PMC8140803_01
The biopsy of the right axial lymph node revealed invasive carcinoma with focal micropapillary pattern.
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fig1
University Hospital with fluorodeoxyglucose-avid right axillary, right neck, and mediastinal lymphadenopathy on positron emission tomography-computed tomography (PET-CT) imaging on day 0. Ultrasound imaging identified a hypoechoic nodule in the right breast; right axillary lymph node fine-needle aspiration biopsy performed at previous hospital on day 13 revealed invasive carcinoma with a focal micropapillary pattern (Fig 1).
Serial monitoring of CEA and the results of response evaluation using RECIST version 1.1 (A). Each arrow (B-E) corresponds with CT imaging performed during the treatment. (B) Baseline CT scan revealed multiple right axial and mediastinal lymph node metastases, metastases in the right breast, and left lung metastases. (C) First response assessment at 21 days after treatment initiation revealed shrinkage of all the metastases, which was evaluated as partial response. (D) Repeat imaging after 3 months of the treatment showed CR. (E) The most recent CT scan revealed that the patient remains in CR. CEA, carcinoembryonic antigen; CR, complete response; CT, computed tomography; LHRHa, luteinizing hormone-releasing hormone agonist; PD, progressive disease; PR, partial response; TAM, tamoxifen.
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fig2
Carcinoembryonic antigen levels rapidly decreased (Fig 2A), and spiral CT imaging on day 147 demonstrated a partial response by using RECIST version 1.1 (RECIST 1.1) (overall tumor reduction -30%), with a reduction in multiple right breast masses, axillary, neck and mediastinal lymphadenopathy, and left lung metastases; follow-up CT scan repeated on day 231 revealed a complete tumor response by using RECIST 1.1 (Fig 2D).