J Breast Cancer.  2010 Sep;13(3):311-317.

Incidental Detection of Ductal Carcinoma In Situ of the Breast from Bilateral Prophylactic Mastectomy of Asymptomatic BRCA2 Mutation Carrier: A Case Report

• Choi MY
• Lee JE
• Kim SW
• Lee SK
• Hur SM
• Kim S
• Koo MY
• Bae SY
• Choe JH
• Kim JH
• Kim JS
• Nam SJ
• Yang JH

Abstract

In women at high-risk for breast cancer with a BRCA mutation, bilateral prophylactic mastectomy (BPM) may achieve a risk reduction. A 35-year-old woman had a strong family history of breast and ovarian cancer. She had a regular checkup and found masses in both breasts that confirmed intraductal papillomas and atypical ductal hyperplasia after vacuum assisted mass excision. When she was referred to our clinic, the genetic testing for BRCA mutation was recommended to her sister that managed for ovarian cancer. It was resulted in the positive for the BRCA2 mutation, so she had checked the genetic testing which resulted in the same as the mutation. After sufficient counseling, she decided to undergo BPM and immediate reconstruction. She is satisfied with the result of surgery. This is the first report of BPM of asymptomatic BRCA2 mutation carrier in Korea and BPM should be considered as a risk-reducing option for BRCA mutation carriers.

Keyword

Bilateral mastectomy; BRCA2 gene mutation; Breast neoplasms; Hereditary; Prevention

MeSH Terms

Adult
Breast
Breast Neoplasms
Carcinoma, Ductal
Carcinoma, Intraductal, Noninfiltrating
Counseling
Female
Genetic Testing
Humans
Hyperplasia
Korea
Mastectomy
Mustard Compounds
Ovarian Neoplasms
Papilloma, Intraductal
Risk Reduction Behavior
Siblings
Vacuum
Mustard Compounds

Figure

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  Figure 1 Family pedigree. One of patient's sisters had breast cancer and the other sister has ovarian cancer. Patient has BRCA2 mutation. Arrow indicates patient. ca=cancer; Lt.=left; DCIS=ductal carcinoma in situ.

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  Figure 2 Preoperative design. A bilateral nipple sparing total mastectomy with sentinel lymph node biopsy was performed. Note the multiple previous scars from vacuum assisted mass excision. Note the neck scar from previous right thyroid lobectomy with central lymph node dissection.

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  Figure 3 Postoperative specimens of the both breasts. A silk suture on the specimen was placed to mark the margin of the nipple side.

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  Figure 4 Pathology of the left breast. Ductal carcinomas in situ, solid type, was identified in the upper central portion of the left breast (H&E staining, A, ×100; B, ×400).

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