講演情報
[P15-7]87歳時に遺伝性乳癌卵巣癌症候群(HBOC)と診断されたLuminal HER2陽性乳癌の一例
○瀧 由美子1, 甲斐 三紀子1, 小島 梨紗2, 岩泉 守屋2, 安田 和世3, 長谷川 聡1 (1.藤枝市立総合病院 乳腺外科, 2.浜松医科大学医学部附属病院 遺伝子診療部, 3.藤枝市立総合病院 病理診断科)
We report a case of an 87-year-old woman was diagnosed with right breast cancer (BC). She had treatment for left BC at the age of 71. In her family history, her brother had bladder cancer. Immunohistochemical analyses of right BC showed ER-positive, HER2-positive. She could take a BRCA gene test, because she was diagnosed with two or more primary BC. She decided to be tested for her descendants. She took it before breast surgery and the result was NM_000059.4(BRCA2):c.8023A＞G. She wanted a low invasive surgery, so she underwent breast conserving surgery. After surgery she received genetic counseling with her three sons and her second son’s wife. No one wants to be tested up to now.The characteristics of HBOC are early-onset and bilateral BC. In addition, among patients with BRCA2-associated tumors often are luminal-like, and some reports shows HER2 positive rate is about 10%. So our case is rare. Next, we consider about a gene test. In this case, it was not necessary to consider contralateral and ipsilateral BC prophylaxis, because of her age. So the result of gene test did not affect the types of surgery. Moreover, there were no relatives who wanted to have a gene test. From these two points, we think that it was not necessary to perform it in a hurry before surgery. Probably, her family will spend more time to face the genetic disease than she will. We should have cared their understanding of HBOC and their mind more. We thought that it would be desirable to consider when and for whom to perform a gene test.