Shimo Tsuyoshi, Yoshioka Norie, Nakamura Masahiro, Ibaragi Soichiro, Okui Tatsuo, Kunisada Yuki, Masui Masanori, Yao Mayumi, Kishimoto Koji, Yoshida Shoko, Nishiyama Akiyoshi, Kamioka Hiroshi, Sasaki Akira
Department of Oral and Maxillofacial Surgery, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical Sciences, Okayama 700-8525, Japan.
Department of Oral and Maxillofacial Surgery, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical Sciences, Okayama 700-8525, Japan.
Int J Surg Case Rep. 2017;31:30-34. doi: 10.1016/j.ijscr.2016.12.014. Epub 2017 Jan 3.
In recent years, patients with orthognathic surgery in middle-aged and elderly people have come to be a more frequent occurrence. Breast cancer is the most frequently diagnosed cancer in woman worldwide, and its prevalence rate is steadily increasing.
We report a case of a 47-year-old Japanese woman in whom left-side breast cancer (Stage 1) was unexpectedly found just before orthognathic surgery in April 2012. Breast-conserving surgery was performed (estrogen receptor+, progesterone receptor+, HER2 -, surgical margin+, sentinel lymph node +) that May. From June to August docetaxel (75mg/m) and cyclophosphamide (600mg/m) were administrated four times every 21days and thereafter radiotherapy (total 60Gy) was completed. The cancer surgeon declared the prognosis good and the patient had a strong desire to undergo orthognathic surgery, so in November we performed a bimaxillary osteotomy, and administration of tamoxifen began 6 weeks after the osteotomy.
There are breast cancer cases in which the prognosis is sufficiently good for a planned orthognathic surgery to proceed. Good communication among surgeons and the patient is important.
We experienced a case in which breast cancer was found just before the orthognathic surgery; we performed a bimaxillary osteotomy, including follow-up tamoxifen administration, during breast cancer treatment.
近年来,中老年患者接受正颌手术的情况越来越常见。乳腺癌是全球女性中最常被诊断出的癌症,其患病率正在稳步上升。
我们报告一例47岁日本女性病例,2012年4月在正颌手术前夕意外发现左侧乳腺癌(1期)。同年5月进行了保乳手术(雌激素受体阳性、孕激素受体阳性、人表皮生长因子受体2阴性、手术切缘阳性、前哨淋巴结阳性)。6月至8月,每21天给予多西他赛(75mg/m)和环磷酰胺(600mg/m),共4次,之后完成放疗(总计60Gy)。肿瘤外科医生宣布预后良好,且患者强烈希望接受正颌手术,因此11月我们进行了双颌截骨术,并在截骨术后6周开始服用他莫昔芬。
存在一些乳腺癌病例,其预后足以支持进行计划中的正颌手术。外科医生与患者之间的良好沟通很重要。
我们遇到一例在正颌手术前夕发现乳腺癌的病例;在乳腺癌治疗期间,我们进行了双颌截骨术,包括后续的他莫昔芬给药。