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1.
Gan To Kagaku Ryoho ; 51(4): 460-462, 2024 Apr.
Article in Japanese | MEDLINE | ID: mdl-38644322

ABSTRACT

Recently, the cases of breast augmentation for cosmetic purposes are rapidly increasing, there are more opportunities to examine for patient with breast augmentation history than before. In some cases, breast cancer screening is difficult due to the effects of breast augmentation. At our clinic, even in cases diagnosed with breast cancer after breast augmentation, we actively perform immediate breast reconstruction using silicone implant. However, it is necessary to consider the condition and type of breast augmentation at the time of diagnosis and also treatment. We will share our algorithm for immediate breast reconstruction using silicone implant for breast cancer after augmentation mammaplasty.


Subject(s)
Algorithms , Breast Implants , Breast Neoplasms , Mammaplasty , Humans , Breast Neoplasms/surgery , Female , Mammaplasty/methods , Silicones
2.
Gan To Kagaku Ryoho ; 48(3): 452-454, 2021 Mar.
Article in Japanese | MEDLINE | ID: mdl-33790185

ABSTRACT

The purpose of our study was to test the efficacy and toxicity of palbociclib therapy for breast cancer treatment. Ten patients diagnosed with breast carcinoma were selected for this retrospective study between 2017 and 2018. After the patients had previously been administered palbociclib, they received either capecitabine or eribulin. As a result, the median PFS of capecitabine and eribulin were 6.4 months(3-10)and 5.8 months(4-7), respectively. Therefore, the treatment administered after palbociclib therapy may be useful for breast cancer patients.


Subject(s)
Breast Neoplasms , Antineoplastic Combined Chemotherapy Protocols/adverse effects , Breast Neoplasms/drug therapy , Humans , Piperazines/therapeutic use , Postmenopause , Pyridines , Receptor, ErbB-2 , Retrospective Studies
3.
Gan To Kagaku Ryoho ; 48(3): 455-456, 2021 Mar.
Article in Japanese | MEDLINE | ID: mdl-33790186

ABSTRACT

Breast cancer patient(invasive ductal carcinoma, ER[+], PgR[+], HER2[3+], Ki-67: 30%)had neoadjuvant chemotherapy( FEC followed by docetaxel plus trastuzumab). After surgical operation(mastectomy and Ax)was performed and she received trastuzumab plus hormone therapy. After 2 years later, she had liver metastasis that showed IDC, ER(+), PgR (+), HER2(-). In addition, BRCA positive was shown. Therefore, the patient received olaparib tablets(300 mg twice daily). After 2 months later, liver metastasis reduced dramatically.


Subject(s)
Breast Neoplasms , Antineoplastic Combined Chemotherapy Protocols/therapeutic use , Breast Neoplasms/drug therapy , Breast Neoplasms/surgery , Female , Humans , Mastectomy , Neoadjuvant Therapy , Phthalazines , Piperazines , Receptor, ErbB-2 , Trastuzumab/therapeutic use
4.
Gan To Kagaku Ryoho ; 47(3): 540-541, 2020 Mar.
Article in Japanese | MEDLINE | ID: mdl-32381942

ABSTRACT

We present the case of an 88-year-old woman who had undergone breast conserving surgery for left breast cancer 8 years ago.She received postoperative radiotherapy(total dose of 60 G/30 Fr)to the residual breast together with endocrine therapy.She underwent skin biopsy after having had a red skin tumor in the left breast.Angiosarcoma was diagnosed and chemotherapy and radiotherapy were initiated.The patient is alive without recurrence 8 months after chemotherapy.


Subject(s)
Breast Neoplasms/etiology , Hemangiosarcoma/etiology , Neoplasms, Radiation-Induced , Aged, 80 and over , Female , Humans , Neoplasm Recurrence, Local
5.
Gan To Kagaku Ryoho ; 46(2): 378-379, 2019 Feb.
Article in Japanese | MEDLINE | ID: mdl-30914566

ABSTRACT

BACKGROUND: Breast carcinoma and precancer are thought to start in the lining of the milk duct or lobule. Ductography and fiberoptic ductoscopy have beenadvocated as the mainprocedures inpatien ts with nipple discharge. METHODS: We investigated the usefulness of microdochectomy(MD)by using indocyanine green(ICG)fluorescence imaging. ICG and indigo carmine were injected into the mammary duct. A periareolar incision was made, and a fluorescence image of the demarcated mammary duct segment was obtained. CONCLUSION: MD using indocyanine green fluorescence imaging is a useful procedure in guiding subsequent breast surgery in the treatment of nipple discharge.


Subject(s)
Breast Neoplasms , Endoscopy , Nipple Discharge , Breast Neoplasms/diagnosis , Humans , Mastectomy, Segmental , Nipples
6.
Gan To Kagaku Ryoho ; 45(4): 725-727, 2018 Apr.
Article in Japanese | MEDLINE | ID: mdl-29650848

ABSTRACT

Foul smell and large amounts ofexudate, bleeding are the most common and serious symptoms with locally advanced breast cancer(LABC). Mohs' paste is made ofa mixture ofzinc chloride and used for treatment ofmalignant skin tumors. Recently some reports show that Mohs' paste is useful for treatment of malignant tumor including unresectable breast cancer and skin metastasis ofcancer. Mohs' paste is useful for reducing symptoms such as foul smell and exudate, Bleeding. We report a successful case of treatment for LABC with using Mohs' paste and chemotherapy and surgery.


Subject(s)
Adenocarcinoma, Mucinous/drug therapy , Antineoplastic Combined Chemotherapy Protocols/therapeutic use , Breast Neoplasms/drug therapy , Chlorides/therapeutic use , Zinc Compounds/therapeutic use , Adenocarcinoma, Mucinous/surgery , Aged , Breast Neoplasms/pathology , Breast Neoplasms/surgery , Combined Modality Therapy , Female , Humans , Mastectomy
7.
Gan To Kagaku Ryoho ; 45(2): 321-323, 2018 Feb.
Article in Japanese | MEDLINE | ID: mdl-29483434

ABSTRACT

Advanced breast cancer has a poor prognosis compared to early breast cancer; however, quality of life and radical operation can be improved in some case by using multidisciplinary treatment. A 54-year-old woman was examined at the hospital because of an enlarging tumor in the left breast. She was aware of a lump for 3 years. Results of the initial examination indicated invasive ductal carcinoma with liver metastasis. She first received chemotherapy(AC followed by weekly paclitaxel). After 4 courses of weekly paclitaxel, computed tomography revealed axillary lymph nodes involved in the axillary vein. Operation was difficult and conversion therapy was administered. The patient underwent radiotherapy, hyperthermia, and hormone therapy. After 1 year from the start of hormone therapy, the metastasis had disappeared and the patient underwent operation in our unit. Eight months after operation, no recurrence was observed.


Subject(s)
Breast Neoplasms/therapy , Liver Neoplasms/therapy , Biopsy, Needle , Breast Neoplasms/pathology , Chemoradiotherapy , Female , Fever , Humans , Liver Neoplasms/secondary , Mastectomy , Middle Aged
8.
Gan To Kagaku Ryoho ; 45(13): 2177-2179, 2018 Dec.
Article in Japanese | MEDLINE | ID: mdl-30692323

ABSTRACT

A69 -year-old woman was diagnosed as having local advanced breast cancer. She was treated with neoadjuvant chemotherapy( AC followed by paclitaxel)and followed up with left total mastectomy with axillary lymphadenectomy for breast cancer(pT3N1aM0, Stage ⅢA, ER positive, PgR positive, and HER2 negative). She received adjuvant therapy with chest wall irradiation and an aromatase inhibitor. Two years after the mastectomy, mediastinal lymph node and rib metastases and dissemination appeared. We changed the regimen to capecitabine. She continued the capecitabine therapy for 7 years and was found to have multiple lung metastasis. Therefore, we chose eribulin mesylate therapy. Ten days after eribulin mesylate (1.0mg/body)was first administered, she suddenly had difficulty breathing, and chest CT revealed left low lobe atelectasis. The superior mediastinal lymph node had grown rapidly and compressed the left main bronchus and superior vena cava. To reduce the lymph node size, we started radiotherapy(50 Gy/25 Fr)for the superior mediastinal area in addition to the eribulin mesylate therapy. After the radiotherapy, chest CT revealed a remarkable reduction of lymph node size and full pulmonary reexpansion. One year after the radiotherapy, she is continuing treatment without systemic progression.


Subject(s)
Antineoplastic Combined Chemotherapy Protocols , Breast Neoplasms , Lymphatic Metastasis , Aged , Antineoplastic Combined Chemotherapy Protocols/therapeutic use , Breast Neoplasms/pathology , Breast Neoplasms/therapy , Female , Furans , Humans , Ketones , Lymph Nodes , Lymphatic Metastasis/radiotherapy , Mastectomy
9.
Mol Clin Oncol ; 6(2): 255-257, 2017 Feb.
Article in English | MEDLINE | ID: mdl-28357105

ABSTRACT

Everolimus, a mammalian target of rapamycin inhibitor, has recently been approved for the treatment of metastatic estrogen receptor-positive breast cancer, at a daily dose of 10 mg in combination with exemestane. Osteonecrosis of the jaw (ONJ) is a rare but severe condition, characterized by exposed necrotic bone, and is associated with various drugs that are often used to treat advanced malignancies. We herein report the case of a patient with breast cancer who developed ONJ during treatment with everolimus, which improved after discontinuation of the drug. To the best of our knowledge, this is the first reported case of everolimus-associated ONJ in a patient receiving everolimus for metastatic breast cancer. In 2014, an 80-year-old woman was started on treatment with everolimus and exemestane for stage IIB estrogen receptor-positive breast cancer. Within 2 months, the left side of her face became edematous, with localized heat and tenderness of the left mandibular region and a 3-mm round area of exposed bone. There was purulent discharge and the surrounding gingiva was edematous and erythematous. The left mandible exhibited a low signal intensity area on T1-weighted magnetic resonance imaging. Treatment was discontinued and ONJ showed improvement after 2 months. Therefore, when prescribing everolimus for metastatic breast cancer, oncologists should be aware of the possibility of ONJ as a complication.

10.
J Patient Rep Outcomes ; 1(1): 8, 2017.
Article in English | MEDLINE | ID: mdl-29757296

ABSTRACT

BACKGROUND: The US National Cancer Institute (NCI) has developed the Patient-Reported Outcomes version of the Common Terminology Criteria for Adverse Events (PRO-CTCAE) to capture patients' self-reported symptomatic adverse events in cancer clinical trials. The aim of this study was to develop and linguistically validate a Japanese translation of PRO-CTCAE. Forward- and back-translations were produced, and an independent review was performed by the Japan Clinical Oncology Group (JCOG) Executive Committee and the US NCI. We then conducted cognitive interviews with 21 patients undergoing cancer treatment. Participants were asked to complete the PRO-CTCAE and were interviewed using semi-structured scripts and predetermined probes to investigate whether any items were difficult to understand or answer. The interviews were recorded and transcribed, and a thematic analysis was performed. The data were split into two categories: 1) remarks on the items and 2) remarks on the questionnaire in general. RESULTS: Twenty-one cancer patients undergoing chemotherapy or hormone therapy were interviewed at the University of Tokyo Hospital and the Kansai Medical University Hirakata Hospital during 2011 and 2012. Thirty-three PRO-CTCAE items were evaluated as "difficult to understand," and 65 items were evaluated as "difficult to answer" by at least one respondent. However, on further investigation, only 24 remarks were categorized as "comprehension difficulties" or "clarity" issues. Most of these remarks concerned patients' difficulties with rating their experience of individual symptomatic events. CONCLUSIONS: The study provides preliminary evidence supporting the linguistic validity of the Japanese version of PRO-CTCAE. Further cognitive interviewing is warranted for PRO-CTCAE items relating to sexuality and anxiety and for response options on severity attribute items.

11.
Gan To Kagaku Ryoho ; 44(12): 1358-1360, 2017 Nov.
Article in Japanese | MEDLINE | ID: mdl-29394633

ABSTRACT

The patient was a 71-year-old woman with ER(+), PgR(-), HER2(3+), and Ki-674 2% breast cancer. After surgery for left breast cancer(Bt+Ax), epirubicin, cyclophosphamide therapy was administered as postoperative adjuvant chemotherapy, and nabPTX plus trastuzumab therapy was started sequentially. The patient was hospitalized due to severe neutrope- nia(neutrophils 0/mm3)from nabPTX, but her condition stabilized after admission. However, the patient suddenly went into shock after 3 days and was thus transferred to the ICU. Her general condition was rapidly improved through cytokine adsorption therapy in the ICU. After 5 days, she was extubated and wheeled back to a general ward. She was discharged without problems in the succeeding months. In this case, FN or cardiovascular diseases was ruled out, and engraftment syndrome was considered given that cytokine adsorption therapy significantly improved the patient's condition. Considering the risk for severe neutropenia in nabPTX administration, clinicians should exercise caution when administering the drug.


Subject(s)
Albumin-Bound Paclitaxel/adverse effects , Antineoplastic Combined Chemotherapy Protocols/therapeutic use , Breast Neoplasms/drug therapy , Catecholamines/therapeutic use , Cytokines/chemistry , Drug Hypersensitivity/therapy , Aged , Albumin-Bound Paclitaxel/administration & dosage , Catecholamines/chemistry , Female , Humans , Treatment Outcome
12.
Gan To Kagaku Ryoho ; 44(12): 1503-1505, 2017 Nov.
Article in Japanese | MEDLINE | ID: mdl-29394682

ABSTRACT

BACKGROUND: Strut adjusted volume implant(SAVI)was approved by the Food and Drug Administration(FDA)for the treatment of breast cancer in 2006. MATERIAL AND METHODS: The phase II study was conducted to investigate the activity and safety of SAVI in breast cancer patients. Criteria for SAVI treatments were N0, T<2 cm, and age≥40. After patients underwent breast-conserving surgery, they received SAVI twice a day×5 days(34 Gy). The primary endpoint are feasibility and safety. Second endpoint are local recurrence rate and cosmesis. RESULTS: Three patients were enrolled and the median duration of administration is 18.7 days(17-20). Further, the most common treatment-related adverse events were thickening and redness of skin(grade 1/2), while there was no deformity of breast in each case. CONCLUSION: The current study demonstrated that SAVI is well tolerated treatment in breast cancer patients and may be convenient for use in patient treatment.


Subject(s)
Breast Implants , Breast Neoplasms/surgery , Patient Satisfaction , Aged , Breast Neoplasms/radiotherapy , Female , Humans , Mastectomy, Segmental , Middle Aged , Multimodal Imaging , Radiotherapy Dosage
13.
Gan To Kagaku Ryoho ; 44(12): 1979-1981, 2017 Nov.
Article in Japanese | MEDLINE | ID: mdl-29394840

ABSTRACT

We introduced stereotactic mammotome biopsy(ST-MMT)for the purpose of screening and other institutions. There are many benign cases to be diagnosed by pathological findings, so it is thought to be necessary to examine the adaptation of STMMT again. We examined the performance of ST-MMT in a case of a non-palpating calcification lesion. Between August 2013 and December 2016, ST-MMT biopsies were performed for 247 microcalcified lesions revealed by mammography(in both breasts in 9 patients; twice in the ipsilateral breast in 2 patients). The mean age of all patients was 46 years(range, 24- 89 years). We found 39 cases(15.8%)of breast cancer. A final diagnosis of breast cancer was made in 39 patients, who comprised 0% of those with Category 2, 53.8% of those with Category 3, 35.9% of those with Category 4, and 10.3% of those with Category 5. Regarding the morphology and distribution of microcalcifications, breast cancer accounted for 46.2%, 5.1%, 2.6%, 35.9%, 7.7%, and 2.6% of the cases with small round/clustered, amorphous/clustered, pleomorphic/clus- tered, pleomorphic/linear segmental, and fine linear/clustered patterns, respectively. Also, we examined each of the patients, (1) who underwent mammography for medical examinations, (2) who underwent mammography performed at other institutions, (3) who underwent follow-up for microcalcifications and postoperative follow-up mammography. The proportions of breast cancer diagnoses were (1) 11.4%, (2) 20.6%, and (3) 7.1%. Proportions of Category 3 breast cancer were (1) 10.3%, (2) 38.5%, and (3) 5.1%. Among the cases in which ST-MMT was performed in this study, Category 3 accounted for more than half. However, 10.9%(21/192 lesions)were diagnosed as malignant in Category 3. The diagnosis of breast cancer in pa- tients who underwent mammography performed at other institutions was not observed in 79.4%(104/131 lesions), and among the 104 lesions, as a result of reassessment of calcification in our hospital, Category 2 was also included. Calcification in Category 2 lesions was benign in all cases. It was suggested that the indication for ST-MMT biopsy could be further narrowed down by being careful not to over-diagnose.


Subject(s)
Breast Neoplasms/diagnostic imaging , Breast Neoplasms/pathology , Calcinosis/diagnostic imaging , Adult , Aged , Aged, 80 and over , Biopsy , Humans , Mammography , Middle Aged , Young Adult
14.
Gan To Kagaku Ryoho ; 43(12): 1458-1460, 2016 Nov.
Article in Japanese | MEDLINE | ID: mdl-28133022

ABSTRACT

Previous studies have reported the benefits of beginning rehabilitation immediately after breast cancer surgery for improving motor function. However, most studies have not evaluated the long-term struggles patients face after hospital discharge in resuming their previous activities and socialparticipation. Furthermore, the intervention methods and effects of rehabilitation for such activities have not been evaluated. We investigated the effectiveness of postoperative physical therapy for upperlimb impairments after breast cancer treatment. Fifty-four women in the postoperative period of surgery for breast cancer participated in the study. Range of motion in the ipsilateral shoulder was initially limited after surgery and recovered during the study period: shoulder flexion range of motion reached a mean value from 110 to 155 degrees, mean abduction was from 70 to 110 degrees, and mean externalshoul der rotation was from 69 to 85 degrees. Lymphedema was present in 5 women. In conclusion, physical functional disabilities were present in the late postoperative period for breast cancer survivors, and limited range of motion in their shoulders negatively affected their functional capacity and quality of life. Therefore, we need to increase rehabilitation care after breast cancer surgery immediately.


Subject(s)
Breast Neoplasms/surgery , Exercise Therapy , Lymphedema/rehabilitation , Postoperative Care , Humans , Lymph Node Excision/adverse effects , Mastectomy , Middle Aged , Range of Motion, Articular , Upper Extremity
15.
Gan To Kagaku Ryoho ; 43(12): 2252-2254, 2016 Nov.
Article in Japanese | MEDLINE | ID: mdl-28133286

ABSTRACT

Metastasis of peritoneal serous carcinoma to the breast and axillary lymph nodes is rare. We present a case of serous carcinoma of the peritoneum with metastases to the breast and axillary lymph nodes. A 72-year-old woman was diagnosed with Stage III peritoneal serous carcinoma in November 2009; she was treated with 6 courses of paclitaxel and carboplatin. In December 2015, she had a palpable mass(2×2 cm)and enlarged axillary lymph nodes. Mammography did not reveal any mass(C1)and ultrasonographic examination demonstrated a partially ill-defined hypoechoic mass with a diameter of 8.7× 7.1 mm. Cytological examination of the axillary lymph node revealed malignancy; breast carcinoma metastasis was suspected and the patient underwent breast-conserving surgery. Histopathological examination of the specimens(breast and axillary lymph nodes)revealed adenocarcinoma, and immunohistochemistry analysis showed that the specimens were CK7(+), CK20(-), CA125(+), PAX8(+), and GCDFP15(-). Taken together, the results indicated peritoneal serous carcinoma metastases to the breast and axillary lymph nodes. CONCLUSION: We report a case of serous carcinoma of the peritoneum with metastases to the breast and axillary lymph nodes.


Subject(s)
Breast Neoplasms/pathology , Lymph Nodes/pathology , Peritoneal Neoplasms/secondary , Aged , Axilla , Breast Neoplasms/surgery , Female , Humans , Lymph Nodes/surgery , Lymphatic Metastasis , Peritoneal Neoplasms/surgery
16.
Gan To Kagaku Ryoho ; 43(12): 2103-2105, 2016 Nov.
Article in Japanese | MEDLINE | ID: mdl-28133236

ABSTRACT

We report a case of gallbladder cancer and right breast cancer associated with pancreaticobiliary maljunction.The patient was a 74-year-old woman who presented with abdominal pain due to cholecystitis.Abdominal CT detected a gallbladder tumor and right breast tumor.Enhanced CT and MRCP examination revealed gallbladder cancer and right breast cancer associated with pancreaticobiliary maljunction.We performed a gallbladder bed resection, bile duct resection, and right total mastectomy.The histopathological diagnosis of the gallbladder was moderately tubular adenocarcinoma and that of the breast tumor was scirrhous carcinoma.The patient remains recurrence-free 8 months after surgery.


Subject(s)
Adenocarcinoma, Scirrhous , Adenocarcinoma , Breast Neoplasms/pathology , Gallbladder Neoplasms/pathology , Neoplasms, Multiple Primary/pathology , Adenocarcinoma/diagnostic imaging , Adenocarcinoma/surgery , Adenocarcinoma, Scirrhous/diagnostic imaging , Adenocarcinoma, Scirrhous/surgery , Aged , Breast Neoplasms/diagnostic imaging , Breast Neoplasms/surgery , Cholecystectomy , Female , Gallbladder Neoplasms/diagnostic imaging , Gallbladder Neoplasms/surgery , Humans , Mastectomy , Neoplasms, Multiple Primary/diagnostic imaging , Neoplasms, Multiple Primary/surgery , Tomography, X-Ray Computed
17.
Gan To Kagaku Ryoho ; 42(10): 1231-3, 2015 Oct.
Article in Japanese | MEDLINE | ID: mdl-26489556

ABSTRACT

The purpose of our study was to test the efficacy and toxicity of hyperthermia for treating breast cancer. Ten patients received treatment (AC, paclitaxel, S-1, and aromatase inhibitor) in combination with hyperthermia. The hyperthermia device was a microwave heating device with water loaded and water-cooled waveguides. The temperature was monitored subcutaneously in the skin under the aperture of the waveguide. Two patients had a partial response to treatment with only mild toxicity (grade 1 acute skin toxicity). Therefore, hyperthermia combined with chemotherapy for treating breast cancer seems to be effective and generally tolerable. A larger patient cohort is needed to confirm these results in the future.


Subject(s)
Breast Neoplasms/therapy , Hyperthermia, Induced , Microwaves , Aged , Aged, 80 and over , Breast Neoplasms/pathology , Combined Modality Therapy , Humans , Middle Aged , Neoplasm Staging , Recurrence
18.
Gan To Kagaku Ryoho ; 42(10): 1319-21, 2015 Oct.
Article in Japanese | MEDLINE | ID: mdl-26489585

ABSTRACT

The purpose of our study was to test the efficacy and toxicity of everolimus plus exemestane therapy for breast cancer. Between 2014 and 2015, 20 patients diagnosed with breast carcinoma were selected for this retrospective study. Patients received everolimus plus exemestane. As a result, 4 patients showed a partial response to treatment and the median PFS was 2.5 months (range, 1-9). The most common adverse events (AEs) associated with combination therapy were stomatitis, rash, dysgeusia, and non-infectious lung disease. The AEs reported were mostly grade 1 and 2, and manageable with appropriate intervention. Therefore, everolimus plus exemestane therapy for breast cancer seems to be effective and generally tolerable.


Subject(s)
Antineoplastic Combined Chemotherapy Protocols/therapeutic use , Breast Neoplasms/drug therapy , Aged , Aged, 80 and over , Androstadienes/administration & dosage , Androstadienes/adverse effects , Antineoplastic Combined Chemotherapy Protocols/adverse effects , Breast Neoplasms/pathology , Breast Neoplasms/surgery , Everolimus/administration & dosage , Everolimus/adverse effects , Female , Humans , Middle Aged , Postmenopause , Retrospective Studies , Treatment Outcome
19.
Clin Breast Cancer ; 15(3): 191-6, 2015 Jun.
Article in English | MEDLINE | ID: mdl-25579459

ABSTRACT

UNLABELLED: We treated patients with operable human epidermal growth factor receptor 2-positive breast cancer with neoadjuvant anthracycline regimens followed by nanoparticle albumin-bound paclitaxel plus trastuzumab. Of the 44 patients, 49% achieved a pathologic complete response (pCR). The pCR rate was 36% and 71% in the patients with estrogen receptor-positive and -negative cancer, respectively. Neoadjuvant therapy using this combination appears to be effective and safe. Introduction: Neoadjuvant chemotherapy plus trastuzumab. INTRODUCTION: Neoadjuvant chemotherapy plus trastuzumab results in a 30% to 50% pathologic complete response (pCR) rate in human epidermal growth factor receptor 2 (HER2)-positive breast cancer and has been associated with improved therapeutic outcomes. Thus, the pCR rate can be useful in evaluating novel agents in this patient population. Nanoparticle albumin-bound (nab)-paclitaxel (PTX) can reduce the toxicity of PTX while maintaining its efficacy. The present study evaluated the activity and safety of nab-PTX as a neoadjuvant treatment of HER2(+) breast cancer. PATIENTS AND METHODS: We treated patients with stage I to IIIA breast cancer using neoadjuvant epirubicin/cyclophosphamide (EC) or 5-fluorouracil/epirubicin/cyclophosphamide every 3 weeks (q3w) for 4 cycles, followed by nab-PTX (260 mg/m(2)) plus trastuzumab q3w for 4 cycles. The primary endpoint was the pCR rate. The secondary endpoints included the clinical response rate, disease-free survival, pathologic response rate (defined as pCR or minimal residual invasive disease only in the breast), breast-conserving surgery rate, and safety. RESULTS: Forty-six patients were enrolled. One patient met the exclusion criteria because of the coexistence of another malignant disease; therefore, we evaluated 45 patients in the entire study. One patient experienced rapid disease progression during EC therapy, leaving 44 patients evaluable for nab-PTX treatment. Of the 45 patients, 49% achieved a pCR. The pCR rate was 36% and 71% in those with estrogen receptor-positive and -negative cancer, respectively. Of all the study treatments, the most frequent reason for delay or dose reduction was hematologic toxicity; only 1 patient required a dose reduction for nab-PTX because of peripheral neuropathy. CONCLUSION: Neoadjuvant therapy using this combination appears to be effective and safe.


Subject(s)
Albumin-Bound Paclitaxel/therapeutic use , Anthracyclines/therapeutic use , Antineoplastic Agents/therapeutic use , Breast Neoplasms/drug therapy , Nanoparticles/therapeutic use , Trastuzumab/therapeutic use , Adult , Aged , Breast Neoplasms/metabolism , Cyclophosphamide/therapeutic use , Drug Therapy, Combination , Epirubicin/therapeutic use , Female , Fluorouracil/therapeutic use , Humans , Middle Aged , Neoadjuvant Therapy , Prospective Studies , Receptor, ErbB-2/metabolism , Treatment Outcome
20.
Gan To Kagaku Ryoho ; 41(12): 1892-4, 2014 Nov.
Article in Japanese | MEDLINE | ID: mdl-25731366

ABSTRACT

We performed immediate breast reconstruction after nipple-sparing mastectomy or skin-sparing mastectomy and evaluated the reconstruction procedure, cosmesis, and complications. Among the 30 patients included in the study, 6 received latissimus dorsi flaps, 1 received a transverse rectus abdominis myocutaneous flap, 7 received deep inferior epigastric perforator flaps, 1 received an implant, and 15 received tissue expanders. In addition, the results were excellent in 25 patients, good in 3 patients, and poor in 2 patients. As the number of patients with breast cancer is increasing, the demand for breast reconstruction will increase. Therefore, it is essential to choose an appropriate method of breast reconstruction for each case.


Subject(s)
Breast Neoplasms/surgery , Mammaplasty/methods , Adult , Age Factors , Aged , Aged, 80 and over , Female , Humans , Middle Aged , Postoperative Complications , Plastic Surgery Procedures , Treatment Outcome
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