Pathological complete response to neoadjuvant TACHP in HER2-positive/HR-positive inflammatory breast cancer: a case report

Inflammatory breast cancer is a highly aggressive and locally advanced form of breast cancer with a poor prognosis. Neoadjuvant chemotherapy is the cornerstone of current treatment, aiming to downstage the disease and enable surgical intervention, which is typically followed by adjuvant radiotherapy. This paper reports the case of a 48-year-old female patient who presented with a large palpable mass and inflammatory skin changes in her left breast. She was diagnosed with left-sided inflammatory breast cancer (cT4dN2aM0, Stage IIIB, HER2-positive/hormone receptor-positive). Considering the established efficacy of anthracycline and taxane agents in breast cancer treatment, as well as the widespread application of the TAC regimen in neoadjuvant therapy, the patient received six cycles of neoadjuvant TAC chemotherapy combined with dual HER2-targeted therapy (HP). This was followed by a modified radical mastectomy of the left breast. The patient tolerated this intensive regimen well, and postoperative pathological evaluation confirmed a pathological complete response (pCR). This case adds evidence that an intensified TACHP regimen may be feasible and effective in high tumor-burden, HER2-positive inflammatory breast cancer. Therefore, for selected high-risk inflammatory breast cancer patients, the TACHP regimen may be considered as a neoadjuvant treatment option under close monitoring.