Spontaneous Regression Of Locally Advanced Breast Cancer Following Cardiopulmonary Arrest: A Case Report
Kannari, A., Kikuchi, M., Matsushima, H., Miyabe, R., & Atsuta, K. (2025). Spontaneous Regression of Locally Advanced Breast Cancer Following Cardiopulmonary Arrest: A Case Report. Cureus, 17(1), e78111. https://doi.org/10.7759/cureus.78111
View Original Source →Abstract
Spontaneous regression in breast cancer is rare but can dramatically improve patient prognosis. Although the underlying mechanism is unknown, it may be due to a biological response to external invasion. An 81-year-old woman presented to our emergency department with a 600x100mm large breast mass. Five days after the emergency room visit, she lost consciousness bleeding from the breast mass. She experienced cardiopulmonary arrest (CPA), and after 10 minutes of cardiopulmonary resuscitation, the patient underwent a return of spontaneous circulation (ROSC). She was diagnosed with hemorrhagic and cardiogenic shock, and the breast mass gradually collapsed on the 17th day. Twelve months after CPA, the patient underwent left mastectomy and axillary lymph node dissection (II) for left breast cancer. Postoperatively, the patient continued to receive aromatase inhibitors and radiation therapy and she did not experience any recurrence two years after surgery. Spontaneous regression of breast cancer following CPA has not been previously reported, and, to the best of our knowledge, this case report is the first. We hypothesized that the tumor might have had relative ischemia and internal necrosis due to the blockage of the nutrient artery.
Case Details
Disease Location
Breast
Personal Characteristics
81-year-old woman. Medical history included cholecystitis, uterine fibroids, and right lower extremity paralysis.
Clinical Characteristics
Presented with lightheadedness and bleeding from a left breast mass. Physical examination: the mass in the left breast was mobile. It showed persistent venous bleeding, which was stopped by compression. Blood test revealed anemia. Carcinoembryonic antigen and cancer antigen 15-3 tumor markers were elevated. CT) showed a 600 x 100 mm mass with a well-defined border and a contrast effect in the left breast. A needle biopsy revealed invasive ductal carcinoma of the breast, characterized by estrogen receptor (er) positivity at 60%, progesterone receptor (pr) positivity at 40%, her-2 was negative. Five days later, the patient was rushed to the emergency room because of loss of consciousness due to massive bleeding from the breast tumor. She experienced cardiopulmonary arrest. Cardiopulmonary resuscitation (cpr) was immediately performed. An electrocardiogram (ecg) revealed pulseless electrical activity, and after 10 minutes of cpr, the patient underwent a return of spontaneous circulation (rosc). Post-resuscitation ecg showed st-segment elevation in leads ii, iii, and avf. The patient was judged to have a right ventricular infarction. She was diagnosed with hemorrhagic and cardiogenic shock. The patient was managed with a ventilator and intensive care with norepinephrine and blood transfusions. On the 21st day, coronary angiography (cag) was performed. Fifteen milligrams of nicorandil, 100 mg of diltiazem, and 10 mg of pravastatin/day were started on the 22nd day
Remission Characteristics
The breast mass suddenly collapsed on the 17th day. CT performed on day 37 revealed that the tumor had regressed to 40 mm
Treatment & Mechanisms
Proposed Remission Mechanisms
The nutrient vessels from the internal thoracic artery to the tumor may have been blocked by a mechanism following the hemorrhage. Although the direct cause of blockage of the nutrient artery is unclear, invasion during cpa or administration of catecholamines may have caused thrombosis.
Clinical Treatment
Needle biopsy, cpr, mechanical ventilation, norepinephrine, blood transfusion.
Non-Clinical Treatment
None reported