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Case Reports
. 2014 Sep 22:14:690.
doi: 10.1186/1471-2407-14-690.

Prolonged complete response after treatment withdrawal in HER2-overexpressed, hormone receptor-negative breast cancer with liver metastases: the prospect of disappearance of an incurable disease

Erika Viel  1 , Flavie Arbion, Catherine Barbe, Philippe Bougnoux
Affiliations
Case Reports

Prolonged complete response after treatment withdrawal in HER2-overexpressed, hormone receptor-negative breast cancer with liver metastases: the prospect of disappearance of an incurable disease

Erika Viel et al. BMC Cancer. .

Abstract

Background: Metastatic breast cancer has consistently been viewed as a non-curable disease. Specific palliative treatments such as chemotherapy and hormone therapy have resulted in a mean overall survival of approximately 30 months. While cases of prolonged complete response have been reported with hormone or trastuzumab monotherapy, rendering metastatic breast cancer a chronic disease, any treatment withdrawal has ineluctably led to relapse. Prolonged remission without any anti-cancer treatment has never been reported to our knowledge.

Case presentation: We report here the unique observation of the spontaneous evolution of two breast cancer patients with synchronous liver metastases who decided to stop trastuzumab after achieving complete response. They were Caucasian women with synchronous liver metastatic breast carcinoma. Both breast cancers reached skin and regional lymph nodes. There were several liver metastases in both patients. They received surgery, radiotherapy and chemotherapy combined with trastuzumab. They decided to stop their treatment, despite guidelines. After a follow-up longer than 20 months, they did not relapse clinically, radiologically, and biologically.

Conclusion: This findings question the belief of the unavoidability of recurrence of metastatic breast cancer, specifically in the liver. It opens up the unprecedented possibility of a cure-like state in exceptional and probably special cases.

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Figures

Figure 1
Figure 1
Clinical features and evolution of patients. Loco-regional and systemic anti-cancer treatments of patients. Pathognomonic CT-scan pictures of liver metastases at presentation (left), and complete response (right).
Figure 2
Figure 2
Pathological and immunohistochemical characterisation of tumors. Pathologic analyses were performed on paraffin-embedded tissue blocks. Haematoxylin and eosin staining (HES) confirmed invasive SBR3 carcinomas. No staining was detected after estrogen receptor (1D5, DAKO) and progesterone receptor (PgR 636 DAKO) branding compared to positive and negative controls. Using the A485 polyclonal antibody (DAKO), a strong brown complete membrane staining was detected in more than 30% tumor cells in both patients.
See this image and copyright information in PMC

References

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Pre-publication history
    1. The pre-publication history for this paper can be accessed here: http://www.biomedcentral.com/1471-2407/14/690/prepub

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