A case of hereditary breast and ovarian cancer syndrome who underwent simultaneous contralateral risk-reducing mastectomy in the diagnosis of right breast cancer following primary peritoneal cancer

Abstract

　Though we experience risk-reducing mastectomy (RRM) increasingly as a practice of HBOC is spread, evidences concerning RRM for patients with prior gynecologic cancers relating to HBOC (ovarian, fallopian tube and peritoneal cancers) are still poor. We present a 65-year-old woman with BRCA2 pathogenic variant, diagnosed as right breast cancer two years after the surgery of previous peritoneal cancer. She selected concurrent contralateral RRM and breast reconstructions through the genetic counseling. BRCA1/2 pathogenic variant carriers affected by ovarian cancer have generally poor prognosis and some authors warranted the survival benefit by RRM for these patients were restricted. On the other hand, the treatment by PARP inhibitor provides the survival improvement for these patients in recent years. We have to construct guidelines to consider which prophylactic intervention, RRM or imaging surveillance, is preferred for each patient. In this study, we focus on the management of the breast for patient involved with gynecologic cancers relating to HBOC.