乳腺癌和共济失调基因突变毛细血管扩张:病例报告

Óscar Alejandro Bonilla Sepúlveda
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摘要

在妇女中,乳腺癌是世界上最常见的癌症,占所有癌症的25.7%,因此使其成为公共卫生感兴趣的话题。乳腺癌是一种复杂的异质性遗传疾病,在绝大多数情况下,病因不明。一般人群中约7%的乳腺癌病例存在孟德尔遗传的易感基因突变。共济失调毛细血管扩张突变(ATM)基因突变在不到1%的普通人群中被发现,与对照进行的关联研究表明,这些等位基因具有中等遗传癌症风险(RR: 2‐4)。ATM的突变不完全共分离该疾病,估计有15%的该基因突变携带者会患上癌症。ATM和其他中等风险基因的不完全外显率支持它们遵循癌症易感性的多基因模型。我们报告一例35岁女性诊断为异时性双侧乳腺癌- t4b N1 M0 iii期ib左乳和T1c N0 I期右乳,内在腔内B亚型,HER2过表达和ATM基因c.7913的致病性变异G>A, p. Trp2638* -患者行新辅助化疗,随后行乳房切除术、前哨淋巴结活检和放疗。本病例报告的目的是描述乳腺癌的临床病理特征及其与中危基因突变的关系
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Cáncer de mama y mutación del gen ataxia telangiectasia: reporte de caso
Among women, breast cancer is the most common cancer in the world, accounting for 25.7 % of all cancers and thus making it a topic of interest in public health. Breast cancer is a complex, heterogeneous genetic disease and, in the vast majority of cases, of unknown etiology. Around 7 % of breast cancer cases in the general population present a susceptibility gene mutation of Mendelian inheritance. The ataxia telangiectasia mutated (ATM) gene mutation is found in less than 1 % of the general population, and association studies conducted with controls have shown that these alleles are characterized by a moderate risk (RR: 2 ‐ 4) for hereditary cancer. Mutations in ATM incompletely cosegregate the disease, with an estimated 15 % of mutation carriers in this gene developing cancer. The incomplete penetrance of ATM, as well as other moderate‐risk genes, supports that they follow a polygenic model of cancer susceptibility. We report the case of a 35‐year‐old woman diagnosed with metachronous bilateral breast carcinoma—T4b N1 M0 stage IIIB left breast and T1c N0 stage I right breast, intrinsic luminal B subtype, HER2 overexpression and pathogenic variant of ATM gene c.7913 G>A, p. Trp2638*—who was treated with neoadjuvant chemotherapy, followed by mastectomy, sentinel node biopsy and radiotherapy. The objective of this case report is to describe the clinicopathological characteristics of breast cancer and its association with moderate‐risk gene mutations
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