Patient records
Name: Aisha
Age: 45
Nationality: Nigeria
Diagnosis: Invasive ductal carcinoma of the right breast (cT3N1M0, stage IIIA), Luminal B type (ER+/PR+/HER2-), Ki-67 40%
Treatment Hospital: Department of Breast Surgery, Fudan University Cancer Hospital
For a woman, breasts are not only a part of her body, but also a symbol of gender identity and dignity. When Aisha heard the suggestion of a total mastectomy in a clinic in Lagos, she felt her world collapsing.
1. "Is it possible for me to save my breasts first?"
Aisha, a university lecturer, discovered a 6-centimeter lump in her right breast, accompanied by lymph node metastasis to the ipsilateral axilla. Local doctors told her that due to the tumor's size, a total mastectomy was necessary before considering further treatment. This news was a devastating blow; she couldn't accept losing a breast at the age of 45.
She contacted us through an international medical aid organization. Her request was very specific and pleading: "Is it possible to shrink the tumor before the surgery so that I can save my breast? Even if there is only a sliver of hope, I want to try."
2. Our Value: Finding opportunities for breast-conserving therapy with neoadjuvant therapy in the face of a "total mastectomy" decision.
Aisha's request has a standard answer in oncology: neoadjuvant therapy. This involves shrinking a non-breast-conserving tumor to a breast-conserving size through preoperative chemotherapy or targeted therapy. After analyzing her pathology report, our medical case manager found that her molecular subtype was Luminal B, with a Ki-67 level as high as 40%. This means that the tumor is proliferating rapidly and may be very sensitive to chemotherapy—ideal conditions for neoadjuvant therapy.
Precise matching and treatment plan planning. We matched her with the Department of Breast Surgery at Fudan University Cancer Hospital , a center with an international reputation in the field of comprehensive breast cancer treatment. During a remote consultation, the experts developed a high-dose preoperative chemotherapy regimen for her. Simultaneously, the experts proposed a crucial surgical plan: after chemotherapy, using China's sentinel lymph node biopsy (SLNB) technique to accurately assess the axillary lymph node status. If there is no metastasis in the sentinel lymph nodes, axillary lymph node dissection can be avoided, significantly reducing the risk of postoperative upper limb lymphedema—crucial for a teacher who frequently needs to raise her hand to write on the blackboard.
We provided comprehensive support throughout the diagnosis and post-treatment process. Aisha completed four cycles of preoperative chemotherapy in China. The side effects of chemotherapy made her want to give up at one point, but our coordinator chatted with her daily, helped her connect with her family in Nigeria via video calls, and encouraged her to persevere. A miracle occurred: the tumor shrank from 6 cm to 1.5 cm. She successfully underwent breast-conserving surgery and sentinel lymph node biopsy, preserving not only her breast but also her armpit. Post-surgery, we connected her with a lymphedema rehabilitation therapist at the hospital to provide preventative rehabilitation training. Post-treatment, we established a "Post-Breast Cancer Endocrine Therapy Follow-up File" for her, tracking the side effects of tamoxifen monthly and arranging for her to undergo breast ultrasound and mammography examinations in Nigeria every six months, with the results simultaneously shared with experts in China.
3. Therapeutic Effects and Insights
Aisha not only saved her breast, but the postoperative pathology also showed complete tumor remission (pCR), which means that chemotherapy was very effective and the prognosis is optimistic. In an email to us, she wrote: "What you saved for me is not just an organ, but also my dignity and confidence as a woman. When I stand on the podium again and face my students, I know that my life has not been incomplete because of cancer. Thank you for letting me find this complete love in faraway China."