An 80-year-old woman who reported the presence of a tumor in the left breast for 16 years and who had not wanted to consult due to fear of diagnosis and possible treatments.
Although he reported that at first growth had been slow and indolent, in the last two years he had progressed to the point of reaching the breast self-amputation.
He had finally come to the consultation animated by his relatives after presenting dorsal pain and progressive dyspnea, more evident in the previous weeks.
At that time, he had ipsilateral axillary and supraclavicular lymphadenopathy.
The chest X-ray showed signs of pleural effusion and probable carcinomatous lymphangitis.
Bone scintigraphy showed multiple uptakes.
The clinical diagnosis was confirmed by puncture of a nodule which stood out above the breast bed; cytology was compatible with ductal carcinoma.
The patient began treatment with tamoxifen.
Two days later, the patient presented with progressive worsening of the dorsal pain, requiring increased analgesia.
In the following two weeks, the patient herself took the analgesics and stopped them.
After a transient increase, both CA153 and alkaline phosphatase levels decreased to normal.
After six months, a complete response of the lymph nodes had been obtained, although a small remnant persisted in the breast bed; the scintigraphy showed some degree of attenuation in the lung zones, with a certain improvement in gamma.
The patient continued responding for 22 months.
After progression he received several lines of hormonal treatment.
She died 56 months after diagnosis.
