[A Case of Lobular Carcinoma In Situ Occurring in a Fibroadenoma of the Breast].

The patient was a 43-year-old premenopausal woman with a 14×11 mm tumor in upper outer quadrant of the left breast, diagnosed as a fibroepithelial lesion using core needle biopsy. Resection was performed. Histopathologically, the resected specimen was diagnosed as a fibroadenoma with lobular carcinoma in situ(LCIS). Tamoxifen was administered as endocrine therapy to reduce recurrence risk. We report a case of LCIS accidentally discovered by surgical resection of a benign tumor.

[A Case of Advanced Breast Cancer with Hypercalcemia and No Bone Metastasis Treated with Multidisciplinary Therapy].

A 37-year-old woman presented with general malaise, anorexia, and nausea. She was hypercalcemic and had an 8-cm- diameter mass in her left breast. Histopathological diagnosis was invasive breast cancer(T3N0M1). She had multiple lung metastases and pleural dissemination, but she did not have bone metastasis. Serum parathyroid hormone-related protein level was elevated. Therefore, it was thought that hypercalcemia was induced by advanced breast cancer. High-volume fluid therapy and bisphosphonate were administered, and electrolyte correction was performed. Her general condition improved after these measures. Although chemotherapy(epirubicin with 5-fluorouracil and cyclophosphamide)was performed twice, breast cancer progressed; therefore, the chemotherapy regimen was changed to nab-paclitaxel, following which the progression of breast cancer was delayed. Left mastectomy was performed to control local tumor enlargement, following which hypercalcemia did not relapse. Hormone therapy showed long-term effectiveness; however, humoral hypercalcemia induced by the malignancy suggested that it was a poor prognosis factor. Aggressive multimodal treatment was important to control tumor growth.

[A Study of Patients Who Underwent Breast-Conserving Surgery and Developed Cryptogenic Organizing Pneumonia(COP)].

Of the 210 patients who underwent breast-conserving surgery for breast cancer and received radiation therapy for 3 years from April 2012 to March 2015 at the Department of Therapeutic Radiology of our hospital, 6 were diagnosed with cryptogenic organizing pneumonia(COP)-like pneumonia and treated as reported. The mean age of the patients was 51years(40- 65 years), and the pathological subtypes were the luminal type(5 cases)and HER2 type(1case ), all of which were treated with radiation therapy for breast conservation. Postoperative systemic therapy included hormonal therapy with anastrozole in 2 cases, tamoxifen plus LH-RH agonist in 3 cases, and chemotherapy in 1case. The mean onset time of COP was 4.2 months after the completion of irradiation therapy, and all of the 5 patients who received endocrine therapy received it concurrently with radiation therapy. The major symptoms were fever(4 cases)and cough(6 cases). Chest radiography showed an infiltrative shadow consistent with pneumonia. Steroid therapy was effective in all cases while antibiotics were not. It was inferred that COP should be regarded as one of the complications of radiation therapy after breast-conserving surgery.

Measuring body composition using the bioelectrical impedance method can predict the outcomes of gemcitabine-based chemotherapy in patients with pancreatobiliary tract cancer.

In order to examine the effect on body composition of anticancer drug treatments, the body composition rate in patients being treated with gemcitabine (GEM)-based chemotherapy was measured over time on an outpatient basis with a simple body composition monitor using the bioelectrical impedance (BI) method. The results revealed a significant reduction in the body fat rate (P=0.01) over the course of treatment in patients with pancreatobiliary tract cancer who became unable to continue GEM-based chemotherapy due to progressive disease or a decreased performance status. Meanwhile, no changes were observed in the body composition of control patients with urothelial carcinoma receiving GEM-based chemotherapy. In association with the adverse reactions to GEM and the hematotoxicity profile, a decreased white blood cell count was more likely to occur in body fat-dominant patients (mean fat rate, 25.8%; mean muscle rate, 26.2%), whereas a decreased blood platelet count was more likely to occur in skeletal muscle-dominant patients (mean fat rate, 23.3%; mean muscle rates, 28.7%). The correlation between body composition parameters and the relative dose intensity (RDI) associated with GEM administration was also analyzed. The results revealed a positive correlation between the RDI and basal metabolism amount (P=0.03); however, the RDI did not correlate with the body fat rate, skeletal muscle rate or body mass index (P=0.61, P=0.14 and P=0.20, respectively). In conclusion, the body composition rate measurement using the BI method over time may be useful for predicting the outcome of GEM-based chemotherapy and adverse events in patients with pancreatobiliary tract cancer. In particular, the present findings indicate that the changes in body fat rate may be helpful as an adjunct index for assessing potential continuation of chemotherapy and changes in physical conditions.

[The case of a giant malignant phyllodes tumor of the breast].

A 75-year-old female patient complained of a mass in her left breast 2 years ago. The patient experienced a rapid enlargement of the mass 2 months later and visited our hospital. A computed tomography (CT) scan indicated a 25-cm tumor with infiltration of the left breast skin. Pectoral muscle invasion was considered. Swelling of the axillary lymph node and remote metastases were not found. A needle biopsy indicated a phyllodes tumor. A pectoral muscle-preserving mastectomy was undertaken. The tumor weighed 7.1 kg. Pathological examination indicated hyperplasia of the stroma and part of the epithelium, which had invaded the skin layer and fatty tissue. The pathological diagnosis was a malignant phyllodes tumor. This paper reports the case of a giant malignant phyllodes tumor.

[A case of locally advanced breast cancer successfully treated with Mohs paste].

We report a case of primary advanced breast cancer that was locally controlled by treatment with Mohs paste. A 57- year-old woman presented with right locally advanced breast cancer with massive exudate and oozing blood. Histopathological examination indicated an invasive ductal carcinoma. Moreover, the patient had lung, liver, and bone metastases. She received chemotherapy, following which the breast tumor was treated using Mohs paste and dissected. The bleeding and exudate stopped almost completely, and the breast tumor became flat. Therefore, it is suggested that locally advanced breast cancer could be controlled by treatment with Mohs paste.

Loss of HITS (FAM107B) expression in cancers of multiple organs: tissue microarray analysis.

Family with sequence similarity 107 (FAM107) proteins consist of two subtypes, FAM107A and FAM107B in mammals, possessing a conserved N-terminal domain of unknown function. Recently we found that FAM107B, an 18 kDa nuclear protein, is expressed in a broad range of tissues and is downregulated in gastrointestinal cancer. Because FAM107B expression is amplified by heat-shock stimulation, we designated it heat shock-inducible tumor small protein (HITS). Although data related to FAM107A as a candidate tumor suppressor have been accumulated, little biological information is available for HITS. In the present study, we examined HITS expression using immunohistochemistry with tissue microarrays and performed detailed statistical analyses. By screening a high-density multiple organ tumor and normal tissue microarray, HITS expression was decreased in tumor tissues of the breast, thyroid, testis and uterine cervix as well as the stomach and colon. Further analysis of tissue microarrays of individual organs showed that loss of HITS expression in cancer tissues was statistically significant and commonly observed in distinct organs in a histological type-specific manner. The HITS expression intensity was inversely correlated with the primary tumor size in breast and thyroid cancers. In addition, effects of tetracycline-inducible HITS expression on tumor growth were investigated in vivo. Forced expression of HITS inhibited tumor xenograft proliferation, compared with the mock-treated tumor xenograft model. These results show that loss of HITS expression is a common phenomenon observed in cancers of distinct organs and involved in tumor development and proliferation.

[A case of bilateral breast cancer and metastatic gastric cancer with peritonitis carcinomatosa successfully treated with a combination therapy of S-1 and paclitaxel].

A 46-year-old woman was diagnosed with complaints of bilateral breast tumor with massive ascites retention. The patient was examined as scirrhous carcinoma by lacteal gland inspection and dysplastic cell by ascites cytotechnology. We diagnosed her case to be bilateral breast cancer with peritonitis carcinomatosa, lymph node metastases and bony metastases. In addition to that, gastric metastasis was diagnosed by the result of widespread irregular gastric mucosa, which was inspected through upper gastrointestinal endoscope. The patient was treated with S-1 and paclitaxel and has achieved a remarkable response. The patient's tumor, gastric metastasis, and ascites were disappeared almost completely.

[Palliative home care for advanced and recurrence breast cancer--a six-case report].

Two years of palliative home care for advanced and recurrent breast cancer of six patients was performed since January 2007. The reasons to provide palliative home care include an administration of skin infiltrative tumor, pain, home oxygen therapy (HOT), and chemotherapy. Most important part of home palliative care is to prepare any physical and psychosocial problems among any types of occupation.