Reduction in tumor grade and Ki-67 in postmenopausal patient with node-positive invasive ductal carcinoma following combination hormone replacement therapy cessation: a case report. 

 -  2022 
<br/><br/> Background: While praised for its benefits in treating symptoms related to menopausal changes, hormone replacement therapy (HRT) has been associated with an increased risk for hormone-dependent cancer development, particularly endometrial and breast. Few studies have elucidated the relationship between HRT cessation and hormone receptor-positive breast cancer proliferation. We report herein, to the best of our knowledge, the first case of 28.6% relative reduction in proliferation index marker Ki-67 in node-positive hormone receptor-positive breast cancer following HRT cessation.  Case Description: We report an unusual case of a 64-year-old female patient with longstanding HRT for fifteen years who underwent immediate discontinuation after diagnosis of poorly differentiated invasive ductal carcinoma. We observed a reduction in tumor grade from poorly differentiated at time of biopsy to moderately differentiated at time of surgery following cessation of HRT, as well as a reduction in the tumor proliferation index (Ki-67) from 70% to 50%. The patient has remained recurrence-free at the one-year mark postoperatively with continued follow-up.  Conclusions: This case highlights potential clinical benefits associated with HRT discontinuation in the postmenopausal population with preexisting hormone-dependent cancers with high proliferation index, as well as the usefulness of Ki-67 in measuring response to aromatase inhibition in this subpopulation of patients.  Keywords: Hormone replacement therapy (HRT); breast cancer; tumor grade; Ki-67; case report. Copyright 2022 Translational Breast Cancer Research. All rights reserved. 
<br/><br/><br/>English 
<br/><br/><label>ISSN: </label>2218-6778 
<br/><br/><label>Standard No.: </label>PMC11093044 [pmc] tbcr-03-29 [pii] 
<br/><br/><label>Subjects--Topical Terms: </label>--Automated
<br/><br/><label>Subjects--Geographic Terms: </label><br/>MedStar Washington Hospital Center
<br/><br/><label>Index Terms--Occupation: </label><br/>MedStar General Surgery Residency<br/>MedStar Georgetown University Hospital/MedStar Washington Hospital Center<br/>Surgery/Plastic Surgery
<br/><br/><label>Index Terms--Function: </label><br/>Case Reports