Early relapse of inflammatory breast carcinoma treated with lapatinib and capecitabine: Ten years of complete response

Abstract

Inflammatory breast carcinoma (IBC) is a rare form of breast cancer characterized by a rapid onset of diffuse skin erythema, edema, induration, and warmth of the breast. Biologically, IBC is usually hormone receptor (HR) negative and experience an overexpression of human epidermal growth factor receptor 2 (HER2), with a high mitotic index (MIB-1 > 20%). Median overall survival is poor. 1Lapatinib is an oral drug that inhibits the tyrosine kinases of HER2 and epidermal growth factor receptor type 1 (EGFR) and has demonstrated clinical activity in trastuzumab-refractory states. 2 Lapatinib has also shown clinical activity in IBC, but evidence in this field is scarce. [3][4][5][6][7][8][9] We present the case of an approximately ten-year maintained complete response using lapatinib and capecitabine to treat an IBC early relapse after trastuzumab treatment.A 34-year-old woman was diagnosed with multifocal invasive ductal carcinoma of the right breast (grade III). The immunohistochemical study showed the lesion tested negative for HR and positive for HER2 protein expression (3+). MIB-1 expression was high, more than 25%, and a strong nuclear P53 expression was established. The patient was diagnosed with locally advanced breast cancer (cT2cN1M0).In April 2007, neo-adjuvant chemotherapy was initiated using doxorubicin plus cyclophosphamide during four cycles, followed byThis is an open access article under the terms of the Creative Commons Attribution License, which permits use, distribution and reproduction in any medium, provided the original work is properly cited.