[A Case of Breast Cancer Recurrence 32 Years after Primary Surgery]

An 80-year-old woman presented with blood-stained sputum. Computed tomography revealed the presence of multiple lung nodules. The patient underwent surgery for left breast cancer at 48 years of age. A transbronchial lung biopsy was performed to identify the primary tumor. The pathological diagnosis was adenocarcinoma and immunohistochemical staining indicated that the lung nodules were breast cancer metastases. Positron emission tomography revealed multiple metastases to the bones, skin, peritoneum, and mesenteric lymph nodes. The patient indicated that the quality of life was a critical factor in selecting therapy. Denosumab and an aromatase inhibitor were selected as the first-line systemic chemotherapies. The treatment resulted in tumor shrinkage that lasted for 3 years, after which the peritoneal metastases started to regrow. We recommended tegafur/gimeracil/oteracil as second-line chemotherapy, which the patient discontinued within 1 month because of severe side effects. We next administered fulvestrant, which resulted in the long-term shrinkage of most tumors without regrowth. This treatment did not negatively affect patients' quality of life. Some breast cancers recur ≥5 years after the primary surgery. Therefore, this is a very rare case of breast cancer recurrence with an interval of 32 years after the initial treatment.