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Shizuoka-shi, Japan

Kiyohara Y.,Shizuoka Cancer Center Hospital | Yamazaki N.,National Cancer Center Hospital | Kishi A.,Toranomon Hospital
Journal of the American Academy of Dermatology | Year: 2013

Skin toxicities are the most common side effects associated with the epidermal growth factor receptor inhibitor erlotinib, occurring in most patients receiving the drug. Clinical trials evaluating erlotinib for the treatment of non-small cell lung cancer have reported a range of skin disorders, the most common being acneiform rash, xeroderma (dry skin), pruritus, and paronychia. Although in the majority of cases these effects are mild and transient, they can have a considerable impact on a patient's quality of life and, if particularly severe and persistent, may necessitate treatment interruption or cessation and compromise treatment outcome. This coupled with recent evidence to suggest a positive correlation between the incidence and severity of rash and clinical outcome among erlotinib-treated patients with advanced or metastatic non-small cell lung cancer highlights the importance of adequately managing epidermal growth factor receptor inhibitor-related skin disorders. Clear treatment strategies are therefore necessary to ensure the prevention and optimal management of erlotinib-related skin toxicities thereby enabling patients to continue erlotinib treatment. In this review we present a practical approach for the treatment of erlotinib-related cutaneous side effects in Japanese patients with advanced non-small cell lung cancer providing details of specific treatment interventions, according to symptom severity, for each of the common skin disorders. In addition, the importance of preventive skin care measures-namely maintaining cleanliness, moisturization, and protection from external stimuli-in preventing the development of serious skin disorders is discussed and guidelines for the practice of proper skin care are presented. © 2013 by the American Academy of Dermatology, Inc.

Uematsu T.,Shizuoka Cancer Center Hospital
Breast Cancer | Year: 2011

Little is known about the MR imaging features of triple-negative breast cancer (TNBC), but TNBC has a worse prognosis because it has no effective therapeutic targets, such as estrogen receptor for endocrine therapy and human epidermal growth factor receptor 2 (HER2) for anti-HER2 therapy. MR findings of a unifocal lesion, mass lesion type, smooth mass margin, rim heterogeneous enhancement, persistent enhancement pattern, and very high signal intensity on T2-weighted images are typical features of breast MR imaging associated with TNBC. Although TNBC can mimic a benign morphology, the early MR imaging recognition of TNBC could assist in both the pretreatment planning and the prognosis, as well as adding to our understanding of the biological behavior of TNBC. © The Japanese Breast Cancer Society 2010.

Uematsu T.,Shizuoka Cancer Center Hospital
Breast Cancer | Year: 2014

Breast ultrasonography (US) is an indispensable tool for diagnosis of palpable and non-palpable breast masses and can facilitate good patient care for breast cancer. However, it is of limited value in cases of isoechoic lesions surrounded by fat, heterogeneous echoic lesions surrounded by a heterogeneous background, deep lesions in huge breasts, subareolar lesions, and lesions caused by poor and underdeveloped operator skills. Some breast tumors such as ductal carcinoma in situ and invasive lobular carcinoma are easily missed on US because of the nature of the lesions. Recent studies have emphasized the use of tools complementary to B-mode US, including real-time elastography and Doppler imaging, in the evaluation of breast lesions missed on US. Radiologists can take a number of steps that will enhance the accuracy of US image interpretation and decrease the rate of false-negative findings. These steps include reviewing clinicopathological data, using mammography and MRI to help assess breast lesions missed on US, strictly adhering to positioning and technical requirements, being alert to subtle features of missed breast lesions, and judging a lesion by its most malignant feature. © 2013 The Japanese Breast Cancer Society.

Inflammatory breast carcinoma (IBC) is rare; however, it is the most aggressive variant of breast cancer with a very poor outcome. Locally advanced breast cancer and acute mastitis have a presentation similar to that of IBC. Therefore, the diagnosis of IBC remains a challenge in breast imaging. MRI can play a crucial role in the differential diagnosis by providing criteria indicative of IBC. Several MRI findings, especially T2-weighted images, are promising for more reliable and accurate interpretation of IBC. © 2012 The Japanese Breast Cancer Society.

Uematsu T.,Shizuoka Cancer Center Hospital
Breast Cancer | Year: 2012

This article reviews various non-mass-like ultrasonography (US) findings of the breast and the sonographic-pathologic correlation with Doppler techniques, elastography, and MRI. High-resolution US allows for identification of small, clinically occult non-mass-like US findings. Ductal carcinoma in situ and invasive lobular carcinoma usually manifest as a non-mass-like lesion on US. It is useful to classify non-mass-like lesions on US in a similar manner to the classification of non-mass-like enhancement on MRI. © 2012 The Japanese Breast Cancer Society.

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