Ms. Wang, 36 years old, came to our hospital in December 2009, left breast cancer postoperative liver metastasis. Yan Min, Department of Breast, Henan Cancer Hospital, medical history: left breast mass, size 3cm, was found in May 2007, resection of the mass was performed, no pathological examination was performed after surgery, pathological consultation was performed in July 2007, results: invasive ductal carcinoma, 2007-7-3 modified radical surgery for left breast cancer, postoperative pathology: left breast cancer local excision after re-operation under the incision tissue cancer residue, lymph nodes did not see cancer metastasis (0/11). Immunohistochemistry ER (-), PR (-), HER-2 (++). HER-2 gene testing and trastuzumab treatment were refused. Six cycles of chemotherapy with FEC regimen were given postoperatively. Recurrence of metastasis: 2009-12-24 During routine review, abdominal ultrasound revealed solid occupancy in the right lobe of liver – liver metastasis, CEA 62.8ng/ml, CA153 36.0 IU/ml, after admission, comprehensive examination: MRI of head, ECT of bone, CT of chest, ultrasound of breast and drainage area, electrocardiogram with no significant abnormality, enhanced CT of upper abdomen suggested: solid occupancy in the right lobe of liver (single, size 5.8 cm), liver puncture biopsy was rejected, and HER-2 gene amplification was detected by FISH of the primary lesion. Treatment process: chemotherapy combined with targeted therapy should be the first choice of treatment for the patient, but due to the economic situation, the patient and his family refused trastuzumab treatment. Firstly, TP (doxorubicin + cisplatin) regimen combined with chemotherapy was given from 2009-12-30 to 2010-4-10 for 6 cycles, 1 cycle every 21 days, and the efficacy was evaluated every 2 cycles, efficacy evaluation: partial remission (PR) (the liver lesion shrunk from 5.8 cm to 1.5 cm before treatment after 6 cycles, and CEA and CA153 decreased to normal range). Adverse effects of combination chemotherapy: nausea, loss of appetite, vomiting degree 1, decrease in white blood cells and granulocytes degree 3, mild weakness, hair loss. No hemoglobin or platelet drop, no muscle aches or other adverse reactions. The patient was considered to have a single lesion and was recommended to undergo stereotactic conformal radiotherapy for liver metastases (2010-5-10~2010-7-1), after which the lesion shrank to 1.2 cm. in July 2010, he was given capecitabine monotherapy regimen to continue the treatment and started to review every 2 cycles to evaluate the efficacy, and after 6 months, he was reviewed every 3 months, the liver lesion basically disappeared and the disease was stable for 25 months. Adverse effects were only mildly elevated bilirubin and transaminases with no GI or hematological reactions. 2012.8.13 CEA 7.47ng/ml (reference value 0-3.5) was found on routine recheck, further examination, 2012.8 .15 PET-CT revealed pulmonary metastases (capecitabine TTP = 25 months) and no liver lesions were found. Puncture biopsy was risky due to the proximity of the pulmonary lesion to the hilum. Communicated with the patient and refused trastuzumab treatment. A single agent doxorubicin regimen was given, and the efficacy was evaluated SD after 2 cycles (increase in length diameter from 2.5 cm to 2.7 cm). The combination of cisplatin was started in cycle 3, and the efficacy was evaluated as PR after two cycles (the length diameter was reduced to 1.5 cm), and the disease is in remission and continues to be treated. Since the recurrence of metastasis, the patient has been under control for almost 3 years using a strategy of single-agent sequential chemotherapy after effective combination chemotherapy, with the addition of local therapy when appropriate, and is still under treatment follow-up.