Ahmet N. Sanli1, Kadri Altundag2
1Department of General Surgery, Silivri State Hospital, Istanbul, Turkey.
2MKA Breast Cancer Clinic, Tepe Prime, Ankara, Turkey.
Abstract
Dear Editor,
Breast cancer is the most common cancer in women worldwide. Bone is the most frequent site of distant metastasis from breast cancer and accounts for the highest proportion of first site relapse in patients with breast cancer [1]. One study evaluated the incidence and distribution of bone metastases in breast cancer. The authors found that the most frequent site was the spine, including thoracic spine (63.6%) and lumbar spine (53.8%). The second commonly metastatic site was ribs (57.4%), followed by pelvis (54.1%) and sternum (44.34). The least affected site of bone metastases were ulna and radius (0.3%) [2]. However,one case with solitary metastasis to radius was reported in the literature [3]. Here, we present the second breast cancer patient having solitary metastasis to radius in the literature. A 55-year-old woman was diagnosed with right invasive breast ductal carcinoma and she underwent right modified radical mastectomy with stage T2N2M0 and luminal subtype B in December 2014 and then she received adjuvant chemotherapy of four cyles of adriamycin-cyclophosphamide, followed by 12 weeks of paclitaxel and furthermore she received adjuvant radiotherapy. She was with adjuvant endocrine treatment with letrozole for about 7.5 years. For the last 2 months, she suffered from right arm pain and right upper extremity MRG clearly showed destructive-lytic lesion 4.5 cm in size, located at the proximal radius in October 2021 and further imaging with PET-CT scan showed solitary right lytic-expansile-destructive lesion observed in the proximal radius with higher FDG uptake. Furthermore, biopsy taken from the right radius showed metastatic breast cancer with luminal B subtype. Currently, she will receive palliative radiotherapy to the radius together with fulvestrant, ribociclib and denosumab.
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