A case report: chemosensory changes in estrogen receptor positive breast carcinoma
Single Paper Presentation

Alan Hirsch, MD
Rush-Presbyterian-St. Luke's Medical Center, Chicago, IL

Michele Bailey
Lake Erie College of Osteopathic Medicine

     Abstract ID Number: 135
     Full text: Not available
     Last modified: May 20, 2003

Abstract
ABSTRACT: Despite reduction in appetite in patients with cancer, physicians rarely assess chemosensory function. A patient with estrogen receptor positive (ER +) breast carcinoma presents with chemosensory complaints.
Case Presentation: A fifty-five year old female, presented with seven months of taste distortion. She initially noted a phanatgeusia of “windex” which changed to a soapy, metallic sensation, localized to the posterior tongue and upper lip. Drinking water improved, and consuming sweets, milk, vinegar or acidic foods worsened the phantageusia. Taste threshold testing revealed hypogeusia to bitter, salt, and sour. Six weeks after evaluation, she underwent modified radical mastectomy for ER (+) breast carcinoma. Immediately thereafter, the phantageusia resolved and her perception of sweet, salty, and sour taste intensified. Repeat chemosensory testing one month later on no medications, prior to any chemotherapy, demonstrated marked improvement for all taste modalities except salt, which remained unchanged.
Discussion: Possible origins for gustatory deficits include remote effects of carcinoma, counter-stimulation from circulating tumor-induced hematogenous tastes, tumor released hematogenous synergistic tastes, taste bud regeneration inhibition, zinc deficiency, elevated calcium or lactate levels, dry mucous membranes, and lack of interest and motivation. Chemosensory evaluation is warranted in patients who present with ER (+) breast carcinoma.