Case Study | Published:

Breast cancer in a BRCA2 mutation carrier with a history of prostate cancer

Nature Reviews Clinical Oncology volume 6, pages 604607 (2009) | Download Citation

Abstract

Background. A 49-year-old patient with high-risk prostate cancer presented to a specialist. He was treated with neoadjuvant hormonal therapy for 6 months, followed by conformal radiotherapy. Three years later, he had a biochemical recurrence and commenced continuous luteinizing hormone-releasing hormone analog and antiandrogen therapy as part of a clinical trial. Aside from notable gynecomastia, he remained asymptomatic. He has a strong family history of breast cancer with multiple sisters affected.

Investigations. At 58 years of age, the patient underwent BRCA2 germline testing and was found to be a mutation carrier. Following post-test counseling, he was offered clinical breast examination, which was unremarkable except for gynecomastia. Baseline screening mammography identified a 4 mm cluster of microcalcifications and ductal carcinoma in situ (DCIS) was confirmed by stereotactic biopsy.

Diagnosis. DCIS in a male BRCA2 mutation carrier undergoing androgen deprivation therapy for prostate cancer.

Management. The patient was treated with bilateral mastectomy and no additional systemic therapy was recommended. This case report illustrates the importance of implementing screening mammography in male BRCA mutation carriers, particularly in those with a BRCA2 mutation.

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Acknowledgements

We would like to thank the Marvelle Koffler Breast Center at Mount Sinai Hospital, as well as the Department of Hematology and Medical Oncology at the University of Toronto for their continued support.

Désirée Lie, University of California, Irvine, CA is the author of and is solely responsible for the content of the learning objectives, questions and answers of the MedscapeCME-accredited continuing medical education activity associated with this article.

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Affiliations

  1. University of Toronto, Toronto, Ontario, Canada.

    • Seema Panchal
    • , Frances O'Malley
    • , Pavel Crystal
    • , Jaime Escallon
    •  & Juanita Crook
  2. Queen's University, Kingston, Ontario, Canada.

    • Orli Shachar
  3. Department of Pathology and Molecular Medicine, McMaster University, Hamilton, Ontario, Canada.

    • Anita Bane
  4. Department of Oncology, McMaster University, Hamilton, Ontario, Canada.

    • Louise Bordeleau

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Competing interests

The authors declare no competing financial interests.

Corresponding author

Correspondence to Louise Bordeleau.

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DOI

https://doi.org/10.1038/nrclinonc.2009.116

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