[A patient with advanced recurrent breast cancer who firmly resisted hair loss and was then treated by combination therapy with high-dose toremifene and capecitabine].

The patient was a 36-year-old woman, who found a mass in her right breast around April 2002, visited a physician in June, and was referred to our department because of suspected right breast cancer. It was confirmed that the cancer had metastasized to the right axillary lymph nodes and the skin of the right breast. After undergoing an operation on July 11 (Bt+Ax), the patient was placed on tamoxifen (TAM). Then, the course was followed while the patient was treated with CEF and 5'-DFUR. In April 2004, she had a recurrence manifesting itself as bone metastasis, partly because of poor compliance with the hospital-visit and dosing schedules. After chemotherapy with paclitaxel, etc., combination therapy with docetaxel (DOC), capecitabine, and high-dose (120 mg/day) toremifene (TOR) was started on October 15, 2004. Subsequently, because the patient firmly resisted hair loss, chemotherapy was continued with a double-drug regimen with capecitabine and high-dose TOR. Treatment was temporarily discontinued because the patient developed hand-foot syndrome, which was probably attributable to capecitabine, but the symptoms improved after administration of vitamin B(6). Thereafter,the patient complied well with the dosing schedule, and no new metastatic focus has been detected by any examination as of October 2005. These findings suggest that the double-drug regimen with capecitabine and high-dose TOR is an effective treatment for patients who can not be treated with anthracyclines or taxanes.