Biomedical subjects

H Takei

Publications and source records attributed to H Takei.

252 records · Page 14Linked to original sources

PubMedDate not supplied

Immunohistochemical analysis of cytokeratin #8 as a prognostic factor in invasive breast carcinoma.

Cytokeratin #8 (CK8) was analysed by immunohistochemistry using a monoclonal antibody in 101 operable invasive breast carcinomas (IBCs). The immunohistochemical staining pattern, and its correlations with patient characteristics and prognosis were studied. Sixty-five (65%) out of 101 patients had CK8 positive tumors. The incidence of CK8 positivity in patients with estrogen receptor (ER) positive tumors was significantly higher than that in patients with ER negative tumors. The same tendency was seen between the CK8 positivity and progesterone receptor (PR) status; however, no statistical significance was found. Furthermore, the incidence of CK8 positivity in premenopausal patients was lower than that in postmenopausal patients with no statistical significance. Relapse-free survival (RFS) for patients with CK8 positive tumors was significantly better than that for patients with CK8 negative tumors. The multivariate analysis of factors related to RFS showed that CK8 staining positivity was an independent prognostic indicator of IBCs. These results suggest that CK8 expression may be one of the prognostic factors of IBCs.

Antibodies, Monoclonal↗

PubMedDate not supplied

Oral high-dose medroxyprogesterone acetate treatment for recurrent breast cancer.

Oral high-dose medroxyprogesterone acetate (MPA) treatment (600, 800, 1200 mg/day or changed dosage) was given to 49 patients with recurrent breast cancer from January 1979 to December 1992. The overall response rate to MPA was 38.8% (19/49). The response rate in the soft tissue was significantly higher compared with that in bone metastases or in visceral metastases. MPA was effective on patients both with or without previous treatment. Several side effects were recognized, but they were mild and tolerable. These results demonstrate that MPA is effective when used as first line or second line treatment.

Administration, Oral↗

PubMedDate not supplied

Subcutaneous mastectomy with axillary dissection plus breast reconstruction using latissimus dorsi myocutaneous flap (or latissimus dorsi muscle) for breast cancer.

Subcutaneous mastectomy with axillary dissection plus breast reconstruction using latissimus dorsi myocutaneous flap (or latissimus dorsi muscle) was carried out for 8 patients with breast cancer. These consisted of 1 patient with non-invasive ductal carcinoma, 5 with stage I (4 invasive ductal carcinomas and 1 invasive lobular carcinoma) and 2 with stage II (1 invasive ductal carcinoma and 1 invasive lobular carcinoma). Cancer cells were recognized histopathologically in the resection margins of the small mammary gland resting under the nipple in only 1 case, and the remaining 7 cases underwent a curative resection. In the prognosis, 7 patients were disease-free and 1 showed a local recurrence. The patient with local recurrence showed no metastasis after the resection of the local lesion. The cosmetic results of this operation were excellent in all patients. This operation was effective both for these patients with breast cancer who did not want to undergo breast conserving surgery or modified radical mastectomy and for those who were excluded from the criteria of breast conserving surgery from the prognostic and cosmetic points of view.

Adult↗

PubMedDate not supplied

Nonpalpable breast cancer.

Thirty-seven patients with nonpalpable breast cancer treated between 1981 and 1992 were analysed. Twenty-five (68%) of the patients were detected by microcalcification of mammogram, 8 by nipple discharge and 4 by other means. Biopsy was carried out in all patients to get a final diagnosis and histopathological examinations were performed using continuous sections (especially the section with microcalcification). The incidence of noninvasive carcinoma was 59% (22 cases) and the remaining invasive carcinomas were 3 minimal lesions less than 0.5 cm, 3 lesions from 0.5 to 1.0 cm, 3 diseases more than 1.0 cm, and 6 invasive carcinomas with noninvasive ductal carcinoma predominant. Modified radical mastectomy was performed in 16 cases, partial glandectomy in 10 and other surgery including subcutaneous mastectomy in 11. All of the patients with nonpalpabl breast cancer showed a good prognosis because of early detection and early treatment. Mammography was useful to detect nonpalpable breast cancers with microcalcification.

Adult↗

PubMedDate not supplied

Clinical significance of first line treatment in recurrent breast cancer.

From 1962 to 1992, 279 patients with recurrent breast cancer were treated. Of these, the cases with resected lesions, imperfectly evaluated cases and cases where information was lacking were excluded, and 185 recurrent breast cancers were evaluable at the first line or subsequent treatment. Sixty-seven (36.2%) out of 185 cases responded to first line treatment, while the remaining 118 cases did not respond. In the 67 responder cases at the first line treatments, 16 (23.9%) responded to second line or third line, however, in the 118 nonresponder cases, only 13 (11.0%) responded to next or subsequent treatment. The incidence of responder in the second line or third line treatment was significantly higher in the first line responder group than in the first line nonresponder group. Furthermore, overall survival of first line responders was significantly better than that of first line nonresponders. There was no significant difference in the survival after recurrence between responders and nonresponders in the first line chemotherapy, chemoendocrine treatment or radiotherapy, however, a significant difference was seen between the two groups in the first line endocrine treatment. These results suggest that first line treatment may select the treatment sensitive (especially, truly hormone-dependent) recurrent breast cancers which show a better prognosis.

Bone Neoplasms↗

PubMedDate not supplied

Subcutaneous mastectomy with axillary dissection for early breast cancer.

From 1983 to 1990, subcutaneous mastectomy with axillary dissection was carried out for 46 patients with early breast cancer including three bilateral breast cancer patients (four breasts). Cancer cells were recognized histopathologically in the resection margins of small mammary gland resting under the nipple in four cases, and the remaining 42 cases underwent a curative resection. Multicentric lesions were found out histopathologically by continuous sections in five cases (six breasts). There was no difference in the prognosis using the case-control comparison method between 34 patients with ipsilateral invasive carcinoma who underwent a subcutaneous mastectomy in this study group and 34 patients who underwent a radical or modified radical mastectomy in the control group. Cosmetic results of the subcutaneous mastectomy were evaluated in 37 patients, and 9 were excellent, 17 were good, 9 were not so good and 2 were poor. Subcutaneous mastectomy with axillary dissection was an effective operation for early breast cancer including multicentric lesions and some non-invasive ductal carcinomas from the prognostic and cosmetic standpoints.

Adult↗

PubMedDate not supplied

Phase II trial of mitoxantrone, doxifluridine and medroxyprogesterone acetate as second-line treatment for anthracycline-resistant metastatic breast cancer.

Sixteen patients with anthracycline resistant metastatic breast cancer were treated with a combination of mitoxantrone (MIT), doxifuridine (5'-DFUR) and medroxyprogesterone acetate (MPA). The median dose of anthracyclines was 360 mg (range 20-540 mg). Eligible patients received 7.0 mg/m2 of MIT every four weeks 600 mg of 5'DFUR were given orally every day. Eight (50.0%) out of 16 patients showed partial response. Six (54.5%) out of 11 bone lesions, 4 (80.0%) out of 5 lung lesions and 1 (20.0%) out of 5 soft tissue lesions responded to this treatment. The median response duration was 26 weeks (range 4-52). Hematological and gastrointestinal toxicity were tolerable. Alopecia was not observed. Tachycardia was noted in patients receiving more than 80 mg of MIT; however, digitalis controlled the symptom. The combined treatment with MIT is useful for anthracycline-resistant metastatic breast cancer.

Adult↗

PubMedDate not supplied

Immunochemotherapies versus chemotherapy as adjuvant treatment after curative resection of operable breast cancer.

In our previous study, oral adjuvant combination chemotherapy of 5-fluorouracil, cyclophosphamide, mitomycin C, and predonisolone (FEMP) after curative resection of operable breast cancer with vascular invasion in the tumor and/or in the metastatic lymph node was found to be more effective than one course of mitomycin C or cyclic course of mitomycin C. In the present study, we have assessed the efficacy of protein-bound polysaccharide (PSK) or levamisole (LMS) in addition to FEMP. Between January 1980 and December 1990, 227 operable breast cancer patients with vascular invasion in the tumor and/or in the metastatic lymph node were randomized into FEMP, FEMP + LMS, or FEMP + PSK. The risk ratio was lower in the FEMP + PSK group compared to the FEMP group. In disease-free survival or overall survival, there was no significant difference between the three groups, however, the survival curve of the FEMP + PSK group tended to be better than that of the FEMP group(logrank, P = 0.0706; generalized Wilcoxon, P = 0.0739). Side effects were observed at a low incidence, but they were mild and tolerable. Immunochemotherapy using PSK improved the prognosis of patients with operable breast cancer with vascular invasion.

Adjuvants, Immunologic↗

PubMedDate not supplied

Relationship between thyroid-pituitary function and response to therapy in patients with recurrent breast cancer.

In this study, thyroid (T3, T4, free T3, free T4) and pituitary function (thyrotropin (TSH), growth hormone (GH), prolactin (PRL)) in 38 patients with recurrent breast cancer were examined. The patients were divided into three groups according to their response to the therapy. There were 16 partial response (PR), 10 no change (NC) and 11 progressive disease (PD) patients. The maximum and the minimum value for each hormone throughout the course of treatment were compared between three groups. The PD group showed significantly lower minimum T3 levels than the other two groups (p < 0.05). The maximum TSH level in the PD group was significantly higher than that of the other groups. The minimum TSH level in the PD group was significantly lower than that in the PR group (p < 0.05). The minimum TSH level in the NC group was also lower than that in the PR group. The maximum PRL level in the NC and the PD group was higher than that in the PR group (p < 0.05, p < 0.01, respectively). The tumors of the patients with temporal increase of TSH level were resistant to all subsequent therapies. These five patients died within four months followed by decreasing of the TSH level. It is concluded that thyroid and pituitary function, especially free T4, TSH and PRL, are predictive indicators of therapeutic response and the prognosis of the patients with recurrent breast cancer.

Adult↗

PubMedDate not supplied

Multidisciplinary treatment with anthracyclines in inflammatory breast cancer.

Twenty-two patients with inflammatory breast cancer treated between 1962 and 1994 were analyzed. Before the introduction of multidisciplinary treatment with anthracycline agents between 1962 and 1981, 11 patients out of 14 were resected, however, a curative operation was performed for only 3 of these patients (29.3%). Ablative endocrine therapy, intraarterial infusion of anticancer drugs (mitomycin C or 5-fluorouracil), and radiation were carried out as the preoperative induction therapy for inflammatory breast cancer. All 14 patients died within 36 months. After the introduction of multi-disciplinary treatment with anthracycline agents between 1981 and 1994, preoperative induction chemotherapy or chemoendocrine therapy using anthracyclines was carried out on 7 out of 8 patients and the remaining patient received radiation. Of the former 7 patients, 6 (85.7%) underwent a curative operation. There was approximately a 35 percent cumulative survival rate observed 60 months after operation, and 3 patients out of the 7 lived for more than 5 years. To conclude, multidisciplinary treatment including systemic induction chemotherapy with anthracyclines was an effective treatment for inflammatory breast cancer.

Adenocarcinoma↗

PubMedDate not supplied

Breast conserving surgery with nipple resection.

Breast conserving surgery with nipple resection was carried out on 4 patients with early breast cancer because location of each tumor was very close to nipple. These consisted of 3 patients with state I invasive ductal carcinoma and 1 patient with stage II invasive ductal carcinoma. Cancer cells were not recognized histopathologically in the resection margins of each case and all cases underwent a curative resection with axillary dissection (up to level III). The rested areola in each case was made to be round-shaped by skin suture and the edge of the wound located in the center of areola looked like a small nipple. The cosmetic result of this operation were excellent in all patients. This operation may be effective both for these patients with early breast cancer locating under the nipple or areola and for those whose tumor was very close to nipple.

Adult↗

PubMedDate not supplied

Changes of cytokines and thyroid function in patients with recurrent breast cancer.

The hypothyroid state or nonthyroidal illness is often observed in patients with recurrent cancer. High levels of cytokines are frequently observed in critically ill patients. Recent studies have shown that interleukin (IL)-6 may be a cause of nonthyroidal illness. We reported the relationship between thyroid function and the prognosis of the patients with recurrent breast cancer. In this study, we measured the serum level of cytokines (IL-2, IL-6, IL-8) and thyroid function (free T3, free T4, and thyrotropin (TSH)) in 38 patients with recurrent breast cancer. All patients had received three or more different courses of therapy before they were entered the study. The patients were divided into three groups according to their response to therapy. There were 16 partial response (PR), 10 no change (NC) and 11 progressive disease (PD) patients. They did not receive any medication that influenced the thyroid hormone level other than medication for cancer. The IL-2 level was under the detectable limit in all groups. No abnormal levels of cytokines were observed in the PR group. IL-6 and IL-8 levels in the PD group were significantly higher than that in the NC group (p < 0.05). Significant negative correlation was observed between IL-6 and thyroid hormones (free T3, free T4). Patients whose IL-6 level was 20 pg/ml or more died within four months after the beginning of the treatment. We concluded that IL-6 may lead to a hypothyroid state in patients with recurrent breast cancer. A high level of IL-6 and IL-8 means the confusion of the defense system in hosts. Therefore, these cytokines will be predictive indicators of the therapeutic response and the prognosis of the patients with recurrent breast cancer.

Adult↗

PubMedDate not supplied

HLA antigen as predictive index for the outcome of breast cancer patients with adjuvant immunochemotherapy with PSK.

We demonstrated that the prognosis of breast cancer patients who received adjuvant immunochemotherapy with Krestin (PSK) showed a tendency to be better than that of breast cancer patients receiving chemotherapy only. We retrospectively investigated the usefulness of HLA typing for selecting patients to receive adjuvant immuno-chemotherapy with PSK. One hundred and thirty-four patients with operable breast cancer were typed as HLA-A, -B, -C by a lymphocytotoxicity test. Patients without vascular invasion had no adjuvant therapy (NA group). Patients with vascular invasion in the tumor and/or in the metastatic lymph node were randomized into two groups. In group 1 (FEMP only), a combination chemotherapy of 100 mg of 5-fluorouracil (F), 50 mg of cyclophosphamide (E), 2 mg of mitomycin C (M), and 5 mg of predonisolone (P) was orally administered daily for 28 days (one course). In group 2 (FEMP+PSK), FEMP and 3.0 g of PSK were orally administered for 28 days (one course). Two courses a year of these agents were given for five years in both groups. Each group (NA, FEMP, FEMP+PSK) was stratified by the presence of HLA B40 type (B40(+)) or not (B40(-)). Five- and 10-year disease-free survival (DFS) rates (93%, 80%, respectively) of patients with B40(+) seemed to be better than those (83% and 51%) of patients with B40(-). In the NA group, 5- and 10-year DFS were 100% and 71% in patients with B40(+), 92% and 76% in those with B40(-), respectively. In the FEMP group (chemotherapy only), 5- and 10-year DFS of patients with B40(+) were both 84%. These were not statistically significant compared with those (82% and 33%) of patients with B40(-). On the other hand, in the FEMP+PSK group, 5- and 10-year DFS of patients with B40(+) were both 100%, and those of patients with B40(-) were 76% and 55%, respectively. DFS of patients with B40(+) was significantly better than that of patients with B40(-). It is concluded that HLA typing may be a predictive index in determining the use of immunochemotherapy combined with PSK for patients with operable breast cancer.

Adjuvants, Immunologic↗

PubMedDate not supplied

Comparison of breast-conserving therapy with mastectomy for treatment of early breast cancer.

The aim of this study was to compare the survival and recurrence rates of patients undergoing breast-conserving therapy with the rates of those undergoing mastectomy. Between August 1991 and June 1994, 229 patients were enrolled in this study, although one was later excluded because the tumor was histologically diagnosed as benign. A total of 119 patients with clinical stage TIS, I or II underwent breast-conserving therapy and 109 patients received mastectomy. Mastectomy was utilized more than breast-conserving therapy in the case of clinical stage II, greater age, larger tumor size or shorter distance between the tumor and the nipple. Twenty-seven patients (23.1%) of the 117 receiving breast-conserving surgery were surgical margin positive. There was no significant difference in the distance between the tumor and the nipple, tumor size or clinical stage in the incidence of surgical margin positive cases. Mean follow-up time of the breast-conserving therapy group and the mastectomy group was 42.4 and 39.7 months, respectively. There was no significant difference in the overall survival and disease-free survival between breast-conserving therapy and mastectomy. After adjustment for the clinical stage, there was no significant difference in the prognosis between breast-conserving therapy and mastectomy.

Adult↗

PubMedDate not supplied

Antitumor effects of SEF19, a new nonsteroidal aromatase inhibitor, on 7,12-dimethylbenz[a]anthracene-induced mammary tumors in rats.

The antitumor and endocrine effects of a new nonsteroidal aromatase inhibitor, 2-(imidazol-1-yl)-4,6-dimorphorino-l, 3, 5-triazine (SEF19) were examined in female Sprague-Dawley rats bearing estrogen dependent 7,12-dimethylbenz[a]anthracene(DMBA)-induced mammary tumors, and the effects were compared with those of CGS20267. The rats bearing DMBA-induced mammary tumors within 6-15 weeks after the DMBA administration were divided into the treatment groups once a week every week, and they were treated with SEF19, CGS20267 and vehicle for 4 weeks. One hundred rats were sacrificed 4 hours after the last administration, and the remaining 60 rats were sacrificed after a 4-week recovery period. During the treatment and recovery period, the tumor size was generally smaller in the SEF19 and CGS20267-treated subgroups than in the control subgroup. Tumor sizes in the subgroups treated with high doses of SEF19 (25 mg/kg/day and 50 mg/kg/2 days) were reduced to the size of the CGS20267-treated subgroup. The CGS20267-treated rats showed decrease in the serum estradiol level and an increase in the serum testosterone level. Their uterine weights were reduced. SEF19 treatment failed to show any effect on the serum levels of estrone, estradiol, testosterone and androstenedione, but it suppressed uterine weight in a dose-dependent manner. After the recovery period, no effect was detected in the serum concentrations of steroid hormones and the weight of the organs. At every dose used in the present study the aromatase inhibitory activity of SEF19 was weaker than that of CGS20267, but the inhibitory effect on mammary tumor growth of SEF19 at high doses was comparable to that of CGS20267. We conclude that the antitumor effect of SEF19 is not due to aromatase inhibition but mainly to its direct cytotoxicity.

9,10-Dimethyl-1,2-benzanthracene↗

PubMedDate not supplied

Age-dependent characteristics of screen-detected patients with breast cancer.

A consecutive series of 128 breast cancer patients detected by breast screening were enrolled in this study to analyze their age-dependent characteristics. They were classified into three groups; 40 years or less (young): 26 patients, 41-55 years (middle-aged): 67 patients and 56 years or over (old): 35 patients. The percentage of patients who had noticed breast abnormality by self-examination at the time of the breast screening increased from the young patients to the old without statistical significance. Nonpalpable breast cancer was more frequently (p < 0.05) observed in the young patients or the middle-aged rather than the old patients. The incidence of noninvasive carcinoma decreased from the young patients to the old without statistical significance. Decreased survival was seen in older patients rather than younger patients, without statistical significance. As a result, prognostic features were more favorable in patients aged 40 years or less than the other. Women aged 35-40 years should be recommended to attend breast screening.

Adult↗

PubMedDate not supplied

Surgical margin and breast recurrence after breast-conserving therapy.

A total of 161 patients with clinical stage I and II breast cancer received breast-conserving therapy between August 1991 and December 1997, and local recurrence occurred in five patients. The actuarial local control 5 years after breast-conserving surgery was 96.6%. We studied microscopic surgical margins of resected specimens in patients with breast-conserving surgery to determine whether the surgical margin was a risk factor for local recurrence in the conserved breast. Microscopic margins were negative in 125 (78%) of 161 patients and positive in 36 (22%). There were no differences between patients with positive surgical margins and those with negative surgical margins in age at operation, tumor size, clinical stage, lymph node status, estrogen receptor status, or distance from tumor to nipple. Local control was significantly better in the surgical margin-negative patients than in the surgical margin-positive patients. We conclude that microscopic surgical margin is a risk factor for local recurrence in the conserved breast.

Actuarial Analysis↗

PubMedDate not supplied

Efficacy of mammography for detecting early breast cancer in women under 50.

Screening mammography (MMG) for women aged 50 years and older has been widely accepted all over the world. However, the efficacy of screening mammography for women aged under 50 years has not been established. We compared mammographic findings of the patients under age 50 (the younger group) and those of patients 50 and older (the older group). From 1992 to 1997, 107 patients with early breast cancer (non-invasive and Stage I) were treated in our hospital. There was no difference between the groups in background. Of 53 patients in the younger group, 40 (75.5%) were diagnosed as having cancer using mammography, while 44 of 54 (81.5%) of the older group were diagnosed as having cancer. A total of 46 (86.8%) patients in the younger group were diagnosed using MMG and physical examination (PE), and 50 (92.6%) in the older group were diagnosed as cancer using MMG and PE. There was no difference in the successful diagnosis rate using mammography in the two groups. Breast cancer screening using MMG may also be useful for women aged under 50.

Adult↗