Diagnosis
Multiple left-sided chest wall tumors, secondary breast cancer recurrence, status post-mastectomy. History of adjuvant chemotherapy and radiation therapy.
Patient:
Female, 45 years old, Kazakhstan
Physician:
Prof. Dr. med. Christoph Lindner, Head Physician of the Breast Cancer Center at Agaplesion Clinic Hamburg
Specialist Assessment by Gynecologist-Mammologist Prof. Dr. Christoph Lindner
Three years ago, the patient from Kazakhstan was diagnosed with left-sided breast carcinoma. She underwent surgery to remove the tumor (mastectomy and axillary lymph node dissection), followed by adjuvant targeted therapy (Trastuzumab), chemotherapy, and radiation therapy.
Later, a local recurrence was detected in the left subclavicular region of the chest wall, which was treated surgically.
The patient contacted our clinic in Germany for comprehensive follow-up diagnostics. We performed a full oncological workup:
- Chest CT scan
- Abdominal ultrasound (sonography)
- Bone scintigraphy (bone scan)
- Blood tests for tumor markers
While no distant metastases were found, the scans revealed multiple neoplastic lesions in the parasternal fat tissue. Based on these findings, the multidisciplinary team recommended surgical intervention.
Treatment Rendered
An extensive resection of the tumor lesions on the left chest wall was successfully performed.
Histopathology Results:
- Confirmed at least 7 small invasive neoplastic lesions.
- Hormone Receptor-Positive (HR+) / HER2-Negative (HER2-) status.
- Clear surgical margins achieved (complete resection / R0 resection).
The resected multifocal tumor specimen confirmed recurrent moderately differentiated invasive breast carcinoma with focal lymphovascular invasion (angioinvasion).
Due to the patient having already received the maximum cumulative dose of radiation (50 Gy), re-irradiation was not feasible. The patient was advised to switch her systemic endocrine therapy to an aromatase inhibitor and was prescribed Exemestane.
Actual Treatment Cost: €4,000
Key Recommendations
- Transition to endocrine therapy with aromatase inhibitors for HR+ breast cancer recurrence.
- Regular follow-up monitoring.
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