A case of advanced breast cancer effectively treated with bevacizumab and letrozole

We report a case of primary advanced breast cancer that was locally controlled by treatment with bevacizumab. A 69-yearold woman presented at our hospital complaining of left breast hemorrhage. Her left breast had a large mass with an ulcer, and there was bleeding. Breast ultrasonography showed a large tumor that involved the whole left breast, and some swollen axillary lymph nodes. Breast MRI showed a mass of 77 mm and skin invasion around the medial area of the left breast. Histopathological examination indicated invasive ductal carcinoma, ER (+), PgR (+), HER2 (-), Ki-67 20%. We diagnosed left breast carcinoma, T4bN1M0, stage IIIB. She received paclitaxel plus bevacizumab as first-line therapy. Breast MRI showed a reduction in the primary tumor and axillary lymph node swelling. Adverse events including hypertension (Grade 3) and peripheral neuropathy (Grade 2) were observed. She received letrozole as second-line therapy. After commencing letrozole, the tumor reduced further, and the local ulcer disappeared showing only induration. Four years from the start of treatment, the woman has obtained good local control and has not developed other metastases.