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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.
Abstract:
Early endometrial metastasis from triple-positive breast cancer is a rare phenomenon in young patients, especially when anti-human epidermal growth factor receptor 2 (HER2) target therapy is used as the primary treatment. We present a case of a 24-year-old patient with advanced triple positive breast cancer. The patient developed abnormal uterine bleeding during chemotherapy combined with anti-HER2 therapy (trastuzumab plus pyrotinib). Due to the transvaginal sonography are not characteristic and the low incidence rate of endometrial metastasis from breast cancer, this potential diagnosis was overlooked. The disease progressed rapidly thereafter, and the overall survival was only 13 months. The swift and devastating progression highlight the immense challenges in managing such complex cases. It remains a current challenge to identify such cases at an early stage and explore more effective therapeutic regimens. Based on this case review and previous studies, we speculate that disease progression might be attributed to the absence of endocrine therapy, chemotherapy resistance, or insufficient anti-HER2 therapeutic intensity. This case provides new insights into the metastatic pattern of HER2-positive breast cancer under targeted drug resistance. Clinicians should be alert to the possibility of reproductive system metastasis during anti-tumor treatment. Timely diagnosis and appropriate treatment are expected to improve patient prognosis.
Insights
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.
