Fulvestrant as a subsequent endocrine therapy in a patient with lung and liver metastases in the course of breast cancer — case report

Abstract

Despite the recent development of diagnostics and new therapeutic options in treating breast cancer still many patients suffer from recurrence of the disease. Palliative endocrine therapy is efficient and relatively low risk of adverse effects, comfortable and acceptable for patients method of treatment. The response may be gained in about half of patients with hormone receptor expression tumor. In this paper there is presented a case of using fulvestrant as a third line of endocrine therapy of metastatic breast cancer in an elderly patient with metastases in lungs and liver. The patient after the radical mastectomy of left breast in 2007 because of carcinoma papillare invasivum ER(+), PR(+), without HER2 receptor overexpression received tamoxifen as the adjuvant therapy. After three and a half years of treatment there were found metastatic lesions in lungs and liver in diagnostic imaging. The patient received subsequent endocrine therapy — letrozole in spite of visceral metastases because of the general condition, slow disease dynamics and lack of symptoms of metastatic disease. After one year and seven months of treatment diagnostic imaging showed progression of lung lesions therefore letrozole therapy was withdrawn and the patient has started treatment with fulvestrant which has been continued for twelve months. The metastatic lesions in her lungs are stable. The endocrine therapy administered in this patient was efficient and well-tolerated, metastatic breast cancer is under control from two and a half years. Fulvestrant seems to be safe and efficient third-line endocrine therapy in an elderly patient with asthma and hypertension.