Application of conformal radiotherapy for multimodality treatment of primary inoperable locally advanced breast cancer. Clinical case

Locally advanced breast cancer is one of the malignant neoplasms of the breast with poor prognosis for treatment. However, the multimodality treatment of the disease and the following rehabilitation result in favorable outcomes. The treatment plan consists of pre-operative drug therapy, loco-regional surgery and/or radiation therapy in the course of adjuvant chemotherapy. It is important to stress that preoperative (Induction) chemoradiation therapy makes possible the following surgery. Currently, induction radiation therapy is recommended if neoadjuvant therapy is insufficient and surgery at the second stage of the treatment is impossible. In the article the authors review previously published features of complex treatment of locally advanced breast cancer. They also present clinical case report with details of the treatment of inoperable primary locally advanced breast cancer. The patient K., 73 y.o, found herself the tumor in the left breast in 04.2017, she did not visit a doctor. In 18 month she visited a doctor for the first time, the tumor size increased, exophytic component was formed in the parasternal region at the left. Clinical diagnosis was established: left breast gland cancer, stage III, cT4bN1M0, G3, luminal type B, Her2-negative subetype (estrogene receptors - 5 balls progesterone receptors - 8 balls, Her2/neu - negative expression, Ki67 - 70%). Induction chemoradiation therapy (capecitabine + conformal radiotherapy with total radiation dose to the target - 60 Gy) followed ineffective hormonal therapy resulted in complete reabsorption of huge exophytic ulcerous tumor, the next modality was radical mastectomy followed by the remission in the course of adjuvant hormonal therapy. If a tumor is radiosensitive, radiotherapy effect is pronounced, tumor becomes operable and the following treatment plan can be implemented on a full scale. That gives a favorable chance for future health life.