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- W2007665105 abstract "A 63-year-old postmenopausal woman was diagnosed with stage II (pT2N0M0), hormone receptor–positive, human epidermal growth factor receptor 2–negative breast cancer 9 years ago. Her treatment course included breast-conserving local therapy, four cycles of adjuvant chemotherapy with doxorubicin and cyclophosphamide, and 5 years of anastrozole. She developed persistent pain in the left hip 2 years after completing adjuvant endocrine therapy. Radiographic studies identified lesions in the left proximal femur and multiple vertebral bodies consistent with skeletal metastases. She started fulvestrant in addition to bone-modifying therapy with zoledronic acid. After 16 months, a nuclear medicine bone scan indicated likely progression in the bone metastases, prompting a switch to exemestane as second-line endocrine therapy. Six months later, a repeat bone scan identified new findings in the right humerus and scapula. Capecitabine was started as first-line chemotherapy at 1,500 mg orally twice per day for 14 days on a 21-day cycle. The patient presents for a routine evaluation after three cycles of capecitabine and reports chronic waxing and waning discomfort in the left hip with weight bearing; left-sided-rib acute pain after she caught her grandson falling off the bed; and progressive dysesthesias, erythema, and capecitabine-related skin thickening and cracking on the palms and soles. A restaging bone scan reveals increased radiotracer activity in the left sixth rib and at the known lesions in the right humerus and right scapula. Computed tomography scans demonstrate increased focal sclerosis in the right scapula, indicative of either disease progression or treatment response. Plain radiographs identify a subtle fracture of the left sixth rib in the midclavicular line. Serum alkaline phosphatase is borderline increased, and the cancer antigen (CA) 27.29 has fluctuated in the range of 20 to 30 U/mL since she first presented with metastatic disease. On the basis of the new left rib discomfort and the bothersome toxicity from capecitabine, she inquires whether a change in systemic therapy is indicated." @default.
- W2007665105 created "2016-06-24" @default.
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- W2007665105 date "2014-11-01" @default.
- W2007665105 modified "2023-09-23" @default.
- W2007665105 title "By the Numbers: Does Circulating Tumor Cell Enumeration Have a Role in Metastatic Breast Cancer?" @default.
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- W2007665105 doi "https://doi.org/10.1200/jco.2014.56.6851" @default.
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