講演情報
[P26-10]乳癌再発患者に対するリスク低減卵巣卵管切除術の妥当性
○樋口 徹1, 阿部 友嘉1, 有澤 文夫1, 林 祐二1, 櫻井 孝志1, 末國 久美子1, 真鍋 育子1,2, 齊藤 毅1 (1.さいたま赤十字病院 乳腺科, 2.さいたま赤十字病院 看護部)
[INTRODUCTION] About 4 years have passed since the genetic test for the germline BRCA1/2 gene was approved. Olaparib is available for recurrent breast-cancer patients carrying germline BRCA1/2 pathogenic variant (PV). In some patients, their disease has been controlled for a long period by olaparib. We would examine the indications for risk reducing salpingo-oophorectomy (RRSO) of recurrent breast cancer patients in this study. [METHODS] We present two relapsed-breast cancer patients and one elderly breast cancer who developed ovarian cancer after breast surgery. They all carried BRCA PV. [RESULTS] Case 1 was 76-year-old recurrent breast cancer with germline BRCA2 PV. Ovarian cancer developed 18 months after starting olaparib. Chemotherapy was unsuccessful and she died 6 months after the onset of ovarian cancer. Case 2 was 78-year-old triple-negative breast cancer (TNBC) with germline BRCA1 PV. She was followed without chemotherapy but ovarian cancer occurred 3 years after breast cancer surgery. She has been eventually treated by chemotherapy for ovary cancer. Case 3 was a 48-year-old TNBC patient with extraordinary bilateral breast cancer. She had a germline BRCA1 PV. Parasternal lymph node recurrence occurred and then olaparib was started. She has maintained a complete response 2 years after the start of administration and RRSO was scheduled.[DISCUSSION]Since ovary cancer would onset either as new cancer or as resistance against treatment of olaparib, it was considered that RRSO could be indicated for recurrent breast cancer patient.