Soleimani Tahereh, Engwall Abigail J, Bourdon Corrie, Torabi Mohammad A, Fortes Thais
MSU/Sparrow Surgery, Lansing, Michigan, USA.
Sparrow Health System, Lansing, Michigan, USA.
Breast Care (Basel). 2022 Feb;17(1):85-89. doi: 10.1159/000513679. Epub 2021 Mar 8.
Breast cancer (BC) is the most common non-skin cancer affecting women but is extremely uncommon in the adolescent population. Genetic inheritance has been linked to <10% of BCs. is an uncommon genetic variant with a reported incidence of 0.3-1.6% in the general population and 4.9-5.7% in those with a family history of BC. Commonly, this mutation presents in females of European descent and is rare in North America.
A 19-year-old Caucasian female presented with breast pain and mass. She had an extensive family history of cancer, as well as a known gene mutation in 2 of her paternal aunts. Ultrasound and MRI confirmed a 4.5-cm mass with an enlarged right axillary lymph node. Image guided biopsy of the breast mass showed ER/PR-positive grade 1 invasive mucinous ductal cancer. Genetic testing confirmed an isolated mutation. After discussion by a multidisciplinary tumor board, the patient deferred bilateral mastectomy and underwent a right mastectomy with sentinel-lymph-node biopsy and immediate tissue-expander reconstruction. Final pathology confirmed ER/PR-positive Stage 1A (pT2 pN0 M0) invasive mucinous carcinoma. Chemotherapy was not recommended.
Malignant adolescent breast masses are relatively rare and does not typically present at younger than 20 years of age. While there are many different differential diagnoses when evaluating an adolescent with a breast mass, we wish to increase providers' suspicion of malignancy, specifically in those individuals who have a strong family history of BC and the *1100delC mutation.
乳腺癌(BC)是影响女性的最常见非皮肤癌,但在青少年人群中极为罕见。遗传因素与不到10%的乳腺癌有关。 是一种罕见的基因变异,在普通人群中的报道发病率为0.3 - 1.6%,在有乳腺癌家族史的人群中为4.9 - 5.7%。通常,这种突变出现在欧洲血统的女性中,在北美较为罕见。
一名19岁的白种女性因乳房疼痛和肿块就诊。她有广泛的癌症家族史,并且已知其两位父系姑姑携带 基因突变。超声和磁共振成像(MRI)证实有一个4.5厘米的肿块以及右侧腋窝淋巴结肿大。乳房肿块的影像引导活检显示雌激素受体/孕激素受体(ER/PR)阳性1级浸润性黏液导管癌。基因检测证实存在孤立的 突变。经过多学科肿瘤委员会讨论后,患者推迟了双侧乳房切除术,接受了右侧乳房切除术加前哨淋巴结活检及即刻组织扩张器重建术。最终病理证实为ER/PR阳性1A期(pT2 pN0 M0)浸润性黏液癌。不建议进行化疗。
青少年恶性乳房肿块相对罕见, 通常不在20岁以下出现。在评估有乳房肿块的青少年时,虽然有许多不同的鉴别诊断,但我们希望提高医疗人员对恶性肿瘤的怀疑,特别是在那些有强烈乳腺癌家族史且携带*1100delC突变的个体中。