Hiroyuki Miura

Norihiko Ikeda

三浦 弘之

池田 徳彦

Tokyo Medical University Institutional Repository / 東京医科大学学術情報リポジトリ

154
1
10
1 2
1
2
10 4 56 77
10 27 2 1 1 3
ER PgR Her2
2 2 2 6 3
2 5 1 7 2 1 8
72 2 : 154-160, 2014
25 11 7 26 1 29
:
: 193-0998 1163
TEL : 042-665-5611 7759 FAX : 042-666-0551
5
91.2% 5
1 10
1-6
10
Table 1
1 : 77
50
ER PgR HER2
27
CEA 2.99 ng/ml CA15-3 
11.06 U/ml NCC-ST439 1.4 U/ml
ER PgR HER2 1+
Epirubicin cyclophosphamide CPA 5-
FU CEF
Taxol Xeloda TS-1 Navelbine
80
6
3
CT Fig. 1a 1b :
CT
1 : 10 1552014 4
Fig. 1c :
2 56
43
T2N2aM0
ER PgR HER2 0
5-FU+CPA 1 pirarubicin 3
tamoxifen 5
13
CEA 0.5 ng/ml CA15-3 
8.37 U/ml NCC-ST439 15.0 U/ml
2
Table 1 Summary of cases
Case 1 2 3 4
Age at recurrence 77 56 61 63
Interval Years 27 13 10 11
Recurrent site Chest wall Lung Lung Pleura
Pathology sol pap pap sol
CEA
CA15-3
NCC-ST439
ER/PgR / / / /
HER2 1 0 2
FISH
2
FISH+
Prognosis
Months
75
dead
84
alive
29
dead
8
alive
Sol : solid tubular carcinoma
Pap : papillo-tubular carcinoma
a b
c
Fig. 1 Case 1
 a : Shadow on chest CT indicated post-radiotherapy pneumonia.
 b : Chest CT indicated invasion of thoracic wall by tumor.  
 c : Pathological ndings suggested invasion of rib by solid tubular carcinoma. HE 20
72 2156
CEF Taxol NCC-ST439
Arimidex
7 2
CT Fig. 2a 2b : 13
CT
7 CT Fig. 2c
Fig. 2d :
3 61
51
ER PgR HER2
10
CEA 1.34 ng/ml CA15-3 
15.7 U/ml NCC-ST439 29.0 U/ml
CT
ER PgR
TTF-1
HER2 2+ FISH
Ki-67 20%
CEF 2
2 CEF
2 5
CT Fig. 3a 3b : 10
CT S4 8 mm S10 15 mm
Fig. 3c 3d :
ER
4 63
52
55 65 40 mm
s ly+ v+
6/29 T4bN3aM0 stage IIIc 
ER PgR HER2
CEF4 tamoxifen 5
11
CEA 13.2 ng/ml CA15-3 
Fig. 2 Case2
 a, b : Chest CT revealed bilateral small nodules.
 c : Chest CT 7 years after therapy.
 d : Pathological ndings on primary breast cancer indicated papillo-tubular carcinoma.
a b
c d
3
1 : 10 1572014 4
58.8 U/ml NCC-ST439 18 U/ml
10
CT
ER PgR TTF-1
HER2
2+ FISH Ki-67
40%
CEF 4 Taxol trastuzumab
8
CT Fig. 4a : 11
CT
Fig. 4b 4c :
ER
1 2 2 5
5 8 4.7% 8 12 3.4%
12
0 7
10
1.5% 10
1.2% 2.5%
1 20 51
40
2
40
3,4
?
Fig. 3 Case 3 
 a : Chest CT revealed nodule in right S4 area.
 b : Chest CT revealed nodule in right S10 area. 
 c : Pathological ndings indicated adenocarcinoma with cribriform pattern resembling breast cancer. HE 10
 d : Immunohistochemical ndings showed strongly positive for ER. ER 10
a b
c d
4
72 2158
disease 
free interval 5
ER 5 10
6
5 Tamoxifen
ER 31%
ER 0 4 5
14 8 ER
5
ER
3 4 ER
7 4 3
10
delayed cutaneous metastases
3 1
10
10
Tumor dormancy
9 1 3
4
10
1
5
10 HER2
a b
c
Fig. 4 Case 4
 a : Chest CT revealed multiple nodules in pleural cavity.
 b : Pathological ndings obtained from video-assisted thoracic surgery revealed papillo-tubular carcinoma.  HE 10
 c : Immunohistochemical ndings showed strongly positive for ER. ER 10
5
1 : 10 1592014 4
3 4 1
HER2 Trastu-
zumab
HER2 10
1 cm
11
7 11
10
 1 41 :
21 : 1167-
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6
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Metastatic breast cancer more than 10 years after initial diagnosis
Hiroyuki MIURA1 , Norihiko IKEDA2
1 Department of Thoracic Surgery, Hachioji Medical Center of Tokyo Medical University 
2 Department of Surgery, Tokyo Medical University, Tokyo
Abstract
Here we report four cases in which a diagnosis of metastatic breast cancer was reached more than 10 years after the initial 
diagnosis. All the patients were women aged between 56 and 77 years. The disease-free interval was from 10 to 27 years.
There were 2 cases of pulmonary metastasis, 1 of pleural dissemination, and 1 of delayed cutaneous metastasis. Three tumors 
were hormone receptor-positive and only the pleural disseminated tumor showed overexpression of Her2. A papillo-tubular 
carcinoma was observed in 3 cases and a solid-tubular carcinoma in one. Cancer death occurred in 1 patient at 27 months and 
in another at 75 months after recurrence. One pulmonary metastatic case was well controlled at 84 months. The patient with 
pleural dissemination received chemotherapy for 8 months. 
Metastatic breast cancer after a long disease-free interval indicated tumor dormancy and slow tumor growth. These results 
indicate the need for careful and protracted follow-up in high-risk breast cancer patients.
Key words : Breast cancer, Recurrent breast cancer, Late recurrence
7


術後10年以上経過し再発を確認した乳癌症例の検討

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術後10年以上経過し再発を確認した乳癌症例の検討

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