51 year old lady presents with a right breast mass Family history of mother succumbing to Carcinoma breast at the age of 61
Mammogram BIRAD 5
Needle biopsy IDH : SCORE 7 : Grade 2 : No peri neural lymphatic invasion : suspicious lymphatic invasion : ER Negative PR Negative Her2 Suspicious FISH Negative
PET CT Organ limited No evidence of distant or lymphnodes hot spots
Therapeutic suggestion : NACT with clip localisation and chaemoport : sentinel node identification with dual tracer : peroperative margin clearance along with sentinel node clearance : wide excision of mass along with cosmetic flap
Post surgical followup with CTRT
The elevent microphotographs , the reports of FISH for Her2 , the mammogram and are in the trail
Would a BRCA 1/2 assessment be necessary for immunotherapy ?
Reference :
Utility BRCA 2 in familial breast cancers
https://www.linkedin.com/pulse/genewise-3-case-study-brca2-associated-hereditary-genevolve
Reference
Guidelines for hereditary breast cancers
https://drive.google.com/file/d/1DWX82NBm4iX7Xbt2MCId5aArKHW_3PvX/view?usp=drivesdk