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An Advanced Triple Positive Breast Cancer Developed Endometrial Metastasis After Anti-HER2-Based Therapy Failed: A
Shanshan Deng1,2, Junzhu Xu1,2, Dingning Deng1,2
1Department of Oncology, The Second Affiliated Hospital of Zunyi Medical University, Zunyi, P. R. China.
Journal of Adolescent and Young Adult Oncology
|June 30, 2026
Summary
Endometrial metastasis from triple-positive breast cancer is rare in young patients, even with HER2-targeted therapy. This case highlights challenges in early diagnosis and swift progression, emphasizing the need for vigilance during anti-tumor treatment.
Area of Science:
- Oncology
- Reproductive Medicine
Background:
- Triple-positive breast cancer (TPBC) metastasis to the endometrium is uncommon, particularly in young patients receiving anti-human epidermal growth factor receptor 2 (HER2) therapy.
- Early detection of endometrial metastasis is challenging due to non-specific sonographic findings and low incidence.
Purpose of the Study:
- To report a rare case of early endometrial metastasis in a young patient with advanced TPBC treated with chemotherapy and anti-HER2 therapy.
- To discuss the diagnostic challenges and potential reasons for rapid disease progression in such cases.
Main Methods:
- Case report of a 24-year-old female with advanced TPBC.
- Review of clinical presentation, diagnostic workup, treatment, and outcomes.
- Literature review on endometrial metastasis in TPBC and HER2-targeted therapy resistance.
Main Results:
- The patient developed abnormal uterine bleeding during combination chemotherapy and anti-HER2 therapy (trastuzumab plus pyrotinib).
- Endometrial metastasis was initially overlooked due to characteristic sonographic findings and rarity.
- The disease progressed rapidly, resulting in a short overall survival of 13 months.
Conclusions:
- This case underscores the importance of considering reproductive system metastasis in young patients with advanced TPBC, even during targeted therapy.
- Potential factors contributing to rapid progression include absence of endocrine therapy, chemotherapy resistance, or insufficient anti-HER2 therapy intensity.
- Early diagnosis and tailored treatment strategies are crucial for improving prognosis in these complex cases.
