内容紹介
Summary
We encountered a case of synchronous bilateral breast cancer in an elderly patient. A 75-year-old woman visited our hospital because she was identified with an abnormality on mammography during breast cancer screening. An elastic hard tumor 2.0 cm in diameter was detected in the A area of her right breast. Mammography showed an irregular tumor shadow with spicula in the right breast and micro-calcifications in her left breast. Ultrasonography showed a low echoic lesion 20 mm in size in the A area of her right breast and a low echoic area 5 mm in size in her left breast. Histological examination of core needle biopsy specimens revealed invasive ductal carcinoma in both breasts. Synchronous bilateral breast cancer was diagnosed. Bilateral muscle-preserving mastectomy with sentinel lymph node biopsy was performed. Postoperative histology revealed bilateral invasive ductal carcinoma without lymph node metastasis that was positive for ER and PgR, was negative for HER2, and had a Ki-67-positive cell index of 20% in the right breast(T1N0M0, StageⅠ), and that was positive for ER, was negative for PgR and HER2, and had a Ki-67-positive cell index of 5% in the left breast(T1N0M0, StageⅠ). The surgical margins were negative. She was administered endocrine therapy as adjuvant therapy for 5 years after the surgery. Eight years after the surgery, she was well without metastasis.
要旨
高齢者に発症した同時性両側性乳癌を経験した。症例は75歳,女性。検診で異常を指摘され,当科を受診した。右乳房A領域にdimplingを認めた。対側乳房,両側腋窩リンパ節に異常を認めなかった。マンモグラフィ検査では右MI領域にspiculationを伴う腫瘤陰影を認め,左MO領域に多形性不均一区域性石灰化を認めた。超音波検査では右A領域に直径20mmの不整形腫瘤,左ACE領域に低エコー域を認めた。針生検の結果,両側ともに浸潤性乳管癌と診断された。全身検索の後,両側乳癌の診断で両側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。病理組織診断では,右側は乳頭腺管癌,ER陽性,PgR陽性,HER2陰性,Ki-67 20%(T1N0M0,StageⅠ),左側は乳頭腺管癌,ER陽性,PgR陰性,HER2陰性,Ki-67 5%(T1N0M0,StageⅠ)と診断された。letrozoleを5年間投与した後,術後8年目の現在,明らかな転移・再発を認めていない。
目次
We encountered a case of synchronous bilateral breast cancer in an elderly patient. A 75-year-old woman visited our hospital because she was identified with an abnormality on mammography during breast cancer screening. An elastic hard tumor 2.0 cm in diameter was detected in the A area of her right breast. Mammography showed an irregular tumor shadow with spicula in the right breast and micro-calcifications in her left breast. Ultrasonography showed a low echoic lesion 20 mm in size in the A area of her right breast and a low echoic area 5 mm in size in her left breast. Histological examination of core needle biopsy specimens revealed invasive ductal carcinoma in both breasts. Synchronous bilateral breast cancer was diagnosed. Bilateral muscle-preserving mastectomy with sentinel lymph node biopsy was performed. Postoperative histology revealed bilateral invasive ductal carcinoma without lymph node metastasis that was positive for ER and PgR, was negative for HER2, and had a Ki-67-positive cell index of 20% in the right breast(T1N0M0, StageⅠ), and that was positive for ER, was negative for PgR and HER2, and had a Ki-67-positive cell index of 5% in the left breast(T1N0M0, StageⅠ). The surgical margins were negative. She was administered endocrine therapy as adjuvant therapy for 5 years after the surgery. Eight years after the surgery, she was well without metastasis.
要旨
高齢者に発症した同時性両側性乳癌を経験した。症例は75歳,女性。検診で異常を指摘され,当科を受診した。右乳房A領域にdimplingを認めた。対側乳房,両側腋窩リンパ節に異常を認めなかった。マンモグラフィ検査では右MI領域にspiculationを伴う腫瘤陰影を認め,左MO領域に多形性不均一区域性石灰化を認めた。超音波検査では右A領域に直径20mmの不整形腫瘤,左ACE領域に低エコー域を認めた。針生検の結果,両側ともに浸潤性乳管癌と診断された。全身検索の後,両側乳癌の診断で両側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。病理組織診断では,右側は乳頭腺管癌,ER陽性,PgR陽性,HER2陰性,Ki-67 20%(T1N0M0,StageⅠ),左側は乳頭腺管癌,ER陽性,PgR陰性,HER2陰性,Ki-67 5%(T1N0M0,StageⅠ)と診断された。letrozoleを5年間投与した後,術後8年目の現在,明らかな転移・再発を認めていない。