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病例16-2012:一位患HER2阳性乳腺癌的32岁女性
Case 16-2012: A 32-Year-Old Woman with HER2-Positive Breast Cancer


José Baselga ... 肿瘤 • 2012.05.24
相关阅读
• 双重靶向HER2阳性乳腺癌

病历陈述


Steven Jay Isakoff医师(血液–肿瘤科):一位32岁女性因右乳浸润性导管癌就诊于我院癌症中心门诊。

患者既往健康,至入院前2个月她发现右侧乳房的上外象限出现皱痕。因为正处在哺乳期,她以为这是乳管堵塞引起的。大约在这次就诊前3周,妇科医师在对她施行常规检查时发现,她的右乳外上象限可触及一个肿物。另一家医院的乳腺钼靶结果显示,右乳可见一不均匀、有毛刺,直径约2 cm的团块,右乳房皮肤增厚;超声检查发现肿块内有大范围的高回声。4天后,行右乳肿物针芯活检,病理诊断为浸润性导管癌(中度分化,无淋巴管侵犯)和导管原位癌(中高核级别,累及小叶)。免疫组织化学(免疫组化)染色实验显示人类表皮生长因子受体2型(HER2)过表达(3+);雌激素受体和孕激素受体均为阴性。第二天用钆之后行乳腺磁共振成像(MRI),结果显示右乳致密并有明显增强。在右乳外上象限,T2加权像显示一直径2 cm、边缘毛刺状的降低的信号衰减区,以及与邻近乳房软组织相比较低的信号增强。这一结果提示边缘强化。磁共振成像还显示可能存在第二个病灶,直径1.6 cm。2天后,第二次超声结果显示:右乳外上可见一1.6 cm ×1.1 cm ×2.0 cm的低回声肿块,其边界不规则,血流信号增强。BRCA1BRCA2基因突变报告为阴性……





作者信息

José Baselga, M.D., Ph.D., Barbara Lynn Smith, M.D., Ph.D., Elizabeth A. Rafferty, M.D., and Alessandro Bombonati, M.D.
From the Division of Hematology–Oncology ( J.B.) and the Departments of Surgery (B.L.S.), Radiology (E.A.R.), and Pathology (A.B.), Massachusetts General Hospital; and the Departments of Medicine (J.B.), Surgery (B.L.S.), Radiology (E.A.R.), and Pathology (A.B.), Harvard Medical School — both in Boston.

 

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