44-Year-Old Female with Locally Advanced Breast Cancer
Nancy, a 44-year-old woman of five, was referred for treatment of locally advanced breast cancer. She had a massive tumor with skin thickening in her right breast. Ultrasound was used instead of mammography due to the hardness of her right breast — revealing pronounced skin thickening, an indistinct mass, and enlarged axillary lymph nodes.
Positron emission tomography revealed no visceral metastases but swelling of the axillar, parasternal, and supraclavicular lymph nodes.
Core needle biopsy showed the primary tumor as luminal — ER-positive, PR-negative with an Allred score of 8. Fine-needle aspiration cytology of the axillar lymph node affirmed metastatic disease.
Is primary endocrine therapy with palliative intent the only option for patients like Nancy?
Is there a pathway for curative intent for this patient?