in south korea , breast cancer is the most common cancer in females ( except for thyroid cancer ) . the annual occurrence was 14,277 , 14.3% of 99,339 total cancer occurrence in women in 2010 . the age - adjusted incidence of female breast cancer in a population of 100,000 is increasing from 24.5% in 1999 to 45.4% in 2010 , at a rate of 6% per year . the traditional surgery for breast cancer was radical mastectomy , including axillary lymph node dissection , but breast conservation surgery ( bcs ) has become the majority nowadays . bcs is performed after lowering the stage with neoadjuvant chemotherapy in regionally progressed breast cancers . adjuvant chemotherapy may decrease the recurrence and the death rate in case of axillary lymph node metastasis , and radiotherapy may reduce the recurrence rate after the surgery of a large mass with an insufficient resection [ 2 , 3 ] . about 40% of patients suffer from a recurrence after their curative resection , and common metastatic sites are the bones , lung , liver , lymph nodes , chest wall and the brain . this report is about a breast cancer patient who suffered from repeated recurrences in the lung and the mediastinal lymph nodes , had surgery , but refused adjuvant or salvage chemotherapy . a 46-year - old korean woman was diagnosed with stage iii ( t2n3m0 ) right breast cancer at a medical center in september 2011 . she underwent 8 cycles of neoadjuvant chemotherapy with adriamycin + cyclophosphamide ( 4 cycles ) and docetaxel ( 4 cycles ) from september 16 , 2011 , to february 6 , 2012 . she underwent right bcs on march 7 , 2012 , and adjuvant radiotherapy ( 5,600 cgy/28 fx ) from april 4 , 2012 , to may 17 , 2012 . however , a 10.8-mm nodule in her right upper lung ( rul ) was found on follow - up ct in march 2013 , and it increased to 13.4 mm in june 2013 . the pet - ct performed on june 27 , 2013 , showed a hypermetabolic pulmonary nodule in the rul and focal hypermetabolic lesions in the right pulmonary hilum ( fig . the rul nodule was removed by wedge resection on july 8 , 2013 , and the pathological findings were revealed as being a metastatic adenocarcinoma . thus , adjuvant chemotherapy was recommended , but she refused because she was afraid of adverse reactions to chemotherapy that she had already experienced during neoadjuvant chemotherapy before her bcs . instead of chemotherapy , she chose a korean medicine therapy ( kmt ) to increase her immune power ; she was then admitted to our hospital . from august 2 , 2013 , she was treated with intravenous wild ginseng pharmacopuncture ( wgp ) 10 ml , cordyceps sinensis pharmacopuncture ( csp ) 10 ml , trichosanthes kirilowii pharmacopuncture ( tkp ) 10 ml , euonymus alatus pharmacopuncture ( eap ) 10 ml , and astragalus membranaceus pharmacopuncture ( amp ) 10 ml 3 times a week ( table 1 ) . on a ct performed on september 9 , 2013 , however , findings of lymphadenopathies were seen on a ct performed on december 2 , 2013 . there were lymph nodes of about 15 mm in size in her right paratracheal , the interlobar hilar and the subcarinal area ( fig . therefore , salvage chemotherapy was recommended , but she refused it again and wanted to continue her kmt . on december 2 , 2013 , prunella vulgaris pharmacopuncture ( pvp ) was started instead of amp ( table 1 ) . on a follow - up ct performed on may 30 , 2014 , all the increased lymph nodes were decreased to less than 10 mm in size ( fig . 3 ) . a pet - ct of the same day showed no significant increase of fdg uptake in her whole body ( fig . intravenous pharmacopuncture was reduced to wgp ( 10 ml ) , eap ( 10 ml ) ( 3 times a week ) , and instead , soram nebulizer solution inhalation ( 8 ml , 3 times a week ) , oral intake of soramdan s ( 8 g , 3 times a week ) and hangamdan s ( 1 g , 3 times a day ) were administered ( table 1 ) . finally , no recurrence was observed on pet - ct performed on november 14 , 2014 ( fig . major medical treatments for breast cancer are surgery , chemotherapy and radiotherapy . at first , this patient was diagnosed pathologically as suffering from estrogen receptor / progesterone receptor / her-2 receptor ( 2+/ 2+/ ) adenocarcinoma , and the radiological stage was t2n3m0 . our patient underwent neoadjuvant chemotherapy , surgery and adjuvant radiotherapy ; however , the cancer radiologically recurred and metastasized to a lung and probably to the lymph nodes within a year . she underwent a second surgery for the diagnostic removal of the lung nodule , and it was identified as metastatic breast cancer . she refused any further chemotherapy . instead of adjuvant chemotherapy , she chose kmt . unfortunately she refused salvage chemotherapy and was treated with kmt . finally , all the lesions resolved within 5 months , and she has remained in stable condition for more than 6 months so far . a nebulizer therapy is the nasal inhalation of distilled liquid herbal extracts in the form of mist ( with a nebulizer ) . oral herbal medicine is made out of single or several kinds of herbs in the form of pills , capsules or fluids . all pharmacopuncture and nebulizer solutions in this case were produced in the pharmacopuncture manufacturing room of our hospital . briefly , a certain amount of herbs was decocted in distilled water for some hours , and the decoction was distilled to produce a certain amount of pharmacopuncture fluid , which , in turn , was filtered with 0.45- and 0.2-m filters and sterilized in vials . wgp 1,000 ml , csp 2,000 ml , tkp 2,000 ml , eap 2,000 ml , amp 2,000 ml and pvp 2,000 ml was produced with wild ginseng 100 g , wild c. sinensis 150 g , t. kirilowii root 300 g , e. alatus 300 g , a. membranaceus 300 g , and p. vulgaris 300 g , respectively . soram nebulizer solution 1,500 ml was produced with wild ginseng 200 g , and wild c. sinensis 200 g. each nebulizer therapy was performed with this solution and an ultrasonic nebulizer ( omron , ne - u17 ) for 20 min . soramdan s was made out of wild ginseng and high - temperature , high - pressure processed ginseng in the ratio of 7:3 . powdered herbs ( 4 g ) were mixed with honey ( 4 g ) to make an 8-gram pill . hangamdan s was made out of cordyceps militaris , panax ginseng radix , commiphora myrrha , bovis calculus , margarita , processed boswellia carteri , processed panax noto - ginseng radix , processed cremastra appendiculata tuber at the ratio of 3:2:2:2:2:2:4:4 . reported a case of a metastatic breast cancer patient who could not continue chemotherapy due to severe pancytopenia , but accomplished a complete remission of the metastatic lung lesions with only kmt ( including wgp and csp ) . reported a case of non - small cell lung cancer that significantly decreased and remained stable for more than 6 months by only using kmt , including wgp , csp , tkp as well as the oral intake of soramdan made out of wild ginseng . the patient 's metastatic lung lesions were resolved with kmt only , including the oral intake of hyunamdan , hangamdan s and by inhaling the soram nebulizer solution . c. sinensis played a role in modulating the immune system and act as an adjuvant in cancer therapy . kim et al .   reported a hot water extract of e. alatus ( thunb . ) sieb has a powerful antiproliferative , antioxidative and apoptosis - inducing effect on the skrb3 human breast cancer cell line . shon et al .   reported that an amp solution inhibits a free radical formation in hl60 cells . p. vulgaris has also been known to have multi - target , multi - pathway effects on anticancer mechanisms . in this case , kmt including various kinds of herb pharmacopunctures , nebulization and oral intake , has been used instead of chemotherapy to treat a recurrent metastatic breast cancer patient . the combination of herbs and pharmaceutical forms as well as administration routes had been changed according to the stage of disease and the general condition of the patient . however , in review of the whole process , it seems that pvp might play a significant role to treat new lymphadenopathies . as this is an estrogen receptor - positive tumor , it is possible that , what is being observed here , is as antiestrogen activity of one of the natural products . the resolution of lymph node enlargement could be from the anti - inflammatory effect of the herbs . p. vulgaris has been reported to exert an antiestrogenic effect   and anti - inflammatory activity . as a result , all the lesions resolved and the patient has remained in a stable condition for more than 6 months . she was never treated with modern chemotherapy but with kmt alone . it is impossible to draw any conclusions from the effect of kmt in metastatic breast cancer with 1 case only . this case proposes a clue to use pvp more actively in the treatment of metastatic lymphadenopathy of breast cancer . it also proposes a primitive protocol to use wgp , eap , soram nebulizer solution inhalation and the oral intake of soramdan s and hangamdan s in the maintenance therapy to prevent a recurrence of breast cancer . more case reports and clinical studies are necessary to establish stronger evidence of the effectiveness of these therapies .
a 46-year - old korean woman was diagnosed with stage iii breast cancer and underwent 8 cycles of neoadjuvant chemotherapy , breast conservation surgery and adjuvant radiotherapy . however , the cancer recurred in the right upper lung ( rul ) and the right pulmonary hilum after 8 months . 
 the rul nodule was removed through a wedge resection , and the pathologic finding was revealed as a metastatic adenocarcinoma . 
 adjuvant chemotherapy was recommended , but she refused it because she feared adverse reactions to chemotherapy . instead , korean medicine therapy with intravenous wild ginseng pharmacopuncture ( wgp ) , cordyceps sinensis pharmacopuncture , trichosanthes kirilowii pharmacopuncture , euonymus alatus pharmacopuncture ( eap ) and astragalus membranaceus pharmacopuncture was started . 
 after a month , the disease looked stable , but findings of newly occurring metastatic lymphadenopathies appeared on ct after 6 months . 
 salvage chemotherapy was recommended , but she also refused it . at this time , prunella vulgaris pharmacopuncture was started . 
 finally , a complete resolution was confirmed on pet - ct after 5 months , and she has remained in stable condition for more than 6 months with wgp , eap , a soram nebulizer solution inhalation and the oral intake of soramdan s and hangamdan s.