[A Case of Recurrent Breast Cancer with Carcinomatous Pleurisy Successfully Treated with Paclitaxel and Bevacizumab after Radical Mastectomy].

A 61-year-old postmenopausal woman with breast cancer and carcinomatous pleurisy was successfully treated with bevacizumab and paclitaxel. In December 2008, after receiving preoperative chemotherapy consisting of q3w 4 cycles of EC (E: 90 mg/m2, C: 600 mg/m2) and 12 cycles of weekly paclitaxel (80 mg/m2), the patient underwent modified radical mastectomy with axillary lymph node dissection for right breast cancer. Pathological examination showed residual tumor cells and lymph node metastasis (pT4bN2M0, Stage III b). In July 2012, 3 and a half years later, she complained of a cough and dyspnea. Chest X-ray and computed tomography scans showed a pleural effusion involving the entire left thoracic cavity, indicating carcinomatous pleurisy. Bevacizumab and paclitaxel therapy was initiated. Soon thereafter, the pleural fluid disappeared, tumor marker levels decreased, and symptoms were ameliorated. After 6 cycles of bevacizumab and paclitaxel therapy, the patient continuously received 3 cycles of weekly paclitaxel (80 mg/m2). Two years and 4 months since the diagnosis, she has remained free of carcinomatous pleurisy recurrence. She is currently receiving hormone therapy on an outpatient basis. Bevacizumab and paclitaxel therapy is potentially effective for the treatment of patients with carcinomatous pleurisy, providing a chance for long-term survival.