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BACKGROUND/AIM: The immune system has a pivotal role in modulating the response to chemotherapy in breast cancer (BC). However, the immune status during chemotherapy remains unclear. We evaluated the sequential changes in peripheral systemic immunity markers in BC patients treated with various chemotherapeutic agents. MATERIALS AND METHODS: We examined the correlation between the peripheral systemic immunity markers, neutrophil-to-lymphocyte ratio (NLR), absolute lymphocyte count (ALC) and the local cytolytic activity (CYT) score obtained by quantitative reverse-transcription polymerase chain reaction of 84 preoperative BC patients. Next, we observed the sequential changes in the peripheral systemic immunity markers during treatment with four anticancer drugs: oral 5-fluorouracil derivative; S-1, epirubicin plus cyclophosphamide; paclitaxel plus the anti-vascular endothelial growth factor antibody bevacizumab, and eribulin in 172 HER2-negative advanced BC patients. Finally, we examined the correlation between the changes in the peripheral systemic immunity markers, time to treatment failure (TTF) and progression-free survival (PFS). RESULTS: A negative correlation was found between ALC and NLR. ALC-low and NLR-high cases were positively associated with CYT score-low cases. The ratio of ALC-increase and NLR-decrease varies depending on the anticancer drugs used. The responder group (TTF ≥3 months) had a higher NLR-decrease ratio than the nonresponder group (TTF <3 months). Patients with a high NLR-decrease ratio showed higher PFS. CONCLUSION: The change in ALC or NLR varies according to the anticancer drugs, suggesting differential immunomodulatory effects of the drugs. Furthermore, the change in NLR reflects the therapeutic efficacy of chemotherapy in advanced BC.
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Antineoplásicos , Neoplasias de la Mama , Humanos , Femenino , Ciclofosfamida , Paclitaxel , EpirrubicinaRESUMEN
We herein report a case of adenomyoepithelioma (AME) of the breast with ductal carcinoma in situ (DCIS) involving a 71-year-old Japanese woman. She presented with bloody discharge from the left nipple. Mammography and ultrasonography showed a well-defined polygonal tumor. Fine-needle aspiration cytology of the mass and stamp cytology of the bloody nipple discharge showed malignancy. Mastectomy and a sentinel lymph node biopsy were performed. The final diagnosis was AME of the breast with DCIS. There are no reports of AME of the breast presenting with bloody nipple discharge; upon a diagnosis of AME of the breast with bloody nipple discharge, the possibility of the coexistence of breast cancer should thus be considered when encountering such cases.
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Male breast cancer is an extremely rare malignancy. We treated three male breast cancer patients. All three patients showed clinical N0 and received sentinel lymph node biopsy. Because the sentinel lymph node was positive for metastasis in one patient, a total mastectomy with axillary lymph node dissection was performed. The other two patients were negative for sentinel lymph node metastasis, and a simple mastectomy was performed. Two of the patients were postoperatively treated with tamoxifen; another patient was treated with adjuvant chemotherapy using taxotere and cyclophosphamide before tamoxifen. There was no recurrence in any of the three patients during an average follow-up period of 56.7 months (range 11.8-80.3). A sentinel lymph node biopsy is recommended for node staging in both male and female breast cancer patients as it is associated with a lower incidence of complications.
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Although basal cell carcinoma (BCC) is the most common dermatological malignancy arising from sun exposed skin, BCC of the nipple is extremely rare. To our knowledge only 34 cases have been reported. We report a 78-year-old man who was undergoing chemotherapy for liver metastasis of gastric cancer 1 year after surgery. The chief complaint was exudation and oozing from the nipple. A mass lesion was palpable and detected on mammography and enhanced computed tomography, and atypical cells were detected on cytological examination. Simple resection was performed because histopathological diagnosis of an intraoperative frozen section revealed BCC. Final pathological diagnosis was also BCC. The authors report this case and review the previous reports, and discuss the clinicopathologic characteristics and adequate treatment for this disease.
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Neoplasias de la Mama Masculina/patología , Carcinoma Basocelular/patología , Pezones/patología , Neoplasias Gástricas/patología , Anciano , Neoplasias de la Mama Masculina/cirugía , Carcinoma Basocelular/cirugía , Humanos , Neoplasias Hepáticas/tratamiento farmacológico , Neoplasias Hepáticas/secundario , Masculino , Recurrencia Local de Neoplasia/patología , Pezones/cirugía , Neoplasias Cutáneas/patología , Neoplasias Cutáneas/cirugía , Neoplasias Gástricas/tratamiento farmacológicoRESUMEN
OBJECTIVE: The primary objective was to assess the feasibility and accuracy of intraoperative sentinel lymph node mapping by using a video-assisted thoracoscopic indocyanine green fluorescence imaging system in patients with clinical stage I non-small-cell lung cancer. METHODS: Thirty-one patients who underwent operation between January 2009 and September 2009 were investigated for sentinel node biopsy. Indocyanine green fluorescence imaging was applied by an infrared light charge-coupled device, and sentinel nodes were identified intraoperatively and dissected. Histologic examination by hematoxylin-eosin staining was used to evaluate metastases. RESULTS: Sentinel lymph nodes were identified by segmentectomy in 11 of 14 patients (78.5%) and by lobectomy in 14 of 17 patients (82.4%). The total identification rate was 80.7% (25/31 patients), the false-negative rate was 0% (0/24 patients), and the overall accuracy rate was 80.7% (25/31 patients). CONCLUSION: Video-assisted thoracoscopic indocyanine green fluorescence image-guided surgery is feasible for sentinel node biopsy and may be a powerful tool to eliminate unnecessary lymph node dissection in patients with lung cancer.
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Carcinoma de Pulmón de Células no Pequeñas/patología , Carcinoma de Pulmón de Células no Pequeñas/cirugía , Colorantes Fluorescentes , Verde de Indocianina , Neoplasias Pulmonares/patología , Neoplasias Pulmonares/cirugía , Biopsia del Ganglio Linfático Centinela/métodos , Cirugía Torácica Asistida por Video , Anciano , Anciano de 80 o más Años , Reacciones Falso Negativas , Estudios de Factibilidad , Femenino , Fluorescencia , Humanos , Japón , Escisión del Ganglio Linfático , Metástasis Linfática , Masculino , Persona de Mediana Edad , Estadificación de Neoplasias , Neumonectomía , Valor Predictivo de las PruebasRESUMEN
BACKGROUND: This study investigated the potential of HE4 to predict disease-free survival for patients with breast cancer. PATIENTS AND METHODS: One hundred and twenty-nine patients with breast cancer underwent surgery from January 2004 to September 2009. Immunohistochemical analysis (IHC) and RT-PCR were used to determine the expression of HE4 which was compared with the clinicopathological factors or prognosis. RESULTS: A total of 71 of 129 cases (55%) were HE4 positive and two cell lines expressed HE4 protein and mRNA. No correlation was found between HE4 expression by IHC and clinicopathological factors; however, lymph node involvement was closely associated with HE4 expression. Five-year disease-free survival in the HE4-positive group (58.6%) was significantly worse than that in the negative group (85.6%, p=0.04). CONCLUSION: These data showed that HE4 expression is associated with lymph node involvement and is a possible predictive factor of breast cancer recurrence.