内容紹介
Summary
A woman in her 30s presented to our hospital with the chief complaint of a right breast mass after the birth of her first child. She was diagnosed as having right invasive ductal carcinoma of Luminal—B type and T3N3cM0, stage Ⅲc. While undergoing neoadjuvant chemotherapy, she received genetic counseling and underwent genetic testing and was determined to have deleterious BRCA1 and BRCA2 mutations. After completing chemotherapy, she underwent a right total mastectomy and axillary lymph node dissection. Two years postoperatively, she requested to undergo a contralateral risk—reducing mastectomy(CRRM)of her left breast. Therefore, CT and breast MRI were performed to confirm the absence of contralateral lesions and distant metastases, and subsequently, CRRM was performed. Postoperative pathology results showed non—invasive ductal carcinoma lesions at 5 sites. In the case of hereditary breast and ovarian cancer syndrome such as in this study, lesions may be discovered at an early stage by performing risk—reducing mastectomy.
要旨
症例は30歳台,女性。第1子出産後,右乳腺腫瘤を主訴に当院を受診した。右浸潤性乳管癌,Luminal—B type,T3N3cM0,stage Ⅲcと診断した。術前化学療法施行中に遺伝カウンセリングおよび遺伝学的検査を施行し,BRCA1およびBRCA2の病的変異が判明した。化学療法後,右乳房全摘,腋窩リンパ節郭清術を施行した。術後2年,左乳房の対側リスク低減乳房切除術(CRRM)を希望されたため全身CT,乳房MRIにて対側病変や遠隔転移がないことを確認し,CRRMを施行した。術後病理結果で,非浸潤性乳管癌を5か所に認めた。本症例のように遺伝性乳癌卵巣癌症候群では,リスク低減乳房切除術を行うことで初期病変が発見されることも考慮すべきと考えられた。
目次
A woman in her 30s presented to our hospital with the chief complaint of a right breast mass after the birth of her first child. She was diagnosed as having right invasive ductal carcinoma of Luminal—B type and T3N3cM0, stage Ⅲc. While undergoing neoadjuvant chemotherapy, she received genetic counseling and underwent genetic testing and was determined to have deleterious BRCA1 and BRCA2 mutations. After completing chemotherapy, she underwent a right total mastectomy and axillary lymph node dissection. Two years postoperatively, she requested to undergo a contralateral risk—reducing mastectomy(CRRM)of her left breast. Therefore, CT and breast MRI were performed to confirm the absence of contralateral lesions and distant metastases, and subsequently, CRRM was performed. Postoperative pathology results showed non—invasive ductal carcinoma lesions at 5 sites. In the case of hereditary breast and ovarian cancer syndrome such as in this study, lesions may be discovered at an early stage by performing risk—reducing mastectomy.
要旨
症例は30歳台,女性。第1子出産後,右乳腺腫瘤を主訴に当院を受診した。右浸潤性乳管癌,Luminal—B type,T3N3cM0,stage Ⅲcと診断した。術前化学療法施行中に遺伝カウンセリングおよび遺伝学的検査を施行し,BRCA1およびBRCA2の病的変異が判明した。化学療法後,右乳房全摘,腋窩リンパ節郭清術を施行した。術後2年,左乳房の対側リスク低減乳房切除術(CRRM)を希望されたため全身CT,乳房MRIにて対側病変や遠隔転移がないことを確認し,CRRMを施行した。術後病理結果で,非浸潤性乳管癌を5か所に認めた。本症例のように遺伝性乳癌卵巣癌症候群では,リスク低減乳房切除術を行うことで初期病変が発見されることも考慮すべきと考えられた。