A Case of Brachial Lymph Node Recurrences after the Resection of Locally Advanced Breast Cancer
We present a case of two recurrences in the brachial lymph nodes after initial resection, which was performed for radical cure. A 66-year-old woman was diagnosed with left breast cancer T4bN3cM0 Stage IIIC and an immunohistochemistry assay showed estrogen receptor (ER) positivity (5%), progesterone-...
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| Format: | Article |
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Karger Publishers
2022-08-01
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| Series: | Case Reports in Oncology |
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| Online Access: | https://beta.karger.com/Article/FullText/525295 |
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| author | Kayono Onishi Rurina Watanuki Takamichi Yokoe Tsuguo Iwatani Chisako Yamauchi Tatsuya Onishi |
| author_facet | Kayono Onishi Rurina Watanuki Takamichi Yokoe Tsuguo Iwatani Chisako Yamauchi Tatsuya Onishi |
| author_sort | Kayono Onishi |
| collection | DOAJ |
| description | We present a case of two recurrences in the brachial lymph nodes after initial resection, which was performed for radical cure. A 66-year-old woman was diagnosed with left breast cancer T4bN3cM0 Stage IIIC and an immunohistochemistry assay showed estrogen receptor (ER) positivity (5%), progesterone-receptor (PgR) positivity (1%), human epidermal growth factor receptor-2 (HER2) positivity (3+), and low Ki-67 (15%). After four courses of adriamycin and cyclophosphamide, followed by four courses of trastuzumab plus docetaxel, the patient underwent left mastectomy and axillary dissection. Postoperatively, she was diagnosed with breast cancer ypT1cN0M0, and trastuzumab and anastrozole were started. Postoperative irradiation was performed. Three years and 5 months after the initial breast cancer surgery, she had left brachial lymph node recurrence. It was resected, and tamoxifen was administered postoperatively. One year and 9 months after, she had another left brachial lymph node recurrence, and it was resected. She received radiation therapy to her upper limb and started taking exemestane. After 1 year and 3 months since the second recurrence surgery, there has been no recurrence. Our case suggests that the replacement of regional lymph nodes with tumor cells may result in the reconstruction of lymph flow to the upper arm and the development of brachial lymph node metastasis. There are no reports of resection of the recurrent tumor in the brachial lymph node for curative treatment. Therefore, careful follow-up is important in the future. |
| first_indexed | 2024-04-12T18:04:14Z |
| format | Article |
| id | doaj.art-4c378e9fbd66410196d0475dcee45fd8 |
| institution | Directory Open Access Journal |
| issn | 1662-6575 |
| language | English |
| last_indexed | 2024-04-12T18:04:14Z |
| publishDate | 2022-08-01 |
| publisher | Karger Publishers |
| record_format | Article |
| series | Case Reports in Oncology |
| spelling | doaj.art-4c378e9fbd66410196d0475dcee45fd82022-12-22T03:22:03ZengKarger PublishersCase Reports in Oncology1662-65752022-08-0115273874410.1159/000525295525295A Case of Brachial Lymph Node Recurrences after the Resection of Locally Advanced Breast CancerKayono Onishi0Rurina Watanuki1https://orcid.org/0000-0002-7462-4137Takamichi Yokoe2https://orcid.org/0000-0001-7068-7117Tsuguo Iwatani3Chisako Yamauchi4Tatsuya Onishi5https://orcid.org/0000-0002-0821-8595Department of Breast Surgery, 6-5-1Kashiwanoha, National Cancer Center Hospital East, Kashiwa, JapanDepartment of Breast Surgery, 6-5-1Kashiwanoha, National Cancer Center Hospital East, Kashiwa, JapanDepartment of Breast Surgery, 6-5-1Kashiwanoha, National Cancer Center Hospital East, Kashiwa, JapanDepartment of Breast Surgery, 6-5-1Kashiwanoha, National Cancer Center Hospital East, Kashiwa, JapanDepartment of Breast Surgery, 6-5-1Kashiwanoha, National Cancer Center Hospital East, Kashiwa, JapanDepartment of Breast Surgery, 6-5-1Kashiwanoha, National Cancer Center Hospital East, Kashiwa, JapanWe present a case of two recurrences in the brachial lymph nodes after initial resection, which was performed for radical cure. A 66-year-old woman was diagnosed with left breast cancer T4bN3cM0 Stage IIIC and an immunohistochemistry assay showed estrogen receptor (ER) positivity (5%), progesterone-receptor (PgR) positivity (1%), human epidermal growth factor receptor-2 (HER2) positivity (3+), and low Ki-67 (15%). After four courses of adriamycin and cyclophosphamide, followed by four courses of trastuzumab plus docetaxel, the patient underwent left mastectomy and axillary dissection. Postoperatively, she was diagnosed with breast cancer ypT1cN0M0, and trastuzumab and anastrozole were started. Postoperative irradiation was performed. Three years and 5 months after the initial breast cancer surgery, she had left brachial lymph node recurrence. It was resected, and tamoxifen was administered postoperatively. One year and 9 months after, she had another left brachial lymph node recurrence, and it was resected. She received radiation therapy to her upper limb and started taking exemestane. After 1 year and 3 months since the second recurrence surgery, there has been no recurrence. Our case suggests that the replacement of regional lymph nodes with tumor cells may result in the reconstruction of lymph flow to the upper arm and the development of brachial lymph node metastasis. There are no reports of resection of the recurrent tumor in the brachial lymph node for curative treatment. Therefore, careful follow-up is important in the future.https://beta.karger.com/Article/FullText/525295breast cancerbrachial lymph noderecurrenceoligometastasis |
| spellingShingle | Kayono Onishi Rurina Watanuki Takamichi Yokoe Tsuguo Iwatani Chisako Yamauchi Tatsuya Onishi A Case of Brachial Lymph Node Recurrences after the Resection of Locally Advanced Breast Cancer Case Reports in Oncology breast cancer brachial lymph node recurrence oligometastasis |
| title | A Case of Brachial Lymph Node Recurrences after the Resection of Locally Advanced Breast Cancer |
| title_full | A Case of Brachial Lymph Node Recurrences after the Resection of Locally Advanced Breast Cancer |
| title_fullStr | A Case of Brachial Lymph Node Recurrences after the Resection of Locally Advanced Breast Cancer |
| title_full_unstemmed | A Case of Brachial Lymph Node Recurrences after the Resection of Locally Advanced Breast Cancer |
| title_short | A Case of Brachial Lymph Node Recurrences after the Resection of Locally Advanced Breast Cancer |
| title_sort | case of brachial lymph node recurrences after the resection of locally advanced breast cancer |
| topic | breast cancer brachial lymph node recurrence oligometastasis |
| url | https://beta.karger.com/Article/FullText/525295 |
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