Ultra-rapid meningeal metastasis in triple-negative breast cancer: A case report.

INTRODUCTION AND

IMPORTANCE

Triple-negative breast cancer (TNBC) is highly invasive and poorly responsive to standard treatments, making it prone to brain metastasis, which exhibits significant intracranial invasiveness. But brain metastasis is extremely rare within one month after neoadjuvant therapy and standard modified radical surgery. Here, we report a case of a patient who, after completing neoadjuvant chemotherapy and achieving partial remission (PR), was diagnosed with brain metastasis one month post-surgery. The uniqueness of this case lies in the imaging description of a 2 cm mass, which was similarly palpable on physical examination. However, at the initial detection, skin invasion and lymph node metastasis on the ipsilateral clavicle were also identified, indicating highly aggressive behavior. For such highly invasive cases, intensified neoadjuvant therapy and close monitoring should be considered.

CASE PRESENTATION: We report a female patient who despite achieving a partial response (PR) after neoadjuvant chemotherapy was found to have brain metastatic lesions due to obvious symptoms of meningeal metastasis only one month after surgery. The patient's meningeal metastasis remained stable only after undergoing whole-brain radiotherapy and intrathecal injection of chemotherapy drugs.

CLINICAL DISCUSSION: Supraclavicular lymph node metastasis is a high - risk factor for metastasis in triple - negative breast cancer. Effective neoadjuvant therapy is a factor contributing to a favorable prognosis. This patient exhibits both of these characteristics. For this particular patient, a head MRI may enable earlier detection of brain metastases.

CONCLUSION

For high - risk triple - negative breast cancer patients, the risk of brain metastasis should be closely monitored.