ISSN 1941-5923

Logo



Get your full text copy in PDF

Long-term complete remission of metastatic breast cancer induced by a steroidal aromatase inhibitor after failure of a non-steroidal aromatase inhibitor

Yoshihiro Shioi, Masahiro Kashiwaba, Toru Inaba, Hideaki Komatsu, Tamotsu Sugai, Go Wakabayashi

(Department of Surgery, Iwate Medical University, Morioka, Japan)

Am J Case Rep 2014; 15:85-89

DOI: 10.12659/AJCR.890023


Abstract: Background: The efficacy of third-generation aromatase inhibitors for hormone receptor-positive postmenopausal metastat­ic breast cancer is well established. Although several clinical trials have reported incomplete cross-resistance between different aromatase inhibitors, few cases of complete responses of recurrent metastatic breast can­cer occurring after substituting a second aromatase inhibitor have been reported. We here present a rare case of non-steroidal aromatase inhibitor-tolerant metastatic breast cancer with long-term complete remission fol­lowing substitution of a steroidal aromatase inhibitor.
Case Report: We present the case of a 56-year-old Japanese woman who underwent right breast-conserving surgery for breast cancer, TNM staging T1, N0, M0, Stage I. She received adjuvant chemotherapy with 6 cycles of FEC100 and radiation therapy, and then began hormonal therapy with anastrozole. Twelve months postoperatively, computed tomography (CT) revealed multiple lung metastases. Exemestane was substituted for anastrozole. After 3 months of exemestane, CT showed that all lung metastases had completely resolved. Her complete re­sponse was maintained for 5 years: she died during a tsunami 6 years after the initial surgery.
Conclusions: Substitution of a steroidal for a non-steroidal aromatase inhibitor produced a sustained complete remission in a patient with hormonal receptor-positive postmenopausal recurrent breast cancer.
Achieving complete response after switching from a non-steroidal to a steroidal aromatase inhibitor in a hor­monal receptor-positive postmenopausal recurrent breast cancer contributed to a higher quality of life for the patient. Further investigation is needed to identify the predictors of long-term remission following such a switch.

This paper has been published under Creative Common Attribution-NonCommercial-NoDerivatives 4.0 International (CC BY-NC-ND 4.0) allowing to download articles and share them with others as long as they credit the authors and the publisher, but without permission to change them in any way or use them commercially.
I agree