🧪 Metastatic Breast Cancer Case Study
📋 Patient
Name: Layla M., 56-year-old postmenopausal female
Chief Concern: Persistent back pain and fatigue
History: Prior early-stage ER+/HER2- breast cancer treated with lumpectomy and tamoxifen 6 years ago. Now reports weight loss and bone pain.
🩺 Initial Presentation
Imaging shows multiple lytic lesions in spine and pelvis, and two liver lesions. Tumor markers elevated. Biopsy confirms ER+/HER2- metastatic breast cancer.
Question 1: What is the best next step for staging?
🧬 How the Medications Worked
CDK4/6 Inhibitors (e.g., Palbociclib, Ribociclib, Abemaciclib)
Mechanism: Inhibit cyclin-dependent kinases 4 and 6, halting cell-cycle transition from G1→S in ER+ tumor cells to suppress proliferation.
Aromatase Inhibitors (e.g., Letrozole, Anastrozole)
Mechanism: Inhibit aromatase in peripheral tissues, lowering estrogen synthesis—removing the growth stimulus for ER+ cancer cells.
Fulvestrant (SERD)
Mechanism: Binds to the estrogen receptor and accelerates its degradation, shutting down ER signaling even when ligand-independent activation exists.
Denosumab (Bone-Targeted Therapy)
Mechanism: Monoclonal antibody against RANKL that prevents osteoclast activation—reducing bone resorption, fractures, and skeletal-related events.
Together: CDK4/6 inhibition + endocrine therapy provide durable disease control by blocking growth signaling and cell-cycle progression, while denosumab stabilizes the skeleton and reduces complications—improving survival, function, and quality of life.