Okayama University Medical SchoolActa Medica Okayama0386-300X7712023Safety and Efficacy of a Well-Fitting Brassiere after Breast Reconstruction: A Qualitative Study1119ENSatokoWatanabeDepartment of Plastic and Reconstructive Surgery, Okayama University HospitalMihoSaigaDepartment of Plastic and Reconstructive Surgery, Okayama University HospitalTakayukiMotokiDepartment of General Surgery, Okayama Saiseikai General HospitalTadahikoShienDepartment of Breast and Endocrine Surgery, Okayama University HospitalNarutoTairaDepartment of Breast and Endocrine Surgery, Okayama University HospitalHiroyoshiDoiharaDepartment of Breast and Endocrine Surgery, Okayama University HospitalYoshihiroKimataDepartment of Plastic and Reconstructive Surgery, Okayama University HospitalOriginal Article10.18926/AMO/64356The importance of a well-fitted, comfortable brassiere to overall quality of life after breast reconstruction has not been evaluated. Our aim was to determine the impact of a semi-customized brassiere on patients’ health-related quality of life after breast reconstruction. The subjects were prospective patients with mastectomy who were to undergo immediate or delayed breast reconstruction at our hospital. After surgery, a professional bra fitter sized each patient for a semi-customized brassiere and provided follow-up consultations. A self-reported questionnaire on breast aesthetics, postoperative pain, and satisfaction was used to assess the primary outcomes. Data were prospectively collected at baseline (before surgery) and at 1, 3, 6, and 12 months after surgery and analyzed. Forty-six patients (50 breasts) were included in the analysis. Consistent wearing of the brassiere reduced pain (p<0.05), with good overall satisfaction (p<0.001). Aesthetic scores on breast shape and size were higher with than without the custom brassiere at 3 months (p=0.02) and 6 months (p=0.03) after surgery. Wearing the brassiere reduced anxiety at all time points of measurement. A well-fitting brassiere ensured safety and provided a high degree of satisfaction without anxiety for patients after breast reconstruction.No potential conflict of interest relevant to this article was reported.Okayama University Medical SchoolActa Medica Okayama0386-300X7052016A Phase I Trial of 100mg/m2 Docetaxel in Patients with Advanced or Recurrent Breast Cancer425427ENTomokiTamuraDepartment of Allergy and Respiratory Medicine, Okayama University HospitalTaizoHirataDepartment of Medical Oncology, National Hospital Organization Kure Medical CenterMasahiroTabataDepartment of Allergy and Respiratory Medicine, Okayama University HospitalShiroHinotsuCenter for Innovative Clinical Medicine, Okayama University HospitalAkinobuHamadaDivision of Clinical Pharmacology & Translational Research, Exploratory Oncology Research & Clinical Trial Center, National Cancer CenterTakayukiMotokiDepartment of Breast and Endocrinological Surgery, Okayama University HospitalTakayukiIwamotoDepartment of Breast and Endocrinological Surgery, Okayama University HospitalTaekoMizooDepartment of Breast and Endocrinological Surgery, Okayama University HospitalTomohiroNogamiDepartment of Breast and Endocrinological Surgery, Okayama University HospitalTadahikoShienDepartment of Breast and Endocrinological Surgery, Okayama University HospitalNarutoTairaDepartment of Breast and Endocrinological Surgery, Okayama University HospitalJunjiMatsuokaDepartment of Breast and Endocrinological Surgery, Okayama University HospitalHiroyoshiDoiharaDepartment of Breast and Endocrinological Surgery, Okayama University HospitalClinical Study Protocols10.18926/AMO/54607Docetaxel is a standard treatment for patients with advanced or recurrent breast cancer. The recommended dose is 60 to 100 mg/m2. Previous study have shown that the tumor response rates of patients who received docetaxel monotherapy at doses of 60, 75, and 100 mg/m2 were 22.1% , 23.3% , and 36.0% , respectively, and there was a significant relationship between the dose and response. In Europe and the United States, docetaxel is approved at a dose of 100 mg/m2, and Japanese guidelines also recommend a dose of 100 mg/m2. However, the approved dose in Japan is up to 75 mg/m2. We have launched a phase I trial evaluating 100 mg/m2 docetaxel in patients with advanced or relapsed breast cancer. The major eligibility criteria are as follows: age ≥20 years, pathologically diagnosed breast cancer, recurrent or advanced breast cancer, a good performance status, and HER2 [human epidermal growth factor receptor 2] negative. The primary endpoint is demonstrated safety of 100 mg/m2 docetaxel. This study will clarify whether 100mg/m2 docetaxel can be administrated safely in Japanese patients with advanced or recurrent breast cancer.No potential conflict of interest relevant to this article was reported.Okayama University Medical SchoolActa Medica Okayama0386-300X6962015Correlation between 18F-fluorodeoxyglucose Positron Emission Tomography/computed Tomography and Clinicopathological Features in Invasive Ductal Carcinoma of the Breast333338ENMaikoItoTadahikoShienMitsumasaKajiTaekoMizooTakayukiIwamotoTomohiroNogamiTakayukiMotokiNarutoTairaHiroyoshiDoiharaShinichiroMiyoshiOriginal Article10.18926/AMO/53907We evaluated the usefulness of preoperative 18F-fluorodeoxyglucose positron emission tomography/computed tomography (18F-FDG PET/CT) examinations to predict the pathological features in primary breast cancer. In particular, we evaluated the correlation between the maximum standardized uptake values (SUVmax) obtained by 18F-FDG PET/CT and the Ki67 expression in estrogen receptor (ER)-positive invasive ductal carcinoma (IDC). Primary IDC patients operated between March 2009 and July 2013 at Okayama University Hospital were enrolled. We evaluated the correlations between the SUVmax and age, postoperative pT, histological grade, lymph vascular invasion, status of hormone receptor, human epidermal growth factor receptor 2 (HER2), Ki67 expression and node status. The Ki67 expression was classified as high (>14%) versus low (<14%). We enrolled 138 patients with IDC. Their median SUVmax was 3.85 (range:0-52.57). In a univariate analysis, the SUVmax was significantly related to age, pT, histological grade, lymphovascular invasion, hormone receptor status, HER2 status, node status and Ki67. In the 113 patients with ER-positive IDC, there was a significant correlation between Ki67 and SUVmax (p=0.0030). The preoperative 18F-FDG PET/CT results of IDC patients had significant relationships with pathological status parameters. The determination of the preoperative SUVmax might help classify Luminal A and Luminal B patients among luminal-type breast cancer patients.No potential conflict of interest relevant to this article was reported.Okayama University Medical SchoolActa Medica Okayama0386-300X6952015Neoadjuvant Chemotherapy with or without Concurrent Hormone Therapy in Estrogen Receptor-Positive Breast Cancer:NACED-Randomized Multicenter Phase II Trial291299ENKumiSugiuTakayukiIwamotoCatherine M.KellyNaokiWatanabeTakayukiMotokiMitsuyaItohShoichiroOhtaniKenjiHigakiTakakoImadaTakeshiYuasaMasakoOmoriHiroshiSonobeToshiyoshiFujiwaraJunjiMatsuokaOriginal Article10.18926/AMO/53675Although in the neoadjuvant setting for estrogen receptor (ER)-positive breast cancers, chemotherapy or hormone therapy alone does not result in satisfactory tumor response, it is unknown whether concurrent chemo-endocrine therapy is superior to chemotherapy alone in clinical outcomes. We conducted a randomized phase II trial to test the responses of ER-positive patients to concurrent administration of chemo-endocrine therapy in the neoadjuvant setting. Women with stage II-III, ER-positive, invasive breast cancer (n=28) received paclitaxel followed by fluorouracil, epirubicin, cyclophosphamide (T-FEC) and were randomized to receive concurrent chemo-endocrine therapy consisting of goserelin administered subcutaneously for premenopausal women or an aromatase inhibitor for postmenopausal women. The primary endpoint was the pathological complete response (pCR) rate after neoadjuvant therapy. Twenty-eight patients were randomized. There were no significant differences in pCR rate between the concurrent group (12.5%;2/16) and the chemotherapy alone group (8.3%;1/12). Tumor size after therapy was significantly reduced in the concurrent therapy group (p=0.035), but not in the chemotherapy-alone group (p=0.622). Neoadjuvant chemotherapy with concurrent hormone therapy provided no significant improvement in pCR rate in ER-positive breast cancers. These preliminary results should be followed up by further studies.No potential conflict of interest relevant to this article was reported.BioMed Central Ltd.Acta Medica Okayama1471-2407132013Effects of lifestyle and single nucleotide polymorphisms on breast cancer risk: a case-control study in Japanese womenENTaekoMizooNarutoTairaKeikoNishiyamaTomohiroNogamiTakayukiIwamotoTakayukiMotokiTadahikoShienJunjiMatsuokaHiroyoshiDoiharaSetsukoIshiharaHiroshiKawaiKensukeKawasakiYouichiIshibeYutakaOgasawaraYoshifumiKomoikeShinichiroMiyoshiBackground: Lifestyle factors, including food and nutrition, physical activity, body composition and reproductive factors, and single nucleotide polymorphisms (SNPs) are associated with breast cancer risk, but few studies of these factors have been performed in the Japanese population. Thus, the goals of this study were to validate the association between reported SNPs and breast cancer risk in the Japanese population and to evaluate the effects of SNP genotypes and lifestyle factors on breast cancer risk.
Methods: A case-control study in 472 patients and 464 controls was conducted from December 2010 to November 2011. Lifestyle was examined using a self-administered questionnaire. We analyzed 16 breast cancer-associated SNPs based on previous GWAS or candidate-gene association studies. Age or multivariate-adjusted odds ratios (OR) and 95% confidence intervals (95% CI) were estimated from logistic regression analyses.
Results: High BMI and current or former smoking were significantly associated with an increased breast cancer risk, while intake of meat, mushrooms, yellow and green vegetables, coffee, and green tea, current leisure-time exercise, and education were significantly associated with a decreased risk. Three SNPs were significantly associated with a breast cancer risk in multivariate analysis: rs2046210 (per allele OR = 1.37 [95% CI: 1.11-1.70]), rs3757318 (OR = 1.33[1.05-1.69]), and rs3803662 (OR = 1.28 [1.07-1.55]). In 2046210 risk allele carriers, leisure-time exercise was associated with a significantly decreased risk for breast cancer, whereas current smoking and high BMI were associated with a significantly decreased risk in non-risk allele carriers.
Conclusion: In Japanese women, rs2046210 and 3757318 located near the ESR1 gene are associated with a risk of breast cancer, as in other Asian women. However, our findings suggest that exercise can decrease this risk in allele carriers.No potential conflict of interest relevant to this article was reported.SpringerActa Medica Okayama0167-680614322014Estrogen receptor (ER) mRNA expression and molecular subtype distribution in ER-negative/progesterone receptor-positive breast cancers403409ENMitsuyaItohTakayukiIwamotoJunjiMatsuokaTomohiroNogamiTakayukiMotokiTadahikoShienNarutoTairaNaokiNiikuraNaokiHayashiShoichiroOhtaniKenjiHigakiToshiyoshiFujiwaraHiroyoshiDoiharaW. FraserSymmansLajosPusztaiWe examined estrogen receptor (ER) mRNA expression and molecular subtypes in stage I-III breast cancers that are progesterone receptor (PR) positive but ER and HER2 negative by immunohistochemistry (IHC) or fluorescent in situ hybridization. The ER, PR, and HER2 status was determined by IHC as part of routine clinical assessment (N = 501). Gene expression profiling was done with the Affymetrix U133A gene chip. We compared expressions of ESR1 and MKI67 mRNA, distribution of molecular subtypes by the PAM50 classifier, the sensitivity to endocrine therapy index, and the DLDA30 chemotherapy response predictor signature among ER/PR-positive (n = 223), ER-positive/PR-negative (<Emphasis Type="ItalicUnderline">n = 73), ER-negative/PR-positive (n = 20), and triple-negative (n = 185) cancers. All patients received neoadjuvant chemotherapy with an anthracycline and taxane and had adjuvant endocrine therapy only if ER or PR > 10 % positive. ESR1 expression was high in 25 % of ER-negative/PR-positive, in 79 % of ER-positive/PR-negative, in 96 % of ER/PR-positive, and in 12 % of triple-negative cancers by IHC. The average MKI67 expression was significantly higher in the ER-negative/PR-positive and triple-negative cohorts. Among the ER-negative/PR-positive patients, 15 % were luminal A, 5 % were Luminal B, and 65 % were basal like. The relapse-free survival rate of ER-negative/PR-positive patients was equivalent to ER-positive cancers and better than the triple-negative cohort. Only 20-25 % of the ER-negative/PR-positive tumors show molecular features of ER-positive cancers. In this rare subset of patients (i) a second RNA-based assessment may help identifying the minority of ESR1 mRNA-positive, luminal-type cancers and (ii) the safest clinical approach may be to consider both adjuvant endocrine and chemotherapy.No potential conflict of interest relevant to this article was reported.岡山医学会Acta Medica Okayama0030-155812612014早期乳癌におけるOne-step Nucleic Acid Amplification(OSNA)法によるセンチネルリンパ節転移診断の検討2530ENTaekoMizooTadahikoShienMaikoItoTomohiroNogamiTakayukiIwamotoTakayukiMotokiNarutoTairaJunjiMatsuokaHiroyoshiDoihara Introduction: The one-step nucleic acid amplification (OSNA) assay is a new method to detect sentinel lymph node (SLN) metastases using cytokeratin 19 (CK19) mRNA in early breast cancer. Here we retrospectively analyzed the advantages and disadvantages of the OSNA assay.
Methods: In a trial period, SLNs were divided into two sections, and we examined one side using the OSNA assay. The other side was examined by pathologists. After this period, we examined whole SLNs using only the OSNA assay. The patients with positive nodes by OSNA assay and/or pathology required axillary dissection.
Results: We examined 27 primary breast cancer patients (36 SLNs) during the trial period. The overall concordance rate between the OSNA assay and pathology results was 91%. In the later period, 157 patients (217 SLNs) were examined. The CK19-positive rate obtained by the OSNA assay was 16.5% (macrometastases OSNA (++) : 7.2%, micrometastases OSNA (+) : 9.2%). The non-SLN positive rate among the CK19-positivecases was 23%. The OSNA assay's false negative was one case in which the expression of CK-19 on the primary tumor and lymph node was not detected.
Conclusions: Our OSNA assay results were comparable to those obtained using a conventional pathological technique. Pathologists and laboratory technicians could save time and effort by using the OSNA assay when seeking the precise diagnosis during surgery.No potential conflict of interest relevant to this article was reported.Landes BioscienceActa Medica Okayama1538-40471432013Antiproliferative effect of a novel mTOR inhibitor temsirolimus contributes to the prolonged survival of orthotopic esophageal cancer-bearing mice230236ENToshioNishikawaMunenoriTakaokaToshiakiOharaYasukoTomonoHuifangHaoXiaohongBaoTakuyaFukazawaZhigangWangKazufumiSakuramaYasuhiroFujiwaraTakayukiMotokiYasuhiroShirakawaTomokiYamatsujiNoriakiTanakaToshiyoshiFujiwaraYoshioNaomotoEsophageal squamous cell carcinoma (ESCC) remains one of the most aggressive cancers with poor prognosis regardless of a several reports that indicate a better therapeutic efficacy using some new chemotherapeutic agents. Recent drug development has contributed to an improved specificity to suppress mTOR activity by which many types of malignancies can be explosively progressed. Temsirolimus (CCI-779, TricelTM) is one of recently synthesized analogs of rapamycin and has provided better outcomes for patients with renal cell carcinoma. In this study, we experimentally evaluated an efficacy of targeting mTOR by temsirolimus for ESCC treatment, with an assessment of its survival advantage using an advanced ESCC animal model.
First, we confirmed that the expression of phosphorylated mTOR was increased in 46 of 58 clinical ESCC tumor tissues (79.3%) and appeared to get strengthened with tumor progression. All of ESCC cell lines used in this study revealed an increase of mTOR phosphorylation, accompanied with the upregulation of hypoxia inducible factor-I alpha (HIF-1 alpha), one of the critical effectors regulated by mTOR. Temsirolimus treatment apparently suppressed the activation of mTOR and its downstream effectors, resulting in the reduced ability of ESCC cell proliferation. Finally, the weekly administration of temsirolimus significantly diminished the size of subcutaneous tumors (vehicle, 3261.6 +/- 722.0; temsirolimus, 599.2 +/- 122.9; p = 0.007) in nude mice and effectively prolonged orthotopic esophageal cancer-bearing mice (median survival periods: control, 31 d; temsirolimus, 43 d; p = 0.0024).
These data suggests that targeting mTOR by temsirolimus may become a therapeutic alternative for esophageal cancer, with a contribution to a better outcome.No potential conflict of interest relevant to this article was reported.Okayama University Medical SchoolActa Medica Okayama0386-300X6732013Association between Mammographic Breast Density and Lifestyle in Japanese Women145151ENSetsukoIshiharaNarutoTairaKensukeKawasakiYouichiIshibeTaekoMizooKeikoNishiyamaTakayukiIwamotoTomohiroNogamiTakayukiMotokiTadahikoShienJunjiMatsuokaHiroyoshiDoiharaYoshifumiKomoikeShuheiSatoSusumuKanazawaOriginal Article10.18926/AMO/50407A high mammographic breast density is considered to be a risk factor for breast cancer. However, only a small number of studies on the association between breast density and lifestyle have been performed. A cross-sectional study was performed using a survey with 29 questions on life history and lifestyle. The breast density on mammography was classified into 4 categories following the BI-RADS criteria. The subjects were 522 women with no medical history of breast cancer. The mean age was 53.3 years old. On multivariate analysis, only BMI was a significant factor determining breast density in premenopausal women (parameter estimate, －0.403;p value, 0.0005), and the density decreased as BMI rose. In postmenopausal women, BMI (parameter estimate, －0.196;p value, 0.0143) and number of deliveries (parameter estimate, －0.388;p value, 0.0186) were significant factors determining breast density;breast density decreased as BMI and number of deliveries increased. Only BMI and number of deliveries were identified as factors significantly influencing breast density. BMI was inversely correlated with breast density before and after menopause, whereas the influence of number of deliveries on breast density was significant only in postmenopausal women in their 50 and 60s.No potential conflict of interest relevant to this article was reported.岡山医学会Acta Medica Okayama0030-155812432012術前化学療法により壁が菲薄化し組織学的寛解（pCR）となった巨大嚢胞内乳癌の１例243247ENTakakoImadaJunjiMatsuokaTakayukiMotokiTakayukiIwamotoMasakoOomoriSigemichiIhaToshieHongoNorikoHenmiMikioMakabeHiromiNogami A 31-year-old woman presented to our hospital because of a lump 5cm in diameter in her right breast. Ultrasonography revealed a multilocular cystic mass with partial thickening of the wall and the septum. Core needle biopsy (CNB) of the septum confirmed invasive ductal carcinoma. The patient was administered neoadjuvant chemotherapy consisting of 12 cycles of weekly paclitaxel followed by 4 cycles of FEC (5FU, Epilubicin and cyclophosphamide). While the thickness of the wall and septum became thinner, the tumor size did not change in diameter. She underwent right mastectomy and sentinel node biopsy. Post-surgical histopathological findings showed a pathological complete response (pCR).<br>
We report a rare case of invasive ductal carcinoma presenting a multilobular phenotype which showed pCR by neoadjuvant chemotherapy despite no size reduction of the tumor.No potential conflict of interest relevant to this article was reported.岡山医学会Acta Medica Okayama0030-155812212010Focal adhesion kinase (FAK) と Insulin-like growth factor-I receptor (IGF-IR) に対するデュアルチロシンキナーゼ阻害剤の食道腺癌における抗腫瘍効果1725ENNobuyukiWatanabeMunenoriTakaokaKazufumiSakuramaYasukoTomonoShinjiHatakeyamaOsamuOhmoriTakayukiMotokiYasuhiroShirakawaTomokiYamatsujiMinoruHaisaJunjiMatsuokaDavid G.BeerHitoshiNagatsukaNoriakiTanakaYoshioNaomotoNo potential conflict of interest relevant to this article was reported.岡山医学会Acta Medica Okayama0030-155811822006非触知乳癌におけるVATSマーカーを用いたエコーガイド下マーキングの有用性127129ENJunjiMatsuokaYokoTabuchiMitsuyaItoRyokoOnoTakakoImadaHiroyosiMatsukawaTakayukiMotokiYoshioNaomotoSusumuKanazawaA preoperative tumor guiding system for nonpalpable breast cancer using a VATS guiding needle (Hakko Co., Ltd., Tokyo Japan) was reported. It was easy to introduce the guiding needle into breast cancers smaller than 1cm under
ultrasonographic observation. Neither bleeding nor infection was experienced. Wound management was easy and painless. This guiding system is very useful for locating and managing nonpalpable breast cancers even in outpatient
settings.No potential conflict of interest relevant to this article was reported.岡山医学会Acta Medica Okayama0030-155811822006乳管洗浄細胞診が診断に有効であった乳癌の一例123125ENJunjiMatsuokaYokoTabuchiRyokoOnoTakakoImadaTatsuoUmeokaNaokiWatanabeTakayukiMotokiHiroyosiMatsukawaYoshioNaomotoNoriakiTanakaHiroyukiYanaiMasakoOmoriAlthough many modalities have been established to diagnose breast cancers, it is sometimes difficult to reveal nonpalpable cases. Duct lavage cytology was originally established to reveal groups at high risk for breast cancers by detecting metaplastic ductal cells. We report here a case where duct lavage was useful for revealing a small cancer that had been undetected by repeated bloody nipple discharge and cytological examinations. Duct lavage cytology may be of use in cases where nipple discharge of unknown origin persists.No potential conflict of interest relevant to this article was reported.岡山医学会Acta Medica Okayama0030-155811822006乳癌術前化学療法の効果判定における画像診断 われわれが経験した病理判定と画像診断の不一致症例について119121ENJunjiMatsuokaYokoTabuchiMitsuyaItoRyokoOnoTakakoImadaTakayukiMotokiHiroyosiMatsukawaMasakoOhmoriHiroyukiYanaiYoshioNaomotoNoriakiTanakaPrimary systemic chemotherapy (PSC) in breast cancer prolongs disease-free survival in patients who have obtained pathological complete remission (pCR). In combination with pathological examination, CT and MRI have been used to
evaluate the efficacy of PSC, they generally coincide well with pathological evaluation. We here present two cases showing discrepancies between pathological examination and imaging analysis after PSC in breast cancer. We should
keep such discrepancies in mind to determine the ideal treatment after PSC. An accurate method of evaluating cellular damage by PSC is needed.No potential conflict of interest relevant to this article was reported.