• Liping Chen, Sha Feng, Xuelian Chen, and Caiwen Du.
• Department of Medical Oncology, National Cancer Center/National Clinical Research Center for Cancer/Cancer Hospital & Shenzhen Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Shenzhen, Guangdong, China.
• Medicine (Baltimore). 2024 Nov 8; 103 (45): e40345e40345.

RationaleHormone receptor-positive, HER2-negative advanced breast cancer complicated by pulmonary lymphangitic carcinomatosis (PLC) poses significant therapeutic challenges due to the lack of standardized treatment protocols. Despite various therapeutic interventions and supportive care, prognosis remains dismal.Patient ConcernsHerein, a 48-year-old Chinese woman presented with a persistent cough, unresponsive to anti-infective treatment for 1 month. A computed tomography (CT) scan revealed lymphatic vessel infiltration and a diffuse nodular pattern, suggestive of PLC.DiagnosesHormone receptor-positive, HER2-negative advanced breast cancer complicated by PLC.InterventionsThe patient was treated with a regimen comprising low-dose apatinib, capecitabine, and albumin-bound paclitaxel.OutcomesThe patient achieved a partial response, with a progression-free survival exceeding beyond ten months. Symptoms of dyspnea and dry cough significantly improved, alongside a notable reduction in lymphangitic carcinomatosis.LessonsThis case highlights the potential antitumor activity of apatinib in breast cancer patients with presenting with PLC. While further studies are necessary, this therapeutic approach could represent a viable option for managing breast cancer in the context of a visceral crisis. The case also emphasizes the importance of individualized treatment strategies and further research to substantiate these promising findings.Copyright © 2024 the Author(s). Published by Wolters Kluwer Health, Inc.

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