2) Stockler M, Wilcken NR, Ghersi D, et al : Systemic reviews of chemotherapy and endcrine therapy in metastatic breast cancer. Cancer Treat Rev 2000 ; 26 : 151-168 4) Tanaka F, Li M, Hanaoka N, et al : Surgery for pulmonary nodules in breast cancer patients. Ann Thorac Surg 2005 ; 79 : 1711-1714 5) Lanza LA, Natarajan G, Roth JA, et al : Long term survival after resection of pulmonary metastases from carcinoma of the breast. Ann Thorac Surg 1992 ; 54 : 244-247 10) Welter S, Jacobs J, Krbek T, et al : Pulmonary metastases of breast cancer. When is resection indicated? Eur J Cardiothrac Surg 2008 ; 34 : 1228-1234 13) McDonald ML, Deschamps C, Ilstrup DM, et al : Pulmonary resection for metastatic breast cancer. Ann Thorac Surg 1994 ; 58 : 1599-1602 7) Friedel G, Pastorino U, Ginsberg RJ, et al : Results of lung metastasectomy from breast cancer : prognostic criteria on the basis of 467 cases of the International Registry of Lung Metastases. Eur J Cardiothorac Surg 2002 ; 22 : 335-344 12) Yhim HY, Han SW, Oh DY, et al : Prognostic factor for recurrent breast cancer patients with an isolated, limited number of lung metastases and implications for pulmonary metastasectomy. Cancer 2010 ; 116 : 2890-2901 9) Yoshimoto M, Tada K, Nishimura S, et al : Favourable long-term results after surgical removal of lung metastases of breast cancer. Breast Cancer Res Treat 2008 ; 110 : 485-491 6) Koodziejski L, Goralcyk J, Dyczek S, et al : The role of surgery in lung metastases. Eur J Surg Oncol 1999 ; 25 : 410-417 14) Planchard D, Soria JC, Michiels S, et al : Uncertain benefit from surgery in patients with lung metastases from breast carcinoma. Cancer 2004 ; 100 : 28-35 |
| References_xml | – reference: 3) Diaz-Canton EA, Valero V, Rahman Z, et al : Clinical course of breast cancer patients with metastases confined to the lungs treated with chemotherapy. The University of Texas M. D. Anderson Cancer Center experience and review of the literature. Ann Oncol 1998 ; 9 : 413-418 – reference: 1) Bergh J, Jönsson PE, Glimelius B, et al : A systemic overview of chemotherapy effects in breast cancer. Acta Oncol 2001 ; 40 : 253-281 – reference: 11) Chen F, Fujinaga T, Sato K, et al : Clinical features of surgical resection for pulmonary metastasis from breast cancer. Eur J Surg Oncol 2009 ; 35 : 393-397 – reference: 12) Yhim HY, Han SW, Oh DY, et al : Prognostic factor for recurrent breast cancer patients with an isolated, limited number of lung metastases and implications for pulmonary metastasectomy. Cancer 2010 ; 116 : 2890-2901 – reference: 6) Koodziejski L, Goralcyk J, Dyczek S, et al : The role of surgery in lung metastases. Eur J Surg Oncol 1999 ; 25 : 410-417 – reference: 9) Yoshimoto M, Tada K, Nishimura S, et al : Favourable long-term results after surgical removal of lung metastases of breast cancer. Breast Cancer Res Treat 2008 ; 110 : 485-491 – reference: 5) Lanza LA, Natarajan G, Roth JA, et al : Long term survival after resection of pulmonary metastases from carcinoma of the breast. Ann Thorac Surg 1992 ; 54 : 244-247 – reference: 8) Ludwig C, Stoelben E, Hasse J : Disease-free survival after resection of lung metastases in patients with breast cancer. Eur J Surg Oncol 2003 ; 29 : 532-535 – reference: 7) Friedel G, Pastorino U, Ginsberg RJ, et al : Results of lung metastasectomy from breast cancer : prognostic criteria on the basis of 467 cases of the International Registry of Lung Metastases. Eur J Cardiothorac Surg 2002 ; 22 : 335-344 – reference: 10) Welter S, Jacobs J, Krbek T, et al : Pulmonary metastases of breast cancer. When is resection indicated? Eur J Cardiothrac Surg 2008 ; 34 : 1228-1234 – reference: 13) McDonald ML, Deschamps C, Ilstrup DM, et al : Pulmonary resection for metastatic breast cancer. Ann Thorac Surg 1994 ; 58 : 1599-1602 – reference: 14) Planchard D, Soria JC, Michiels S, et al : Uncertain benefit from surgery in patients with lung metastases from breast carcinoma. Cancer 2004 ; 100 : 28-35 – reference: 2) Stockler M, Wilcken NR, Ghersi D, et al : Systemic reviews of chemotherapy and endcrine therapy in metastatic breast cancer. Cancer Treat Rev 2000 ; 26 : 151-168 – reference: 4) Tanaka F, Li M, Hanaoka N, et al : Surgery for pulmonary nodules in breast cancer patients. Ann Thorac Surg 2005 ; 79 : 1711-1714 |
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| SubjectTerms | 乳癌 手術 肺再発 |
| Title | 乳癌肺再発巣切除後10年無再発生存している1例 |
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