Introduction. Angiogenesis and VEGF (vascular endothelial growth factor) over expression play an important role inthe growth and development of many kinds of cancers. The role of bevacizumab, humanised, anti-VEGF antibody, intreatment of patients with metastatic breast canser (MBC) is still an open question. The aim of this paper is to present a case report of the use of bevacizumab with chemotherapy in the first line treatment of triple negative MBC.

Case. We present the case of a 57-year-old woman with infiltrating ductal carcinoma of the right breast (pT1N0M0, TNBC). She underwent wide excision of the tumour with the excision of right axillary lymph nodes, adjuvant chemoterapy and radiotherapy. Four years later metastases in the left lung (two lesions) and mediastinum occured. For this reason the patient started immunochemotherapy — paclitaxel and bevacizumab. She ended paclitaxel after nine cycles, and continued bevacizumab as a maintenance. We observed a marked decrease in size of the metatstatic lesions. No serious adverse events during treatment were noted. From October 2009 to September 2013 the patient received 70 doses of bevacizumab. In September 2013 the treatment was ended due to progression of the size of the lung metastases. No new site of metastases was noted. The patient was considered suitable for stereotactic radiosurgery.

Discussion. To date three randomised, multicenter studies, which evaluated effectiveness of adding bevacizumab to chemotherapy were performed. In all trials significant prolongation of progression-free survival (PFS) was observed but with no statistically significant influence on overall survival (OS). The toxicity of the combined treatment was higher. Many experts put a great emphasis on the need to discover a group of patients who will gain a significant benefit from antiangiogenic treatment. Reports in the literature indicate that probably the greatest benefit from adding bevacizumab to the chemotherapy is gained by women with triple-negative breast cancer, who receive bevacizumab as first-line treatment after cancer progression, as our patient described above.