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Figure 3　Representative image of whole-body magnetic resonance imaging surveillanceFigure 4　Conceptualization of a long-term Li-Fraumeni syndrome surveillance system to be conducted in collaboration among departments. US, ultrasound; CS, colonoscopy; GS, gastroscopycancer, as it may affect treatment choices.Meanwhile, there are cases where the benefits to the patient exceed the harms in cancer treatment. The decision of whether or not to prescribe RTx in LFS patients with cancer relies on a delicate multi-disciplinary assessment of the risk of a second cancer (based on age and pathogenic variants, or whether heterozygous or in a state) and the onco-logical prognosis15).Surgical treatment in LFSTotal mastectomy should be the surgical treat-ment of choice for LFS. As for risk-reducing strat-egies, in HBOC, contralateral risk-reducing mastec-tomy (CRRM) is covered by insurance. However, CRRM is not recommended for breast cancer patients who have a mutation in a moderate-pene-trance breast cancer gene, and therefore an appli-cation to an ethics committee is required. As a rare disease, it is difficult to establish evidence regarding LFS, but we believe that it is necessary to provide medical care based on individual requests. In this case, the patient had a positive DCIS margin, which made it appropriate to perform a residual mastec-tomy16). The local recurrence rate is twice as high when the margin of DCIS is positive as when it is negative, and half of the patients with DCIS recur-rence will have invasive cancer, so complete resec-tion is recommended. Our case underwent reconstruction, and in recent years there have been increased warnings about breast-implant-associated anaplastic large 409