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Mutimodal treatment for metastatic breast cancer

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Background: The prognosis for patients with metastatic breast cancer has significantly improved over the past decade due to advances in treatment. Patients who present with large primary tumors and extensive local disease are at high risk for both distant and loco-regional disease recurrence. Here we evaluate the local response to external beam radiotherapy for stage IV breast cancer.

Case report: We present the case of a 65 year old female, diagnosed with stage IV invasive left-breast ductal carcinoma, biopsied in 2013, clinical staging T3N2M1, with lung metastasis and skin metastasis localized at the left breast. The histopatological finding after the tumor biopsy was invasive mammary carcinoma, moderately differentiated. Following multiple chemotherapy series and Trastuzumab treatment, at the evaluation computed tomography (CT)-scans, the patient shows mixed response with partial tumoral and systemic response with the apparition of skin metastasis on the same breast. At post chemotherapy evaluation, an 8 centimeter ulcerative skin metastasis is reviewed. Because surgery was not feasible, left breast palliative radiotherapy was taken into consideration.

Conclusions: This patient, suffering from progressive systemic disease with localized symptomatology benefits because this treatment reduces discomfort greatly and improves quality of life, taking into consideration the low life expectancy. Radiotherapy is suitable as an adequate treatment to achieve good local control.

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