case_images: PMC10976348_01
case_images: Magnetic resonance imaging (MRI) of bilateral breasts. (A) Two cycles of TEC. (B) Four cycles of TEC. (C) Two cycles of NP. (D) Four cycles of NP. (E) Capecitabine + FUL for 3 + months. The left breast lesion has disappeared. The yellow circle shows that left breast lesion.
case_images: fendo-15-1362725-g001.jpg
case_images: PMC10976348_01_fendo-15-1362725-g001.jpg
case_images: f1
case_images: Figure 1 . Subsequent percutaneous needle biopsy of the mass in the left breast confirmed the presence of invasive ductal carcinoma, grade I, estrogen receptor (ER, +, 60%), progesterone receptor (PR, -), HER2 (1+), Ki-67 (45%). Furthermore, the patient with pathologically confirmed left supraclavicular lymph node and left axillary lymph node metastases via puncture biopsy. Notably, following this modified treatment approach, the patient exhibited a reduction in the size of primary breast foci as well as lymph nodes ( Figure 1 ), accompanied by a normalization of serum tumor marker levels ( Figure 2 ).
case_images: Changes in tumor markers during patient treatment. (A) Capecitabine+ FUL for 3 + months. CA153 decreased to below the normal reference value (30U/ml) (B) Capecitabine+ FUL for 3+ months. CA125 decreased to below the normal reference value (35U/ml).
case_images: fendo-15-1362725-g002.jpg
case_images: PMC10976348_01_fendo-15-1362725-g002.jpg
case_images: f2
case_images: Notably, following this modified treatment approach, the patient exhibited a reduction in the size of primary breast foci as well as lymph nodes ( Figure 1 ), accompanied by a normalization of serum tumor marker levels ( Figure 2 ).
case_images: Representative histopathological findings of the primary lesion in the left breast. (A) Core needle biopsy of the primary lesion before neoadjuvant chemotherapy. (B) Core needle biopsy of the primary lesion after 4 cycles of TEC. (C) Tumor of the resected left breast after capecitabine + FUL 3 months.
case_images: fendo-15-1362725-g003.jpg
case_images: PMC10976348_01_fendo-15-1362725-g003.jpg
case_images: f3
case_images: Importantly, no residual tumors were observed upon extensive sampling, and there was no evidence of tumor metastasis in the left axillary lymph nodes (0/13), with the pectoral interstitial lymph nodes exhibiting adipose fibrous connective tissue without tumor involvement ( Figure 3 ).
case_images: Timeline of interventions and efficacy evaluations. TEC, docetaxel + doxorubicin liposomes+ cyclophosphamide; NP, vinorelbine+ carboplatin; Capecitabine + FUL, capecitabine + fulvestrant.
case_images: fendo-15-1362725-g004.jpg
case_images: PMC10976348_01_fendo-15-1362725-g004.jpg
case_images: f4
case_images: The treatment flow is illustrated in  Figure 4 .