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3. DIP during perioperative chemotherapy

Author

Ikeuchi, Mayumi, Hino, Naoki, Nishisyo, Aya, Aoyama, Mariko, Kanematsu, Miyuki, Inoue, Hiroaki, Sasa, Soichiro, Inui, Tomohiro, Miyamoto, Naoki, Okumura, Kazumasa, and Takizawa, Hiromitsu

Subjects
musculoskeletal diseases, body regions, breast cancer, perioperative chemotherapy, technology, industry, and agriculture, Drug-induced interstitial pneumonia
Abstract

Purpose : Drug-induced interstitial pneumonia (DIP) that occurs during chemotherapy for breast cancer is a rare but a serious adverse event. Treatments of DIP requires interruption of breast cancer treatment, which may affect the patient’s prognosis. However, there are few reports which discuss DIP during breast cancer treatments. Purpose of this report is to make clear how DIP occurred and influenced breast cancer treatment in our hospital. Patients and Methods : A total of 74 patients who started perioperative chemotherapy in Tokushima Municipal Hospital for breast cancer from January 2019 to December 2020 were evaluated for DIP. Patients’ and tumors’ characteristics, and regimens which caused DIP were investigated. The clinical courses of the DIP patients were also followed up. Results : Twelve of the 74 patients developed DIP. All 12 patients had histories of cyclophosphamide administration ; however, the causative drug could not be determined. Ten of the 12 patients were treated with steroids, and all the patients recovered ultimately from the interstitial pneumonia. While chemotherapy was administered in six patients after mild DIP, no relapse of pneumonia was observed. Conclusion : DIP during perioperative chemotherapy for breast cancer was resolved with appropriate treatment. Patients were able to resume breast cancer treatment with minimal interruption.

Published
2022

5. False–negatives due to poor specimens can be prevented based on the macroscopic findings for breast Vacuum–Assisted Biopsy specimens

Author

Izumori, Ayumi, Takahashi, Masako, Sasa, Soichiro, Inoue, Hiroaki, Tangoku, Akira, Kanematsu, Miyuki, Sasa, Mitsunori, Izumori, Ayumi, Takahashi, Masako, Sasa, Soichiro, Inoue, Hiroaki, Tangoku, Akira, Kanematsu, Miyuki, and Sasa, Mitsunori

Abstract

Purpose : Ultrasound-guided breast tissue biopsy is an essential technique for diagnosing breast disease, but sample errors reduce its accuracy. This study investigated whether the histopathological results can be inferred from the macroscopic findings for Ultrasound-guided breast Vacuum Assisted Biopsy (VAB) specimens. Methods: Biopsy specimens from 101 patients who underwent mammary gland VAB were photographed with a smartphone, and the relationships between the macroscopic findings and the pathological results were examined. Results : A significant difference was observed with regard to the presence / absence of turbidity: malignancy was detected in 33 / 37 (89%) specimens with turbidity and in 2 / 47 (4%) cases without turbidity (p < 0.001). A significant difference was also observed regarding the surface properties : malignancy was detected in 14 / 70 (19%) smooth specimens and in 24 / 29 (83%) rough specimens (p < 0.001). Also, malignancy was detected in 11 / 13 (85%) specimens with white spots, and the difference was significant (p < 0.001). In addition, the characteristics of intraductal papilloma, fibroadenoma, and mastopathy could be confirmed by macroscopic findings. Conclusions : When needle–biopsy of a lesion that is targeted for resection yields macroscopic findings that match the predicted histopathological findings, it can be thought that the biopsy had been properly performed. This means that false–negatives due to poor specimens can be prevented.

Published
2022

12. Ductal carcinoma in situ of the breast arising in encapsulated mammary hamartoma : A case report

Author

Komaki, Kansei, Funagayama, Mayumi, Saitoh, Tomokazu, Maeda, Yorio, Hayashi, Toru, Kanematsu, Miyuki, Tangoku, Akira, Komaki, Kansei, Funagayama, Mayumi, Saitoh, Tomokazu, Maeda, Yorio, Hayashi, Toru, Kanematsu, Miyuki, and Tangoku, Akira

Abstract

Mammary hamartoma is benign lesion and relatively rare. 17 cases of breast cancer associated with a hamartoma had been previously documented in the literature. We describe herein a case of noninvasive ductal carcinoma of the breast arising in hamartoma in a woman of 60’s. The discordance of images of the mass between mammogram and ultrasonogram can lead us to detect the carcinoma within the hamartoma in our case.

Published
2020

13. 30% of Breast DCIS in Japan is low-grade

Author

Kanematsu, Miyuki, Morimoto, Masami, Takahashi, Masako, Honda, Junko, Bando, Yoshimi, Moriya, Takuya, Tadokoro, Yukiko, Nakagawa, Misako, Takechi, Hirokazu, Yoshida, Takahiro, Toba, Hiroaki, Yoshida, Mitsuteru, Kajikawa, Aiichiro, Tangoku, Akira, Imoto, Issei, and Sasa, Mitsunori

Subjects
Low grade DCIS, comedo-necrosis, mammography, Ki67 index, ER positive and HER2 negative, skin and connective tissue diseases, neoplasms
Abstract

Background Overdiagnosis in mammography (MMG) is a problem. Combination of MMG and ultrasonography for breast cancer screening may increase overdiagnosis. Most cases of overdiagnosis are low-grade ductal carcinoma in situ (LGD), but no reports have focused on them. Materials and methods We immunostained 169 ductal carcinoma in situ (DCIS) cases for ER, PgR, HER2 and Ki67 and classified them into 4 subtypes : ER(+)/ HER2(-), ER(+)/HER2(+), ER(-)/HER2(-) and ER(-)/HER2(+). The Ki67 index was used to evaluate the grade of malignancy and examined for correlations with each ER/HER2 subtype and the nuclear grade (NG), with/without comedo necrosis. Results The Ki67 index correlated significantly with NG, both with/without comedo necrosis, and reliably evaluated the grade of malignancy. The index for ER(+)/HER2(-) (n=117, 69.2%) was 7.45±7.10, which was significantly lower than for each of the other types. The index was 5.71±6.94 for ER(+)/HER2(-) without comedo necrosis (n=52, 30.8%), which was significantly lower than with comedo necrosis. This was considered LGD, characterized by absence of microcalcification in MMG and either presence of a solid mass or cystic lesion or absence of hypoechoic areas in ultrasound. Conclusion In Japan, ER(+)/HER2(-) without comedo necrosis accounts for about 30% of DCIS and is LGD. This may be being overdiagnosed.

Published
2016

15. The time since last menstrual period is important as a clinical predictor for non-steroidal aromatase inhibitor-related arthralgia

Author

Takahashi Masako, Nakagawa Misako, Nagao Taeko, Honda Junko, Morimoto Masami, Kanematsu Miyuki, Tangoku Akira, and Sasa Mitsunori

Subjects
Neoplasms. Tumors. Oncology. Including cancer and carcinogens, RC254-282
Abstract

Abstract Background The clinical predictors of aromatase inhibitor-related arthralgia (AIA), a drug-related adverse reaction of aromatase inhibitors (AIs), remain unclear. Methods AIA was prospectively surveyed every 4 months in 328 postmenopausal breast cancer patients administered a non-steroidal AI (anastrozole). Various clinicopathological parameters were recorded and analyzed (chi-square test, Fisher's exact test and logistic regression analysis). Results The mean observation period was 39.9 months. AIA manifested in 114 patients (34.8%), with peaks of onset at 4 (33.7%) and 8 months (11.4%) after starting AI administration. Some cases manifested even after 13 months. AIA tended to occur in younger patients (incidences of 46.3%, 37.4% and 28.0% for ages of < 55, 55-65 and > 65 years, respectively (p = 0.063)) and decreased significantly with the age at menarche (53.3%, 35.3% and 15.4% for < 12, 12-15 and > 15 years, respectively (p = 0.036)). The incidences were 45.1%, 46.3 and 25.1% for the time since the last menstrual period (LMP) < 5 years, 5-10 years and > 10 years, being significantly lower at > 10 years (p < 0.001). In logistic regression analysis, the AIA incidence was significantly lower in the time since LMP > 10-year group versus the < 5-year group (odds ratio 0.44, p = 0.002), but the age at menarche showed no association. AIA manifested significantly earlier (≤ 6 months) as the time since LMP became shorter (< 5 years). Conclusion AIA tends to manifest early after starting AI, but some cases show delayed onset. The incidence was significantly lower in patients with a duration of > 10 years since LMP. When the time since LMP was short, the onset of AIA was significantly earlier after starting AI administration.

Published
2011
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16. Thirty percent of ductal carcinoma in situ of the breast in Japan is extremely low-grade ER(+)/HER2(-) type without comedo necrosis

Author

Kanematsu, Miyuki, primary, Morimoto, Masami, additional, Takahashi, Masako, additional, Honda, Junko, additional, Bando, Yoshimi, additional, Moriya, Takuya, additional, Tadokoro, Yukiko, additional, Nakagawa, Misako, additional, Takechi, Hirokazu, additional, Yoshida, Takahiro, additional, Toba, Hiroaki, additional, Yoshida, Mitsuteru, additional, Kajikawa, Aiichiro, additional, Tangoku, Akira, additional, Imoto, Issei, additional, and Sasa, Mitsunori, additional

Published
2016
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