Management of oligometastatic triple-negative breast cancer with lung metastasis using 4DCT: a case report

Abstract

Introduction: Breast cancer remains the most prevalent disease in women. Oligometastatic breast cancer (OMBC), is defined by a limited disease burden. 40% of Triple negative breast cancer are associated with Lung metastasis. Stereotactic body radiotherapy is used for lung metastasis. We report a case of oligometastatic triple-negative breast cancer with lung metastasis treated with the deep inspiratory breath hold technique via four-dimensional (4D) respiratory correlated CT imaging (4DCT).

Case presentation: A 77-year-old Asian Indian female patient presented with breathing difficulty. Evaluation revealed it as Oligometastatic breast carcinoma with solitary lung metastasis. She was treated with SBRT to her lung lesion using 4DCT after her primary management.

Discussion: 4DCT has revolutionized the radiotherapy planning for gated radiotherapy delivery. Retrospective 4DCT allows the reconstruction of a number of breathing phases that demonstrate the motion of the tumor and surrounding tissue. Despite its limits, the addition of this technology has been beneficial to the overall sector.

Conclusion: A total dose of 50 Gy in 5 fractions (BED10: 100 Gy) via volumetric modulated arc therapy (VMAT) was delivered to solitary lung metastasis. During surveillance imaging with PET/CT, there was no sign of progression or distant failure, and the treated lesion responded almost completely after 3 months beyond evidence of pneumonitis.