title: Problems with the use of breast conservation therapy for breast cancer in a patient with neurofibromatosis type 1: a case report.
abstract: Patients with neurofibromatosis type I and breast cancer represent a subset of people who may be considered at high risk for secondary cancers after conventional whole breast radiation therapy and breast conservation surgery. A case of a 49-year-old woman with neurofibromatosis type I is presented. She was diagnosed with a 1.1-cm right breast infiltrating ductal carcinoma. Clinical, diagnostic imaging, and pathologic features are discussed. Her initial treatment plan of breast conserving therapy was thwarted when her sentinel node biopsy was positive for micrometastatic disease in 1/14 lymph nodes. She elected to have a bilateral simple mastectomy. This case addresses the rare dilemma of offering breast conservation therapy as a viable option for patients with neurofibromatosis type I. Current data on radiation-induced secondary cancers such as sarcoma after treatment for breast and other cancers are reviewed.
authors.affiliation: Department of Surgery, Comprehensive Breast Cancer Program, H. Lee Moffitt Cancer Center and Research Institute, University of South Florida, Tampa, FL 33612, USA.
authors.forename: Danielle M
authors.initials: DM
authors.lastname: Hasson
authors.forename: Samira Y
authors.initials: SY
authors.lastname: Khera
authors.forename: Tammi L
authors.initials: TL
authors.lastname: Meade
authors.forename: Elisabeth L
authors.initials: EL
authors.lastname: Dupont
authors.forename: Harvey M
authors.initials: HM
authors.lastname: Greenberg
authors.forename: Nils M
authors.initials: NM
authors.lastname: Diaz
authors.forename: A Pat
authors.initials: AP
authors.lastname: Romilly
authors.forename: Charles E
authors.initials: CE
authors.lastname: Cox
mesh_terms: D001707:Biopsy, Needle; D001943:Breast Neoplasms / Q000150:complications* / Q000175:diagnosis / Q000628:therapy*; D018270:Carcinoma, Ductal, Breast / Q000150:complications* / Q000175:diagnosis / Q000628:therapy*; D005260:Female; D020022:Genetic Predisposition to Disease; D006801:Humans; D008327:Mammography; D008408:Mastectomy; D015412:Mastectomy, Segmental; D008875:Middle Aged; D009381:Neoplasms, Radiation-Induced / Q000209:etiology; D016609:Neoplasms, Second Primary; D009456:Neurofibromatosis 1 / Q000150:complications*; D018714:Radiotherapy, Adjuvant / Q000009:adverse effects; D021701:Sentinel Lymph Node Biopsy