Contralateral Prophylactic Mastectomy and Prophylactic Salphingo-Oophorectomy in a BRCA1-Positive Breast Cancer Patient: A Case Report / 한국유방암학회지

Risk-reducing surgery is known as the most powerful preventive strategy for BRCA mutation carriers. This current case report represents the first documentation of the contralateral prophylactic mastectomy (CPM) and bilateral salphingo-oophorectomy (BSO) in a carrier of BRCA mutation in Korea. The patient was a 39-year-old woman who was seen in at a genetic counseling clinic for discussing of risk-reducing strategies for the breast and ovarian cancer. She presented at the age of 38 year with a 1.5 cm sized, grade 3, and ER/PR/HER2 negative infiltrating ductal carcinoma of the right breast. She was treated with wide local excision of the right breast and sentinel lymph node biopsy of the axilla. She was then treated with CAF (Cyclophosphamide+Doxorubicin+5-Fluorouracil) chemotherapy and radiation therapy. She was initially counseled at the time of surgery due to the family history of her mother, who suffered with breast cancer at the age of 58. After the completion of chemotherapy, we received the genetic test results and it was positive for the BRCA1 mutation (3746_3747insA). After a long discussion of cancer surveillance and risk-reducing options, she decided to undergo ipsilateral mastectomy and CPM and BSO. Before surgery, psychiatric consultation was done and questionnaires evaluating her depression, anxiety, body image, quality of life, and psychological distress were filled out. After discussion with the plastic surgeon, she decided to undergo delayed reconstruction of the breast. We performed endoscopic bilateral skin-sparing mastectomy and a laparoscopic bilateral salphingo-oophorectomy. There was no complication after surgery and the pathologic examination revealed no evidence of cancer in both breasts and ovaries. We think that CPM and BSO are feasible risk-reducing options for the breast cancer patients with the BRCA mutation in Korea.

A Case of Ovarian Mucinous Cystadenoma, Borderline Malignancy in Pediatric Patient

Ovarian tumors of an epithelial origin in pediatric age are uncommon and mucinous cystadenoma, borderline malignancy is extremely rare. We experienced a case of ovarian mucinous cystadenoma, borderline malignancy in a 14-year-old girl. She was admitted due to huge abdominal distension for 2 months. Her past history and family history were normal. The physical examination was normal except tense and distended abdomen. All laboratory findings were normal. On abdominal ultrasonography and CT scan, a huge cystic tumor filled with fluid and inner multiseptation was noted. Unilateral salphingo- oophorectomy was done and pathologic findings were compatible with ovarian borderline malignancy of mucionous cystadenoma. The postoperative course was uneventful.