Genetic Counseling in the Follow-up of Breast Cancer patients; Conversion of a Luminal Tumor to TNBC

Background: Triple-negative subtype does not have any of the receptors thatare commonly found in breast cancer. Patients suffering from Triple-negativebreast cancer are at risk of early metastasis and BRCA mutation. The conversion ofthe receptors during the metastatic progression or local recurrence of breast canceris a well-known topic that affects the therapeutic measures and outcome.Confirmation of immunohistochemistry is essential in these conditions, butgenetic evaluation is controversial.Question: Does the patient need genetics counseling in a conversion setting?And does the new specimen need CISH/FISH techniques to confirm TNBCtumors?Conclusion: There are no strong guidelines to recommend genetic counselingand BRCA testing for patients with breast cancer biomarkers conversion. Reassessingthe specimen for ER, PR, and HER-۲ is necessary for this setting.Case presentation: A woman suffering from primary luminal breast cancerpresented with femoral bone metastasis in the follow-up after two years. Bonemetastasis was compatible with the triple-negative subtype. This case wasdiscussed at the weekly breast multidisciplinary team session of the Department ofBreast Surgery, Tehran University of Medical Sciences.

Keywords:

Breast cancer , genetic counseling , triple negative , IHC , conversion