A CASE OF BILATERAL MULTIPLE NON-PALPABLE BREAST CANCER DIAGNOSED DURING ESTROGEN REPLACEMENT THERAPY

Abstract

A 57-year-old woman who had been treated with estrogen replacement therapy for menopausal syndrome after hysterectomy for uterine cancer since 10 years earlier was referred to the hospital because she was pointed out breast abnormalities at a periodic examination elsewhere. Physical examination, palpation, and mammography revealed no abnormalities, however, ultrasonic study visualized multiple and scattered small tumors in the bilateral breasts which were 0.4-0.5cm in diameter with a high D/W ratio. Ultrasonography-guided cytodiagnoses of these tumors were class III. Then lumpectomies for 2 tumors of the right breast and 3 tumors of the left breast were performed under local anesthesia. As a result, invasive ductal carcinoma was diagnosed in all the resected materials. Bilateral mastectomy was carried out. All cancer foci were ER-positive and PgR-positive.
It is indicated that the estrogen replacement therapy is a risk factor for carcinogenesis of the breast. This case of bilateral multiple non-palpable breast cancer diagnosed during estrogen replacement therapy is reported, together with a review of the literature.