Non-invasive Ductal Carcinoma Discovered during Risk-reducing Mastectomy

Abstract

A 47-year-old woman had been treated for breast cancer at age 34 years (left partial mastectomy with sentinel node biopsy) and at age 44 years (right total mastectomy with sentinel node biopsy). In light of her history of cancer in both breasts, young onset, and family history, genetic screening was recommended. She underwent BRCA screening, which identified a BRCA1 pathogenic variant, and she was diagnosed with hereditary breast and ovarian cancer syndrome. She requested prophylactic surgery and underwent risk-reducing salpingo-oophorectomy in the Department of Women's Medicine. Mammography, breast ultrasound, and breast magnetic resonance imaging (MRI) all showed no lesion in the breast, and risk-reducing mastectomy of the remaining left breast was conducted. Postoperative pathological investigations showed a non-invasive ductal carcinoma [estrogen-receptor (ER)-positive], measuring 2 mm. The patient had been undergoing postoperative treatment with tamoxifen and luteinizing hormone-releasing hormone (LH-RH) agonist for the right breast cancer, but after the risk-reducing salpingo-oophorectomy, the hormonal agent was switched to anastrozole, and she currently remains under observation.