[A Case of Axillary Arterial Bleeding after Axillary Metastatic Lymph Node Necrosis during Treatment with Paclitaxel and Bevacizumabfor Breast Cancer]

Gan To Kagaku Ryoho. 2016 Nov;43(12):2062-2064.
[Article in Japanese]

Abstract

A 44-year-old woman was diagnosed cT4bcN3cM1(LYM), Stage IV triple-negative breast cancer.Enhanced computed tomography revealed ipsilateral axillary lymph node metastasis, 10 cm in diameter.The supraclavicular and cervical lymph nodes also had metastases.She received paclitaxel(90mg/m2, on days 1, 8, and 15 every 4 weeks)in combination with bevacizumab(10mg/kg, on days 1 and 15 every 28 days).Her height was 165 cm, and her body weight was 100 kg.After 1 course of chemotherapy, a metastatic axillary lymph node with necrotic changes was removed spontaneously.A few days later, she experienced severe bleeding from her axillary artery, and she went into hypovolemic shock.Despite undergoing surgical hemostasis, the bleeding recurred twice, so we performed coil embolization of her subclavian artery.Thirty -five days after the first occurrence of bleeding, the patient died of sepsis and ARDS due to left arm necrosis.Bevacizumab is effective for the treatment of large tumors, but when the tumor is close to an artery, clinicians should be wary of fatal bleeding after necrosis.

Publication types

  • Case Reports

MeSH terms

  • Adult
  • Antineoplastic Combined Chemotherapy Protocols / adverse effects*
  • Antineoplastic Combined Chemotherapy Protocols / therapeutic use
  • Axilla / blood supply
  • Axilla / pathology*
  • Bevacizumab / administration & dosage
  • Bevacizumab / adverse effects*
  • Breast Neoplasms / drug therapy*
  • Breast Neoplasms / pathology
  • Carcinoma, Ductal, Breast / drug therapy*
  • Fatal Outcome
  • Female
  • Hemorrhage / etiology
  • Hemorrhage / therapy*
  • Humans
  • Lymph Nodes / pathology*
  • Lymphatic Metastasis
  • Necrosis / complications
  • Paclitaxel / administration & dosage

Substances

  • Bevacizumab
  • Paclitaxel