Panchal Seema, Shachar Orli, O'Malley Frances, Crystal Pavel, Escallon Jaime, Crook Juanita, Bane Anita, Bordeleau Louise
University of Toronto, Toronto, Ontario, Canada.
Nat Rev Clin Oncol. 2009 Oct;6(10):604-7. doi: 10.1038/nrclinonc.2009.116.
A 49-year-old patient with high-risk prostate cancer presented to a specialist. He was treated with neoadjuvant hormonal therapy for 6 months, followed by conformal radiotherapy. Three years later, he had a biochemical recurrence and commenced continuous luteinizing hormone-releasing hormone analog and antiandrogen therapy as part of a clinical trial. Aside from notable gynecomastia, he remained asymptomatic. He has a strong family history of breast cancer with multiple sisters affected.
At 58 years of age, the patient underwent BRCA2 germline testing and was found to be a mutation carrier. Following post-test counseling, he was offered clinical breast examination, which was unremarkable except for gynecomastia. Baseline screening mammography identified a 4 mm cluster of microcalcifications and ductal carcinoma in situ (DCIS) was confirmed by stereotactic biopsy.
DCIS in a male BRCA2 mutation carrier undergoing androgen deprivation therapy for prostate cancer.
The patient was treated with bilateral mastectomy and no additional systemic therapy was recommended. This case report illustrates the importance of implementing screening mammography in male BRCA mutation carriers, particularly in those with a BRCA2 mutation.
一名49岁的高危前列腺癌患者求诊于一名专科医生。他接受了6个月的新辅助激素治疗，随后进行了适形放疗。三年后，他出现生化复发，并开始接受持续的促黄体生成素释放激素类似物和抗雄激素治疗，作为一项临床试验的一部分。除了明显的男性乳房发育外，他没有其他症状。他有很强的乳腺癌家族史，多个姐妹患病。
58岁时，患者接受了BRCA2种系检测，结果发现他是一名突变携带者。在检测后咨询中，他接受了临床乳房检查，除男性乳房发育外，检查结果无异常。基线筛查乳房X光检查发现一个4毫米的微钙化簇，立体定向活检证实为导管原位癌（DCIS）。
一名接受雄激素剥夺治疗的前列腺癌男性BRCA2突变携带者患有DCIS。
患者接受了双侧乳房切除术，不建议进行额外的全身治疗。本病例报告说明了对男性BRCA突变携带者，特别是那些携带BRCA2突变的人进行筛查乳房X光检查的重要性。
