Breast cancer in the young patients Case Story 31 years woman, - - PowerPoint PPT Presentation

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Aug 27, 2023 658 likes •800 views

th 5 Aarhus Workshop in: Department of Plastic and Breast Surgery Aarhus University Hospital Denmark Breast cancer in the young patients th 5 Aarhus Workshop in: Breast cancer in the young patients Case Story 31 years woman, nulli para.

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5 Aarhus Workshop in:

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Department of Plastic and Breast Surgery Aarhus University Hospital Denmark

Breast cancer in the young patients

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Aarhus University Hospital Region Midtjylland

5 Aarhus Workshop in:

Breast cancer in the young patients Case Story 31 years woman, nulli para. Palpable mass > 5 cm in the right breast.

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Aarhus University Hospital Region Midtjylland

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Mammogram and Histology - right

Malignant tumour > 40 mm. No sign of lymph node metastasis Core needle biopsy: Poorly differentiated ductal carcinoma, ER positive, Her2 normal.

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Aarhus University Hospital Region Midtjylland

5 Aarhus Workshop in:

Mammogram and Histology - left

5 mm suspicious microcalcifications. No sign of lymph node metastasis. Core needle biopsy: Mikro invasive focus and DCIS, ER pos, Her2 normal.

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Aarhus University Hospital Region Midtjylland

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Strategy

Treatment Genetics Fertility

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Aarhus University Hospital Region Midtjylland

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Treatment

Immediate Surgery? Neoadjuvant Therapy?

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Aarhus University Hospital Region Midtjylland

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Treatment strategy – Immediate surgery??

Surgery Removal of ovarian tissue for cryopreservation Adjuvant therapy Genetic testing

Further surgery??

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Aarhus University Hospital Region Midtjylland

5 Aarhus Workshop in:

Treatment strategy – Neoadjuvant therapy

Sentinel node Removal of ovarian tissue for cryopreservation Neoadjuvant therapy Genetic testing Surgery

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Aarhus University Hospital Region Midtjylland

5 Aarhus Workshop in:

Treatment scedule

MRI Tumor marking with coils Bilateral sentinel node biopsy Ovarian tissue for CRYO Neoadjuvant Therapy Genetic testing Surgery

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Aarhus University Hospital Region Midtjylland

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Treatment surveillance

4 series of EC 4 series of docetaxel MRI after 2nd 7th treatment

Tumor size mm:
Before treatment: 37 x 35 x 30
After 2nd: 30 x 25 x 29
After 7th.: 24 x 16 x 22

Final surgery

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Aarhus University Hospital Region Midtjylland

5 Aarhus Workshop in:

”Accelerated” genetic testing

The test results ready after 2 months, before the end of chemotherapy. No family history of breast or ovarian cancer. Genetic testing for BRCA1, BRCA2 and PTEN Results: BRCA2 mutation

(De novo mutation - none of the parents are carriers of the mutation).

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Aarhus University Hospital Region Midtjylland

5 Aarhus Workshop in:

Surgery

Bilateral Mastectomy with immediate rekonstruction, with

Implants and ADM.

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Aarhus University Hospital Region Midtjylland

5 Aarhus Workshop in:

Fertility !

Wants to be pregnant: After 2 years of Tamoxifen, pause - Admitted to Fertility clinic:

IVF with PGD (Pre-implantation Genetic Diagnosis).