骨转移性乳腺癌.ppt

MetastaticBreastcancer,CaseReport,Generalinformation,Name:WUChunHongAge:40ySex:FemaleDateofadmission:February9th,2011Dateofdischarge:April23th,2011,Chiefcomplaint,Shegothypoesthesiaoflowerlimbsandinabilitytowalkformorethanamonth,Historyofpresentillness,ThepatientfeltpainonthebackbynoobviousincentivesinJune2010Thepainwastingling,especiallyinnight-timeThepatienttookorallytraditionalChinesemedicine,buthadnottangibleeffects,Past,Personal&FamilyHistory,Nohepatitis,hypertension,ordiabetesNosmoking,alcoholordrugabuseNoinheriteddiseasesNohistoryofdrugallergyNormalmenstruation,Clinicalfindings,Theleftbreastpresentedwithdiffusederythemaandedema,indurationaboutsizeof3.0cm*3.0cm,Ultrasoundexamination,a3cmleftbreastmassandanormalrightbreast,ThoracicMRIexamination,ThoracicMRIexamination,High-densitymasswasshownonthesevenththoracic,andbonedestructionalsohadbeenfound.,EnhancedMRI,Laboratoryexamination,2011-02-091.HepaticfunctionsALT40U/LAST20U/LTBNormal3.TumormarkersCA19-9Normal,2.BloodroutinetestHb82g/LRBC4.541012/LWBC6.1109/LPLT201109/L,puncturebiopsy,ShereceivedultrasoundguidedbreastcoreneedlepuncturebiopsyPuncturetissuepathology:Theleftbreastinvasiveductalcarcinoma,Primarydiagnosis,Breastcancerwithbonemetastasis,Treatment,OnFebruary11,2011inorthopedicdepartment,ThePatientreceivedthesevenththoracictumorresectionandpediclescrewfixation,Histologicalexamination,Sevenththoracictumorswasidentifiedasmetastaticcarcinoma,andtheimmunohistochemistryresultsshowedthepossibilityofbreastcancerbonemetastasiswasverylarge,IMMUNOHISTOCHEMICALresults,ER+PR+CerbB2-CK20-EMA+,Ckpan+,CK5/6-,Treatment,Thepatientrecoveredwell,andthentransferredintoourdepartmentChemotherapytwotimesbeforeoperation:February23,2011March20,2011ThechemotherapyplanwasTEC,Treatment,AfterthechemotherapyThelesionsareaofleftbreastshowednoreduction,Treatment,Modifiedradicalmastectomyonmarch31,2011,BilateraloophorectomyOnthesameday,Histologicalexamination,TheleftbreastinvasiveductalcarcinomaThebasalresectionmarginoftumorwasclosetothesurroundingnormaltissueTheaxillarylymphnodesmetastasis(13/15),Immunohistochemical,ER+PR+CerbB2-E-cad+,Ki