Pathological Complete Response after Robot-Assisted Pulmonary Resection Following CDK4/6 Inhibitor-Combined Endocrine Therapy for Endobronchial Oligometastatic Breast Cancer: A Case Report.

introductionEndobronchial metastasis from breast cancer is rare. Even in oligometastatic disease, systemic therapy remains the standard treatment, and the role of surgical resection is not well established. We report a case of endobronchial oligometastatic breast cancer that achieved pathological complete response (pCR) after endocrine therapy combined with a cyclin-dependent kinase 4/6 (CDK4/6) inhibitor, followed by pulmonary resection. CASE PRESENTATION: A 48-year-old female with bilateral hormone receptor-positive, human epidermal growth factor receptor 2-negative breast cancer underwent surgery, followed by adjuvant chemotherapy and endocrine therapy. Two years and 8 months later, an elevated NCC-ST-439 level prompted further evaluation, which revealed a lesion in the right bronchus. Bronchoscopic biopsy confirmed metastatic breast cancer. No other metastatic lesions were detected, and the patient was diagnosed with endobronchial oligometastatic disease. Combination therapy with endocrine therapy and a CDK4/6 inhibitor resulted in tumor regression without new metastases. After 9 months of systemic therapy, robot-assisted right lower lobectomy with lymph node dissection was performed. Pathological examination revealed pCR. The patient remains progression-free 1 year and 9 months after surgery.

conclusionsThis case suggests that surgical resection following effective systemic therapy may be a treatment option in selected patients with endobronchial oligometastatic breast cancer.