Conversion to a leadless pacemaker enabled safe left total mastectomy and axillary lymph node dissection with pacemaker resection in a patient with breast cancer located directly above an implanted pacemaker, with no recurrence at 2 years.
Case Report (n=1)
No
Conversion to a leadless pacemaker is a viable and safe strategy to facilitate surgical resection in patients with breast cancer located near or directly above a conventional pacemaker generator.
症例は79歳，女性．主訴は左乳房2時方向の腫瘤を自覚．20年前に右乳癌に対し右乳房全切除術，16年前に不整脈に対し左前胸部にペースメーカー（pm）植込み術施行の既往があった．身体所見上，自覚部位の他に植込み型pm直上にも硬結を触知した．超音波所見では，乳房2時方向に皮膚浸潤を伴う低エコー腫瘤およびpm直上にも低エコー腫瘤を認めた．2時方向腫瘤から施行した針生検では，浸潤性乳管癌の診断であった．fdg-Petにて，pm直上腫瘤にも主腫瘤と同様に集積を認め，pm同側の多発乳癌の診断となった．リードレスpmへ変更した後，pmを合併切除する形で左乳房全切除術および腋窩リンパ節郭清術を施行した．病理ではpm直上腫瘤も独立した浸潤癌であり，切除断端は陰性であった．高齢化に伴いpm合併乳癌は増加することが予測され，治療方法の決定には個々に応じた対応が必要となる．pm合併乳癌の診断・治療につき，文献的考察を交え報告する．
Asada et al. (Sun,) conducted a case report in Breast cancer located directly above an implantable pacemaker (n=1). Conversion to leadless pacemaker and surgical resection was evaluated on Surgical success and recurrence. Conversion to a leadless pacemaker enabled safe left total mastectomy and axillary lymph node dissection with pacemaker resection in a patient with breast cancer located directly above an implanted pacemaker, with no recurrence at 2 years.
Synapse has enriched 5 closely related papers on similar clinical questions. Consider them for comparative context: