What happened, in summary

A woman in her late 40s had been diagnosed with bilateral breast cancer in her late 30s. She had a strong family history that included pancreatic cancer in her father, ovarian cancer in her mother, and breast cancer in her sister. Her breast surgery consisted of partial mastectomy with sentinel lymph-node biopsy. Pathology showed stage I invasive ductal carcinoma, classified as pT1N0M0, and the tumor was described as triple-negative.

After surgery, she received radiotherapy and then took tegafur-uracil for 2 years. Follow-up showed no evidence that the breast cancer had returned. Although hereditary breast and ovarian cancer was strongly suspected from her personal and family history, she initially declined BRCA testing because she feared learning that she might develop another cancer.

Later gynecologic screening identified ovarian cancer, and subsequent testing confirmed a germline BRCA1 pathogenic variant. The ovarian cancer required its own surgery and systemic therapy. Her earlier breast cancer remained without recurrence after surgery, radiation, and 2 years of oral chemotherapy.