A Case of Bilateral Breast Cancer with Congenital Absence of the Left Pectoralis Muscles

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  • OKI Toyokazu
    Breast Center, Kochi Medical School Hospital Department of Surgery, Kochi Medical School
  • SUGIMOTO Takeki
    Breast Center, Kochi Medical School Hospital Department of Surgery, Kochi Medical School
  • OKADA Iyo
    Breast Center, Kochi Medical School Hospital Department of Surgery, Kochi Medical School
  • OGAWA Maho
    Breast Center, Kochi Medical School Hospital Department of Surgery, Kochi Medical School
  • DABANAKA Ken
    Department of Surgery, Kochi Medical School
  • HANAZAKI Kazuhiro
    Department of Surgery, Kochi Medical School

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Other Title
  • 先天性左胸筋欠損症が併存した両側多発乳癌の1例
  • センテンセイ サ キョウキン ケッソンショウ ガ ヘイソン シタ リョウガワ タハツ ニュウガン ノ 1レイ

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Abstract

<p>The congenital absence of the pectoralis muscles with breast cancer is quite rare. We report a case of bilateral breast cancer with congenital absence of the left pectoralis muscles in a 49-year-old woman who was operated on for a brain tumor at age 8 and was suspected of bilateral breast cancer during cancer screening. On pathological examination, the tumors were found to be invasive ductal carcinomas (IDC) measuring 2.2 cm and 1.7 cm in the left breast and 1.4 cm and 0.9 cm in the right breast. A bilateral modified radical mastectomy was performed. During surgery, the complete absence of the pectoralis major and minor was noted on the left side, the left axillary vein was close to the mammary gland, and the pectoral nerve was absent. On the right side, the pectoralis muscles were intact. Postoperative histology revealed IDC that stained positive for ER and PgR and negative for HER2, and the Ki-67 labeling index was 1% in the left breast (pT1cpN2aM0 pStage IIIA) and 2% in the right (pT2pN1aM0 pStage IIB). A heredity neoplasm syndrome like Li-Fraumeni syndrome could be considered due to her brain tumor and bilateral breast cancer, and genetic testing might be necessary to decide on the use of radiation therapy. However, radiation therapy was not performed due to a bone fracture in her right upper arm. Therefore, when performing breast cancer operations in patients with congenital absence of the pectoralis muscles, it is necessary to pay attention to the unusual surgical orientation.</p>

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