内容紹介
Synchronous and Unilateral Breast Cancers(Invasive Lobular Carcinoma and Non-Invasive Ductal Carcinoma)―A Case Report
Summary
We report a case of synchronous and unilateral breast cancers in a 51-year-old female. A focal asymmetric right breast density was detected on breast cancer screening mammography. Ultrasonography showed a low echoic mass, 9 mm in diameter, in the B area, and a second low echoic mass in the CD area of her right breast. A core needle biopsy of the B area mass led to a diagnosis of an invasive lobular carcinoma, positive for estrogen receptor(ER)and progesterone receptor(PgR), and negative for HER2/neu. One-percent of the tumor cells were Ki-67 positive. Her preoperative diagnosis was Stage Ⅰ(T1N0M0). She underwent muscle-preserving mastectomy plus sentinel lymph node biopsy. The pathological diagnosis from the resected surgical specimen was invasive lobular carcinoma(B area), positive for ER, and negative for PgR and HER2/neu protein expression. From this, she was additionally diagnosed with non-invasive ductal carcinoma(CD area)that was positive for ER, and negative for PgR and HER2/neu protein expression. The surgical margins were negative, and there were no sentinel lymph node metastases. These tumors were independent. She was given adjuvant endocrine therapy. Two years and 6 months after surgery, the patient was doing well and without metastases.
要旨
浸潤性小葉癌と非浸潤性乳管癌(DCIS)が同時性・片側性に併存した症例を経験した。症例は51歳,女性。乳癌検診で異常を指摘されて受診した。マンモグラフィ検査では右M領域にFADを認めた。超音波検査では右B領域に直径9 mmの不整形低エコー腫瘍として描出された。腫瘤周囲より,右CD領域まで連続する低エコー域も認められた。針生検術を施行したところ,浸潤性小葉癌と診断された。全身検索では遠隔転移を認めず,T1N0M0,Stage Ⅰの術前診断で胸筋温存乳房切除術+センチネルリンパ節生検術を施行した。病理組織診断は右B領域に浸潤性小葉癌,腫瘍径2.1 cm,右CD領域にDCISが存在した。切除断端陰性,リンパ節転移陰性,ER陽性,PgR陽性,HER2陰性,Ki-67 10%であり,T2N0M0,Stage ⅡAと診断された。術後はLH-RH agonist+tamoxifenで経過をみているが,術後2年6か月目の現在,明らかな転移・再発を認めていない。
目次
Summary
We report a case of synchronous and unilateral breast cancers in a 51-year-old female. A focal asymmetric right breast density was detected on breast cancer screening mammography. Ultrasonography showed a low echoic mass, 9 mm in diameter, in the B area, and a second low echoic mass in the CD area of her right breast. A core needle biopsy of the B area mass led to a diagnosis of an invasive lobular carcinoma, positive for estrogen receptor(ER)and progesterone receptor(PgR), and negative for HER2/neu. One-percent of the tumor cells were Ki-67 positive. Her preoperative diagnosis was Stage Ⅰ(T1N0M0). She underwent muscle-preserving mastectomy plus sentinel lymph node biopsy. The pathological diagnosis from the resected surgical specimen was invasive lobular carcinoma(B area), positive for ER, and negative for PgR and HER2/neu protein expression. From this, she was additionally diagnosed with non-invasive ductal carcinoma(CD area)that was positive for ER, and negative for PgR and HER2/neu protein expression. The surgical margins were negative, and there were no sentinel lymph node metastases. These tumors were independent. She was given adjuvant endocrine therapy. Two years and 6 months after surgery, the patient was doing well and without metastases.
要旨
浸潤性小葉癌と非浸潤性乳管癌(DCIS)が同時性・片側性に併存した症例を経験した。症例は51歳,女性。乳癌検診で異常を指摘されて受診した。マンモグラフィ検査では右M領域にFADを認めた。超音波検査では右B領域に直径9 mmの不整形低エコー腫瘍として描出された。腫瘤周囲より,右CD領域まで連続する低エコー域も認められた。針生検術を施行したところ,浸潤性小葉癌と診断された。全身検索では遠隔転移を認めず,T1N0M0,Stage Ⅰの術前診断で胸筋温存乳房切除術+センチネルリンパ節生検術を施行した。病理組織診断は右B領域に浸潤性小葉癌,腫瘍径2.1 cm,右CD領域にDCISが存在した。切除断端陰性,リンパ節転移陰性,ER陽性,PgR陽性,HER2陰性,Ki-67 10%であり,T2N0M0,Stage ⅡAと診断された。術後はLH-RH agonist+tamoxifenで経過をみているが,術後2年6か月目の現在,明らかな転移・再発を認めていない。