Primary multiple breast cancer (complex radiological and molecular-genetic diagnosis)

The modern mammography, ultrasound and other diagnostic methods allow to diagnose early stage breast cancer (BS) with high clinical accuracy. However, specificity of these methods is low to provide preoperative assessment of lymphogenic tumor spread. Standard volume of lympadenectomy according to preoperative US examination of axillary lymph nodes can be too aggressive and can be accompanied by side effects because of prolonged lymphorhea. Sentinel lymph node (SLN) is considered as the method of chose for early BC staging. Purpose: analysis of the effectiveness of complex radiological and molecular-genetic study of women with PMBC to select the rational treatment strategy. Experimental design: 107 patients with PMBC, who underwent the complex radiological diagnostics and molecular-genetic testing for the presence of hereditary mutations in the genes BRCA1/2, were included in this investigation. Results: When the first cancer is diagnosed in patients older than forty years, the risk of the second (metachronous) cancer is 25%. If the first cancer occurs before the age of forty, the risk of the second cancer is approximately 60%. PMBC is more frequent among BRCA1/2 mutation carriers in comparison with the patients from the general population. Conclusion: The high percentage of hereditary mutation carriers among patients with PMBC implies the necessity of the molecular-genetic analysis. The results of the analysis may help to choose the proper treatment option with the personalized approach.