Young adult with bone metastasis in breast cancer: a case report

Abstract

Introduction. Breast cancer is the most commonly diagnosed malignancy and leading cause of cancer-related death among women worldwide (1). About 75% of deaths are related to the development of metastases (2). The occurrence of breast cancer metastases in the bones is determined by the size of the tumor, damage to the lymph nodes, histological grade, hormone receptor status and human epidermal growth factor receptor 2 (HER2) (3). Bone metastases – one of the most common and associated with shorter survival (4). Case discussion. 38 years old women went to the hospital because of increasing pain in the groin area. In 2016, she was diagnosed with invasive ductal carcinoma of the right breast (ER+, PR+, Her2-), then neoadjuvant chemotherapy was prescribed and a mastectomy was performed, no metastases were observed. After surgery, radiation and hormone therapy were prescribed. The patient was consulted by an orthopedic oncologist due to a suspicion of impending pathologic fracture of the right femur, caused by metastaticbreast cancer. Magnetic resonance maging showed destruction of the right femur at the lesser trochanter – signs of impending fracture. A biopsy was performrd and metastasis of invasive ductal carcinoma were detected with reaction of tumor cells ER+, PR+, HER2-. Radical resection of the right femur and endoprosthesis with MUTARS system were performed. In histological examination, the spread of tumor infiltration into the surrounding soft tissues was observed, radiation therapy was prescribed. Currently, the patients is being treated with palliative radiation therapy due to newly identified metastases in the mediastinum and liver. Conclusions. Invasive ductal carcinoma is not the most aggressive but follow-up of the patient for the occurence of metastases in the bones is necesary because metastatic breast cancer among young women represents a serious public heath issue.