Management of Recurrent Breast Cancer without Systemic Therapy but with Natural Menopause as Endocrine Therapy: A Report of Two Cases

ABSTRACT

We have recently managed two women of estrogen receptor (ER)-positive recurrent breast cancer without systemic therapy but with natural menopause. Case 1 was originally diagnosed with ER-positive breast cancer as a 36- year-old premenopausal woman. Seven years after surgery for her primary disease, a solitary lung metastasis developed. Although she has refused endocrine therapy, natural menopause has caused regression of her lung tumor. Case 2 presented with ER-positive breast cancer as a 43-year-old premenopausal woman. Nine years after surgery, her disease relapsed with lung and pleural metastases, and she received LHRH agonist and tamoxifen as first-line treatment. After 4 years of this treatment, the disease had progressed. LHRH agonist and tamoxifen were discontinued and she has been followed without systemic therapy. She became menopausal and her metastatic disease has decreased. It is concluded that low serum estrogen levels resulting from natural menopause have acted as endocrine therapy for these patients’ metastatic diseases.