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Breast Cancer

, 16:88 | Cite as

Successful treatment of leptomeningeal metastases from breast cancer using the combination of trastuzumab and capecitabine: a case report

  • Takashi ShigekawaEmail author
  • Hideki Takeuchi
  • Misono Misumi
  • Kazuo Matsuura
  • Hiroshi Sano
  • Nobuko Fujiuchi
  • Katsuhiko Okubo
  • Akihiko Osaki
  • Kenjiro Aogi
  • Toshiaki Saeki
Case Report

Abstract

We report a case of metastatic breast cancer with leptomeninges and multiple bone metastases that showed an excellent response to the combination of trastuzumab and capecitabine; therapeutic effect was evaluated by MRI at follow-up. A 44-year-old woman underwent modified radical mastectomy in February 1997. In April 2003, a tumor at the right basis cerebri and multiple bone metastases were noted, and in October 2003, she underwent enucleation of the tumor. Histopathologically, the tumor was consistent with a basal skull metastasis from breast cancer. In March 2004, the patient began to experience pain, weakness, and paresthesia of both legs. She was diagnosed, with leptomeningeal metastasis (LM) from breast cancer using MRI. In December 2005, the combination of trastuzumab and capecitabine administered as sixth-line treatment was very effective for LM. Although it is generally very difficult to diagnose LM and assess the therapeutic effect with MRI, in this case, it was possible. To our knowledge, there has been no report in the literature describing the combination of trastuzumab and capecitabine for LM from breast cancer. Although the mechanism underlying the efficacy of this combination is still unknown, the treatment would be worth trying because of its few side effects in extensively treated patients with LM from breast cancer. To confirm the antitumor efficacy of trastuzumab and capecitabine, however, further investigations are required.

Keywords

Breast cancer Leptomeningeal metastasis Trastuzumab Capecitabine 

Abbreviations

LM

Leptomeningeal metastasis

CSF

Cerebrospinal fluid

HER2

Human epidermal growth factor receptor-2

IHC

Immunohistochemistry

FISH

Fluorescence in situ hybridization

MBC

Metastatic breast cancer

BBB

Blood–brain barrier

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Copyright information

© The Japanese Breast Cancer Society 2008

Authors and Affiliations

  • Takashi Shigekawa
    • 1
    Email author
  • Hideki Takeuchi
    • 1
  • Misono Misumi
    • 1
  • Kazuo Matsuura
    • 1
  • Hiroshi Sano
    • 1
  • Nobuko Fujiuchi
    • 1
  • Katsuhiko Okubo
    • 1
  • Akihiko Osaki
    • 1
  • Kenjiro Aogi
    • 2
  • Toshiaki Saeki
    • 1
  1. 1.Department of Breast OncologySaitama Medical University International Medical CenterHidakaJapan
  2. 2.Department of SurgeryNational Hospital Organization Shikoku Cancer CenterMatsuyamaJapan

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