Long-lasting control of HER-2 positive disseminated breast cancer in a reproductive aged patient

Background. Breast cancer ranks as the second most common cancer (14.9 %) and the most common female cancer (20.9 %) in Russia. At the time of diagnosis, 11.0 % of patients have already developed metastases, and 10.3 % of patients die within the first year of diagnosis from disease progression. Distant metastasis is the leading cause of death from breast cancer, and brain metastasis is a significant prognostic factor for poor survival. Case description. We report the case of a long-lasting control of advanced breast cancer with brain metastases in a 32-year-old woman. Low grade tubular breast carcinoma was histologically confirmed. Immunohistochemical study: ER-Ts-4 points, PR-Ts - 3 points, Her-2 positive, Ki67 - 35.0 %. BRCA1 5382ins C mutation was not detected. The long-term use of therapy with lapatinib and capecitabine was described. Conclusion. This case demonstrates the feasibility of long-term (31 months) control over Her-2 positive disseminated breast cancer with multiple metastases to the brain and bones, while maintaining the quality of life and social activity of a young patient. Despite the risks associated with whole brain radiotherapy, no cognitive impairment was observed. Therapy with lapatinib and capecitabine was effective for 28 months with good tolerance.