A Three-Year TCM Case Report of Triple-Negative Breast Cancer Patient Zhao
Zhao, female, born October 1980, from Baoding, Hebei Province. First visit on April 18, 2019. A nodule was found on a physical examination in November 2016; in December, while breastfeeding, she noticed localized redness and swelling in the outer upper quadrant of the right breast, with a tender mass palpable beneath the red area. Neither nipple was retracted or bloody-discharging. No family history of cancer. At age 20 she had a lipoma excised at Baoding Third Hospital; at age 21 a breast fibroma was surgically removed at Baoding 252 Hospital.
On May 25, 2017, an ultrasound at the Affiliated Hospital of Hebei University (ID no. 599430) showed a hypoechoic mass in the outer quadrant of the right breast, approximately 3.6 x 3.2 x 2.1 cm, with ill-defined borders, irregular shape, and internal blood flow signals. Scattered hypoechoic nodules were seen in both breasts; a nodule at the 12-1 o'clock position of the left breast measured about 0.9 x 0.7 x 0.5 cm. Multiple axillary nodules were also present, the largest about 3.0 x 0.9 cm. There were cystic-solid thyroid nodules and a small cord-like shadow in the dorsal segment of the right lower lobe. Pathology revealed invasive ductal carcinoma of the breast, with ER, PR, AR, and Her-2 all negative. Cancer antigen CA125 was 47.57 (reference range 0-35). She then underwent breast mass resection at that hospital followed by postoperative chemotherapy.
No history of hypertension, diabetes, or heart disease. Multiple uterine fibroids were found before pregnancy; four were removed during cesarean section and two were left in place. Menstruation was irregular during lactation; after chemotherapy menstruation ceased, and she has had no period for nearly two years. She was emotionally depressed, with fairly severe postpartum depression and anxiety. Her work environment was heavily polluted by renovation and outdoor air. She often stayed up late after childbirth and has enjoyed swimming since childhood.
The patient has been constipated since childhood, sometimes going four to five days without a bowel movement, with pellet-like stools; eating wood ear fungus improved it. As a child she was a picky eater with a sweet tooth, adding white sugar to every dish. Previously, after taking Chinese medicine from other practitioners, her bowel movements became once or twice daily, but constipation returned once she stopped. Supplementing probiotics normalized her stools. She weighed about 90 jin (45 kg) and was 164 cm tall. Multiple pulmonary nodules, the largest 0.6 cm, were present. Her father has diabetes, her mother heart disease, and her maternal grandmother coronary heart disease. She dreams frequently and feels fatigued on waking. Her mouth is dry and she is thirsty. She is allergic to Xiaoyao Pills, developing a facial rash after taking them.
Right pulse: fine, wiry, and slow; left pulse: deep, soft, and weak. Blood pressure/heart rate: 97/53/59. She has low blood pressure when thin, and her palms tend to sweat. Pulmonary and thyroid nodules remain, and tumor markers are elevated.
The initial visit was treated with modified Shiliu Liuqi Yin combined with Herong Sanjian Wan, Xiaoluo Wan, and Liuwei Dihuang Wan.
Decoction: Chuanxiong (Rhizoma Chuanxiong) 6 g, Danggui (Radix Angelicae sinensis) 6 g, Baishao (Radix Paeoniae alba) 6 g, Fangfeng (Radix Saposhnikoviae) 6 g, Renshen (Radix Ginseng) 6 g, Muxiang (Radix Aucklandiae) 6 g, Sheng Huangqi (raw Radix Astragali) 6 g, Rougui (Cortex Cinnamomi) 6 g, Jiegeng (Radix Platycodi) 6 g, Baizhi (Radix Angelicae dahuricae) 6 g, Binglang (Semen Arecae) 6 g, Houpo (Cortex Magnoliae) 6 g, Wuyao (Radix Linderae) 6 g, Gancao (Radix Glycyrrhizae) 6 g, Zisu (Folium Perillae) 6 g, Zhiqiao (Fructus Aurantii) 6 g. Patent medicines: Herong Sanjian Wan, Compound Banmao Capsules, etc.
After taking the decoction and patent medicines she felt fatigued, so I followed the comprehensive medication approach described in my article "My Experience Using Multi-Target Broad-Spectrum Anticancer Chinese Herbal Compounds". Following the formula strategy in that article (see the article for details), I used over a hundred herbs in trace amounts, combined for anticancer effect. After taking the medicine she tolerated it well, and follow-up indicators were good. From then on, this regimen was essentially fixed, and she continued taking it until May 2022.
During treatment she had regular follow-ups with no signs of recurrence, and tumor markers remained normal. Because more than five years had passed since surgery, and the pulmonary and thyroid nodules had not changed significantly on follow-up, while multiple small nodules remained in the breast and axillae (graded BI-RADS category 3 and largely unchanged over the years), I advised stopping medication and observing. However, she remained anxious about recurrence and finally decided to take medicine for one month each quarter as prevention.
She now works normally and is in good condition. A follow-up on July 1, 2022 still showed no signs of recurrence; she remains under continued follow-up. Chinese medicine played a role in her treatment and also in preventing recurrence.