Abstract
We report a case of breast cancer in the nipple-areola component after Nipple-sparing mastectomy（NSM） with a pathogenic variant of BRCA2. The patient was a 49-year-old woman. At the age of 33, she underwent NSM and axillary dissection for left breast cancer pT3N1M0 Stage ⅢA, and the resection margins were negative. At the age of 43, she underwent NSM for right breast cancer pTisN0M0 Stage 0. At the age of 49, she came to hospital because she was aware of a mass just below the left nipple. A hypoechoic mass of 5.3 mm in size was found on ultrasonography, and left breast cancer was diagnosed by excisional biopsy. A total excision including the left nipple and areola was performed as a radical surgery. Genetic testing performed due to 3 breast cancers under age 50. The results of the genetic testing showed that pathogenic variant of c.9076C>T (p.Gln3026*) in BRCA2.
NSM is also performed in the treatment of cancer in patients with HBOC. Reports of therapeutic NSM for HBOC cases are fewer than reports of NSM for sporadic breast cancer cases, but there have been no reports of recurrence in the nipple-areola component for HBOC cases. However, the observation period of most of these reports is short (2-5 years), and there is a possibility that breast cancer may develop in HBOC after a long period of time after surgery, as in this case, so long-term accumulation of cases is necessary.
