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A 62-years-old woman visited a dermatology clinic for hard mass at her scalp. Clinicallly, the mass was hard and alopecic. The diameter was 3 cm. A skin biopsy was done and histpathological examination showed adenocarcinoma. Immunehistchemically, estrogen receptor was positive. It was suspected that breast cancer could be metastasized to the scalp, but mammography, ultrasound, and positron emission tomography showed no particular metastases in her breast and other organs. Magnetic resonance imaging showed enhanced lesions in her birateral breast. Needle biopsy was done and pathological findings showed bilateral breast carcinoma and metastases to the scalp. So we started endocrine therapy using letrozole, the mass was shrunk to 1 cm after 6-month. It is rare that breast cancer was metastasized to the scalp. But Conner et al. reported that 84% of metastatic scalp carcinoma was from the breast, so we should examine the breast more carefully.

We report a 55-year-old female with liver metastases from breast cancer who responded to lapatinib and capecitabine combination therapy as third-line. She was diagnosed as invasive ductal carcinoma (T1cN1M0, stage IIA). Biomarker of breast cancer was negative hormone receptor (ER-, PgR-) and overexpression of HER2(HercepTest 3+). We started preoperative chemotherapy with weekly paclitaxel followed by FEC100. Then mastectomy with axillary dissection was performed. Histopathology of the breast and lymph nodes showed complete disappear of invasive cancer cells( pCR, grade 3). We performed her adjuvant therapy with trastuzumab after surgery. The liver metastases developed 5 months after surgery. We treated her in trasutumab combined with vinorelbine, and followed by docetaxel during one year and four months. Because liver metastases re-grew during the combination therapy with trastuzumab, we switched to lapatinib and capecitabine combination therapy. After four months of administration, abdominal CT revealed liver metastases were remarkably reduced in size. The efficacy of chemotherapy lasted for eight months.

A case was a 48 years old woman. She was aware of a lump in her left breast and visited our hospital. We diagnosed it as an invasive ductal carcinoma. Immunostaining for both ER and PgR was strongly positive. CT of the initial consultation showed multiple bone metastases (thoracic vertebrae, lumbar vertebrae, and iliac bone). After AC followed by docetaxel and tamoxifen, LH-RH analogue was started. We used anastrozole after menopause. The bisphosphonate has been used from the beginning of the treatment. After the chemotherapy, the clinical response of primary tumor was judged as partial response. For six years, the size of primary tumor has not been changed, and PET-CT has not showed another metastasis. Anastrozole was superior to tamoxifen with respect to TTP (median values of 10.7 and 6.4 months for anastrozole and tamoxifen, respectively) in postmenopausal women with ER and/or PgR receptor positive tumors. Our study indicated that many patients responding to hormonal therapy appear to have been increasing from now on.

A recent breast cancer operation appears to have become more simplified, and we may cure an early stage breast cancer without a surgery in the future. This study was approved by our institutional review board and all patients received the study information. We started a radiofrequency ablation (RFA) in April 2008 for breast cancer patients without extensive ductal spreads and the tumor size of 2 cm or less measured by magnetic resonance imaging (MRI). At first, we performed five patients from a clinical viewpoint of technique and safety. All cases were performed safely. There was no complication such as burns. At the mid observation period of 22 months in average (range 21-24), no local recurrence and distant metastases were occurred after RFA. Cosmetic after RFA was excellent in all cases.

A case is 61 years old woman. In February 2008, she was aware of swelling, skin redness and edema in her left breast and visited our hospital. We diagnosed it as inflammatory breast cancer with positive hormone receptor (ER+, PgR+) and unexpression of HER2 (HercepTest 1 +). We started preoperative chemotherapy with weekly paclitaxel followed by FEC100, but we canceled chemotherapy because she developed cerebral infarction when we administered paclitaxel twice. Then, hormonotherapy using anastrozole (Arimidex) was therefore attempted. Three months later, treatment with anastrozole alone reduced the swelling, skin redness and edema in her left breast. After eight months of administration, the breast swelling, skin redness and edema were completely disappeared. MRI revealed the disappearance of the enhanced area. Then mastectomy with auxiliary dissection was performed.

The ratio of cis/trans isomers (referring to 11b-substituent and 2- or 3-substituent) of benzodiazepinooxazoles was estimated by using the lanthanide shift reagent (Eu(fod)3-d27) for nuclear magnetic resonance (NMR) spectroscopy. The amide carbonyl oxygen at 6-position is considered to coordinate with the reagent, because the largest downfield shifts were observed at the amide carbonyl carbon (C-6) in 13C-NMR and the amide hydrogen (H-7) in 1H-NMR. The ratios depend largely on the substituents at 11b-, 2-, and 3-positions. The cis isomer for compounds having 11b-hydrogen increases with an increase in the bulkiness of the substituents at 2-position. The cis isomer for compounds having 3-methyl group decreases with change from 11b-2'-chlorophenyl group (mexazolam) to 11b-hydrogen.