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Introducción: La dermatomiositis y la polimiositis son trastornos inflamatorios que se asocian con relativa frecuencia a neoplasias malignas y se consideran dentro de los síndromes paraneoplásicos reumatológicos. Objetivo: Describir el caso de una paciente diagnosticada con polimiositis paraneoplásica asociada a un cáncer de mama metastásico. Presentación del caso: Se trata de una mujer de 65 años que inicia con un cuadro de debilidad proximal inicialmente en miembros superiores y posteriormente en miembros inferiores. Una biopsia de músculo reveló datos sugestivos de polimiositis. Se inició tratamiento con metotrexato, azatioprina y prednisona, sin observarse mejoría sustancial de los síntomas. Durante el examen se encontró una tumoración palpable de 4 cm en glándula mamaria derecha, cuya biopsia reveló la presencia de un carcinoma ductal infiltrante HER2 enriquecido (+++) de la mama, con estudios posteriores de extensión sugestivos de enfermedad metastásica hepática corroborados por biopsia. Se decidió tratamiento sistémico paliativo con quimioterapia a base de paclitaxel + trastuzumab con resolución del síndrome paraneoplásico tras tres ciclos de tratamiento, respuesta parcial de la actividad tumoral y adecuada tolerancia al tratamiento. Conclusión: Los síndromes paraneoplásicos reumatológicos son relativamente frecuentes en pacientes oncológicos, sin embargo, las neoplasias malignas de la mama no se encuentran dentro de las principales neoplasias asociadas a dichos síndromes. [ABSTRACT FROM AUTHOR]

Background: Retreatment with weekly paclitaxel in heavily pretreated breast cancer patients has been reported before with varying results, but has not been addressed specifically. Methods: Patients with metastatic breast cancer, histologically confirmed with measurable disease, previously exposed to weekly paclitaxel in the adjuvant or neoadjuvant setting or as therapy for metastatic disease were treated with paclitaxel 80 mg/m2 body surface area, weekly for three weeks with an interval of one week rest (fourweek cycle). Results: 18 patients were enrolled from December 2011 to July 2013; 100% of the patients had received paclitaxel previously, 39% neoadjuvant, 17% adjuvant, 44% in the metastatic setting. Of the patients, 56% were in the fifth line, 28% in the third line, and 16% in the fourth line. Thirty-three percent of the patients received paclitaxel more than a year before, 11% more than four years, and 56% more than seven years. Grade 3 neutropenia was observed in 12%, and one case of grade 4 neutropenia was observed. There were no deaths due to toxicity. Grade 1 peripheral neuropathy was observed in 34% of the patients, grade 2 in 22%, and grade 3 in 12%. Two patients had therapy withheld due to neuropathy. Progression-free survival was 6.2 months for the whole group. Partial responses were seen in 28% and stable disease in 61%. Two patients had progressive disease. Conclusions: Retreatment with this schedule of weekly paclitaxel was well tolerated and effective in controlling metastatic breast cancer after multiple lines of therapy. [ABSTRACT FROM AUTHOR]