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A woman in her 30s presented to our hospital with the chief complaint of a right breast mass after the birth of her first child. She was diagnosed as having right invasive ductal carcinoma of Luminal-B type and T3N3cM0, stage Ⅲc. While undergoing neoadjuvant chemotherapy, she received genetic counseling and underwent genetic testing and was determined to have deleterious BRCA1 and BRCA2 mutations. After completing chemotherapy, she underwent a right total mastectomy and axillary lymph node dissection. Two years postoperatively, she requested to undergo a contralateral risk-reducing mastectomy( CRRM)of her left breast. Therefore, CT and breast MRI were performed to confirm the absence of contralateral lesions and distant metastases, and subsequently, CRRM was performed. Postoperative pathology results showed non-invasive ductal carcinoma lesions at 5 sites. In the case of hereditary breast and ovarian cancer syndrome such as in this study, lesions may be discovered at an early stage by performing risk-reducing mastectomy.

The patient was a 50-year-old woman. She had been diagnosed with bilateral breast tumors at another hospital 5 years previously and was followed up every 2 months. Ultrasonography showed hypoechoic masses in her breasts. The largest tumor in the right breast was 15mm in diameter and located in region A, while that in the left breast was 8mm in diameter and located in region B. Magnetic resonance imaging(MRI)showed multiple bilateral breast tumors. The largest tumor was 12mm in diameter and was suggestive of breast cancer. Core needle biopsies(CNB)of the largest tumors in both breasts were performed. Intraductal papilloma(IDP)and low-grade intraductal papillary carcinoma were diagnosed in the right and left breasts, respectively, on immunohistochemical staining. We performed left nipple-sparing mastectomy with sentinel lymph node biopsy and right tumor excision for diagnoses of carcinoma of the left breast(cTisN0M0)and IDP of the right breast. The histopathological diagnosis of the left breast tumor was pT1aN0M0, triple negative breast cancer with extensive intraductal components, and that of the right breast tumor was IDP with atypical ductal hyperplasia. Chemotherapy was administered postoperatively. Several studies have reported that peripheral IDP often coexists with or follows the development of carcinoma. Therefore, we should also closely follow-upthe patient's right breast.

Background: With the recent rise in mammography (MMG) screenings there has been an increase in the identification of microcalcifications without lump. Therefore, a vacuum-assisted needle biopsy under stereotactic guidance (ST-MTB) is frequently performed for diagnosis. However, ST-MTB is a highly invasive examination. In this study, we investigated the effectiveness of utilizing contrast-enhanced magnetic resonance imaging (MRI) to differentiate between benign and malignant category 3 (C3) calcifications., Materials and Methods: One hundred and sixty-eight patients with microcalcifications underwent contrast-enhanced MRI prior to ST-MTB in our hospital. Their MRI scans were reviewed to determine whether the contrast-enhanced MRI findings were consistent. We calculated the sensitivity, specificity, positive predictive value (PPV) and negative predictive value (NPV) of contrast-enhanced MRI., Results: No malignancy was not found in the 51 of the 168 cases analyzed by MRI. The calculated sensitivity, specificity, PPV and NPV of contrast-enhanced MRI were 84%, 82%, 58% and 95%, respectively., Conclusion: Contrast-enhanced MRI for Category 3 calcified lesions would be a useful diagnostic tool for identifying ST-MTB-indicated patients., (Copyright© 2014 International Institute of Anticancer Research (Dr. John G. Delinassios), All rights reserved.)