The National Hospital Organization Shikoku Cancer Center

Matsuyama-shi, Japan

The National Hospital Organization Shikoku Cancer Center

Matsuyama-shi, Japan
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Ishitobi M.,Japan National Cardiovascular Center Research Institute | Suzuki O.,Japan National Cardiovascular Center Research Institute | Komoike Y.,Japan National Cardiovascular Center Research Institute | Ohsumi S.,The National Hospital Organization Shikoku Cancer Center | And 5 more authors.
Breast Cancer | Year: 2012

Backgrounds: The aim of this study was to assess the efficacy and safety of neoadjuvant anastrozole and radiation in postmenopausal breast cancer patients with hormone-receptor-positive tumors. In addition, we assessed the predictive factors for clinical and pathological response for concurrent anastrozole and radiotherapy. Methods: Patients with tumors 3 cm or larger were treated with neoadjuvant anastrozole for 24 weeks, and concurrent radiation was administered from 12 weeks after the start of anastrozole. Core biopsies were obtained at baseline and 12 weeks after the start of anastrozole. After completing neoadjuvant treatment, patients underwent definitive surgery. The primary endpoint was the overall objective response. In addition, we assessed the predictive factors for clinical and pathological response for concurrent anastrozole and radiotherapy. This trial is registered with the UMIN Clinical Trials Registry, no. UMIN000002266. Results: The overall objective response rate was 92 %. Toxicity during neoadjuvant therapy was acceptable, with no grade 3 toxicities. After surgery, grade 3 toxicities occurred in 2 of 25 patients (8 %). Conclusions: Our preliminary data suggest that neoadjuvant anastrozole and radiation therapy in postmenopausal breast cancer patients with hormone-receptor-positive tumors has a high potential for clinical response. © 2012 The Japanese Breast Cancer Society.


PubMed | The National Hospital Organization Shikoku Cancer Center
Type: Journal Article | Journal: Breast cancer (Tokyo, Japan) | Year: 2013

The aim of healthcare providers is to help patients regain their health and/or maintain or increase their happiness. The quality of healthcare can be assessed objectively by using indices such as survival rates, but subjective assessment is sometimes more important than objective evaluation, because whether patients feel healthy or happy or not is their major concern. Quality of life (QOL) research is a typical approach to subjective assessment of health. Self-administered health-related QOL (HRQOL) questionnaires are used to obtain patient-reported outcome (PRO) data. PRO is defined by the US Food and Drug Administration (FDA) as any report of the status of a patients health condition that comes directly from the patient, without interpretation of the patients response by a clinician or anyone else. PRO data are regarded as more accurate than clinician-rated ones in terms of assessing patients symptoms and HRQOL. The Comprehensive Support Project for Health Outcome Research of the Public Health Research Foundation has conducted much PRO research in collaboration with the Comprehensive Support Project for Oncology Research, especially in randomized controlled trials (RCTs). Here, we review the results of PRO research in RCTs conducted in Japan and examine future perspectives in this field.


The most common diagnostic procedure in the United States for mammographically detected nonpalpable lesions is a combination of a vacuum-assisted biopsy device and a prone-type biopsy table. We have used an upright-type stereotactic mammography unit without a digital imaging system instead of the prone table.Five-hundred ten biopsies of 506 mammographically detected nonpalpable breast lesions in 488 patients, consisting of 445 lesions with microcalcifications alone, 39 masses without calcifications, and 22 with both masses and microcalcifications, were attempted using a combination of a vacuum-assisted device (Mammotome) and an upright unit without a digital imaging system in a sitting position between May 1999 and February 2007.Breast tissue was obtained in 497 biopsies. Microcalcifications were confirmed radiographically in the tissue of 447 out of 459 biopsies from lesions with microcalcifications (97.4 %). One hundred thirty-seven were diagnosed as malignant, 10 as atypical ductal hyperplasia, 345 as benign, and 1 was not diagnosable. The underestimation rate was 28.0 %. Overall, 26 patients (5.1 %) had vasovagal reactions, while 19 (3.8 %) experienced mild subcutaneous bleeding. Two hundred fifty of 350 lesions, for which biopsy diagnoses were benign, were followed for a median period of 33 months. Four lesions turned out to be malignant. The false-negative rate was 2.8 %.The biopsy technique using the combination of the Mammotome and an upright unit without a digital imaging system is cost-effective, safe, and accurate, and should be regarded as one of the standard biopsy methods for mammographically detected nonpalpable lesions.

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