The 65 year old female patient noticed her breast tumor that caused left inflammatory breast cancer in 2007. Imaging examinations revealed no organic metastases. After histological sample collection she received 6 cycles of neoadjuvant Taxotere-Epirubicin treatment, then left mastectomy and axillary block dissection was performed. The surgical histological result concurred with that of the biopsy: invasive ductal carcinoma, Grade III, TRG1, ypT2 (35mm), ypN2 (6/6), ER, PR: negative, HER2: +++, Ki67: 60% (Figure 1 a-e).

Three months after surgery the patient was still fighting a wound healing disorder, her right breast has become swollen and a few lymph nodes became palpable in her right axilla (Figure 2). A complex breast examination revealed mastitis carcinomatosa of the right breast that histologically (core biopsy) corresponded to the recurrence of the previous tumor. She received palliative Taxol-Herceptin treatment for six months, followed by Herceptin monotherapy for 1 year. In spring 2010, chest wall progression, hepatic metastasis and osseal metastasis developed. Within a clinical trial, she received Herceptin-Vinorelbin treatment for another 6 months, by which her disease did not deteriorate (it was stable). For further 9 months she received Herceptin monotherapy again, then we switched to Lapatinib-Xeloda treatment due to the progression of the cutaneous metastases.

In May, 2012 there was progression again. In the frame of a clinical trial it was possible to give her trastuzumab-emtansine (conjugate of trastuzumab and a tubule inhibitor cytostatic) treatment that is still going on. After 5 years from the first diagnosis the disease is still under a satisfactory control.

Edited by Dr. Ágnes Dobi