New Delhi, Oct 1 (PTI) A 40-year-old Delhi woman diagnosed with triple-negative breast cancer was found to carry a BRCA1 gene mutation, prompting doctors to treat her existing cancer while also taking steps to reduce her risk of developing breast and ovarian cancer in the future.
The woman, identified as Sushma, underwent eight cycles of chemotherapy along with immunotherapy and responded well to the treatment, according to Apollo Athenaa Women’s Cancer Centre. Genetic testing was recommended because of her relatively young age and family history of breast cancer.
The tests found that she carried a mutation in the BRCA1 gene, which normally helps protect cells from developing cancer. Changes, or mutations, in this gene can significantly increase
a person’s risk of breast and ovarian cancers and can also raise the risk of cancer developing in the other breast.
Following detailed counselling, Sushma opted for a bilateral mastectomy, a surgery to remove both breasts, along with a sentinel lymph node biopsy on the affected side. The latter involves checking the first few lymph nodes to which cancer is most likely to spread, helping doctors determine whether the cancer has moved beyond the breast.
She also underwent a bilateral salpingo-oophorectomy, a preventive surgery in which both ovaries and fallopian tubes are removed to lower the risk of ovarian cancer associated with the BRCA1 mutation.
At the same time, she underwent immediate reconstruction of both breasts using tissue taken from her abdomen. This allowed the breast reconstruction to be carried out during the same surgical setting as the cancer and risk-reducing procedures.
“Mrs Sushma’s case required us to look beyond the cancer that was already present,” said Dr Geeta Kadayaprath, Principal Lead, Apollo Athenaa Women’s Cancer Centre.
She said the treatment plan combined treatment of the existing cancer with surgery to reduce the risk of future breast cancer, while reconstruction using abdominal tissue allowed both breasts to be rebuilt during the same operation.
The case also involved preventive gynaecological surgery because BRCA1 mutations are associated with a higher risk of ovarian cancer.
Dr Rupinder Sekhon, Principal Lead, Gynae-Oncology and Robotic Surgery, said the removal of both ovaries and fallopian tubes was performed as part of the woman’s risk-reduction strategy.
The surgery can cause early menopause because the ovaries produce hormones involved in the menstrual cycle. Women may experience symptoms such as hot flushes and mood changes and may also need monitoring for longer-term concerns such as bone health, she said.
The woman’s treatment involved specialists in medical oncology, which focuses on cancer treatment using medicines; breast surgical oncology, which deals with cancer-related breast surgery; genetic counselling; gynaecological oncology, which focuses on cancers of the female reproductive system; reconstructive surgery; and supportive care.
The hospital said the integrated approach was aimed at treating the existing cancer, reducing the woman’s future cancer risks, addressing preventive health needs and reconstructing the breasts as part of one coordinated treatment plan.
The case highlights the role of genetic testing and treatment involving multiple medical specialties in patients who may have an inherited risk of cancer, where treatment can involve not only the existing cancer but also measures to reduce future risks, reconstruction, reproductive health and long-term follow-up, the hospital said. PTI SGV SKY
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