Gmur Maksym K, Gajewski Michal, Goliat Weronika, Haraziński Konrad, Dalski-Szelag Przemyslaw R, Jastrzebska Izabela, Sławińska Barbara, Maryniak Nicole, Sysło Oliwia, Błecha Zuzanna, Rubik Nikola
Medicine, Provincial Hospital in Poznań, Poznań, POL.
Internal Medicine, Międzyleski Specialized Hospital in Warsaw, Warsaw, POL.
Cureus. 2025 Aug 9;17(8):e89666. doi: 10.7759/cureus.89666. eCollection 2025 Aug.
We present the case of a 45-year-old Caucasian woman diagnosed with synchronous bicentric breast cancer of differing molecular phenotypes in the same breast. The first tumor, an invasive ductal carcinoma (G1), was estrogen and progesterone receptor-positive and HER2-negative, with a low proliferative index (Ki67 10%). A second lesion, located in a different quadrant and appearing within weeks after biopsy, exhibited a triple-negative phenotype and a higher proliferative index (Ki67 30%). Both tumors were classified as stage IA. Due to the multicentric nature of disease, the patient underwent mastectomy with sentinel node biopsy and immediate reconstruction. Genetic testing was negative for BRCA1/2, CHEK2, and PALB2 mutations, though familial cancer history suggested a possible hereditary syndrome (FCC suspicion). This case underscores the complexity of managing multicentric breast cancer with discordant receptor status and raises questions about the role of biopsy sites in tumor development.
我们报告了一例45岁的白种女性病例，该患者被诊断为同一侧乳房内具有不同分子表型的同步双中心性乳腺癌。第一个肿瘤为浸润性导管癌（G1级），雌激素和孕激素受体阳性，HER2阴性，增殖指数较低（Ki67为10%）。第二个病灶位于不同象限，在活检后数周内出现，表现为三阴性表型且增殖指数较高（Ki67为30%）。两个肿瘤均被分类为IA期。由于疾病的多中心性质，患者接受了乳房切除术并进行前哨淋巴结活检及即刻重建。BRCA1/2、CHEK2和PALB2基因检测均为阴性，尽管家族癌症病史提示可能存在遗传性综合征（疑似家族性癌症综合征）。该病例突显了管理受体状态不一致的多中心性乳腺癌的复杂性，并引发了关于活检部位在肿瘤发生发展中作用的疑问。
