Publications by authors named "Haruru Kotani"
Article Synopsis
- Breast cancer-related lymphedema (LE) negatively affects quality of life, with axillary lymph node dissection (ALND) and postoperative docetaxel (DTX) being significant risk factors.
- Among 214 patients studied, 24% developed objective LE, with supraclavicular irradiation identified as a key risk factor, more so when combined with taxane chemotherapy.
- The findings highlight the need for careful management of LE in patients undergoing both taxane-based treatments and supraclavicular radiation therapy.
Article Synopsis
- Tailored axillary surgery (TAS) is a new method for selectively removing metastatic lymph nodes in breast cancer patients using a breast biopsy clip and point marker.
- The study involved 30 patients, with 20 undergoing TAS after neoadjuvant chemotherapy, achieving a 90% success rate and 0% false-negative rate in cases also undergoing traditional dissection.
- The findings suggest that TAS is a safe and effective approach for treating breast cancer with lymph node metastases.
Article Synopsis
- Fosnetupitant is an anti-nausea medication used for patients undergoing chemotherapy, showing non-inferiority to another treatment in prior studies.
- A phase II study evaluated the safety of a faster 15-minute infusion of fosnetupitant in cancer patients, focusing on allergic reaction incidents and other side effects.
- Results indicated that the 15-minute infusion was safe, with no allergic reactions or severe side effects reported, and a high complete response rate of 87%.
Article Synopsis
- Trastuzumab deruxtecan (T-DXd) improves outcomes for patients with HER2-positive metastatic breast cancer, but there's limited guidance on subsequent treatment options.
- In a study involving 29 patients, the median time to treatment failure (mTTF) was 3.5 months across all treatments, with regimens containing trastuzumab showing longer mTTF compared to HER2 tyrosine kinase inhibitors (TKIs).
- The median overall survival (OS) for patients was 14.9 months, indicating a need for more research to determine the most effective treatments following T-DXd therapy.
Purpose: Oncotype DX® is a frequently used multigene assay for hormone receptor-positive breast cancers. However, limited evidence is available regarding its application in Japan owing to the lack of insurance coverage. Therefore, we conducted this large-scale, retrospective study by collecting data from nine Japanese institutes and assessed postoperative treatment choice and prognosis by using Oncotype DX®.
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- A patient with hereditary breast and ovarian cancer syndrome (HBOC) was found to have both breast and ovarian cancer, which is a rare occurrence.
- Laparoscopic examination was conducted to evaluate the presence of concurrent tumors and to determine the possibility of primary debulking surgery (PDS) for the ovarian cancer.
- The procedure confirmed ovarian cancer and allowed for successful surgical treatment, leading to a final diagnosis of both invasive ductal breast carcinoma and high-grade serous ovarian carcinoma, highlighting the potential utility of laparoscopy in managing multiple cancers.
Article Synopsis
- Advances in breast cancer treatment are focusing on de-escalation therapy, particularly for elderly patients, to minimize harm during treatment.
- An 88-year-old woman with early-stage HER2-positive breast cancer had a remarkable response to a single dose of trastuzumab, leading to a pathological complete response before her scheduled mastectomy.
- This case highlights the potential of trastuzumab monotherapy for certain patients and emphasizes the need for identifying individuals who can benefit from less aggressive treatment options without chemotherapy.
Article Synopsis
- - The study investigates the effectiveness of fine-needle aspiration cytology (FNAC) in diagnosing metastasis in axillary lymph nodes of breast cancer patients, highlighting its variability in sensitivity and the uncertainty regarding sentinel lymph node biopsy (SLNB) for neoadjuvant chemotherapy (NAC) patients with negative FNAC results.
- - An analysis of 3,810 clinically node-negative breast cancer patients showed that SLNs' positivity rates were significantly higher in the non-NAC group compared to NAC patients with negative FNAC results, indicating a potential under-diagnosis in the latter.
- - The study concludes that while FNAC has a high false-negative rate, SLNB remains a crucial tool in staging axillary nodes for patients undergoing NAC
Article Synopsis
- A study investigated the effectiveness of a breast tissue marker in predicting pathological complete response (pCR) in patients with invasive breast cancer undergoing neoadjuvant chemotherapy (NAC).
- Out of 102 patients, 34.3% achieved clinical complete response (cCR), with 52.2% receiving a pCR; the marker's absence of cancer showed a low probability of undetected cancer in removed tissues.
- The findings suggest that if no cancer is found at the marker's site after NAC, it may indicate that surgery could be avoided in some cases.
Article Synopsis
- The study focused on using three-dimensional (3D) breast imaging to help patients understand the potential changes in breast appearance after breast-conserving surgery (BCS).
- A survey of 162 breast cancer patients showed that a significant majority (84.6%) were satisfied with how the procedure was explained and with the use of 3D imaging.
- The findings indicate that this method not only aids in patient preparation for BCS but also influences some patients' decisions toward mastectomy if they found the potential deformations unacceptable.
Article Synopsis
- Cyclin-dependent kinase 4/6 inhibitors (CDK4/6i) combined with endocrine therapy (ET) have been approved for treating breast cancer and may reduce arthralgia (joint pain) compared to ET alone.
- Research analyzed 12 phase II/III trials with nearly 17,440 patients and found significantly lower arthralgia rates in those receiving CDK4/6i alongside ET (27.6% vs. 34.8% for ET alone).
- This suggests that CDK4/6i not only enhances treatment effectiveness but also helps minimize joint pain, particularly in patients with early-stage breast cancer.
Purpose: Safely postponing the use of chemotherapy is important for quality of life maintenance in patients with hormone receptor-positive advanced breast cancer. In previous studies, a combination of cyclin-dependent kinase 4 and 6 inhibitors (CDK4/6i) and fulvestrant prolonged the time to chemotherapy (TTC). In this study, we used real-world data to evaluate TTC in the context of CDK4/6i therapy.
View Article and Find Full Text PDFBackground: Talazoparib, a poly(ADP-ribose) polymerase enzyme inhibitor, is approved for the treatment of patients with germline BRCA1/2 (gBRCA1/2)-mutated HER2-negative advanced breast cancer. This two-part study, a recently published dose-escalation part followed by the dose-expansion part reported here, evaluated the efficacy and safety of talazoparib in Japanese patients with gBRCA1/2-mutated advanced breast cancer.
Methods: In this open-label, multicenter phase 1 study (NCT03343054), the primary endpoint of the dose-expansion part was confirmed objective response rate (ORR), determined by investigator assessment (RECIST 1.
Article Synopsis
- The study aimed to compare survival outcomes among breast cancer patients who achieved a pathological complete response (pCR), those who did not (non-pCR), and those who experienced tumor progression during neoadjuvant systemic therapy (NST).
- Out of 595 patients reviewed, 28.1% achieved pCR, 67.9% did not, and 4.0% had progression; the progression group had significantly shorter disease-free and overall survival times compared to the other groups.
- The findings highlight that patients with tumor progression during NST have the worst survival outcomes, indicating a need for new treatment approaches for these individuals.
Article Synopsis
- The study investigated how often interstitial lung disease (ILD) occurs in cancer patients treated with or without the drug bevacizumab.
- Researchers analyzed data from 13 clinical trials that included 7201 patients and found that ILD events were significantly lower in the bevacizumab group compared to the control group.
- The results suggest that bevacizumab might be effective in reducing the chances of developing ILD in patients undergoing targeted cancer therapies.
Article Synopsis
- - The DESTINY-Breast04 trial is exploring the effectiveness of trastuzumab deruxtecan (T-DXd) for treating both HER2-low and HER2-positive breast cancer, emphasizing the need for targeted treatments in HER2-low patients.
- - A study analyzed data from nearly 5,000 breast cancer patients, discovering that 64.4% had low HER2 expression, with comparisons made between HER2-low and HER2-negative patient prognoses.
- - Although HER2-low and HER2-negative patients exhibited similar prognosis overall, the HER2-low patients showed a tendency for better outcomes, highlighting the potential for personalized treatment based on hormone receptor status.
Article Synopsis
- A study in Japan found that early breast cancer patients often perceive their baseline risk of progression as higher than what their physicians estimate, highlighting a significant gap in understanding between the two parties.
- Out of 262 enrolled patients, 190 believed their risk was higher than the physicians' assessments, with the majority estimating significantly greater risks (P < 0.001).
- Patients who understood the term 'baseline risk' and those with stage II cancer had smaller differences in estimates compared to other patient factors, suggesting the importance of education and the specific stage of cancer in shaping perceptions of risk.
Article Synopsis
- The study explored the effectiveness of compression therapy using surgical gloves to prevent chemotherapy-induced peripheral neuropathy (CIPN) in patients receiving paclitaxel (PTX).
- The trial involved 56 patients, with a double-blind design comparing two glove sizes on each hand during PTX infusions to assess differences in CIPN incidence.
- Results indicated no significant difference in the occurrence of sensory or motor neuropathy between the compression (study) and control sides, suggesting that this method is not effective in preventing PTX-induced PN.
Article Synopsis
- Neoplastic seeding (NS) can happen after tissue biopsies, especially during mastectomy with immediate reconstruction, leading to higher local recurrence risks.
- A study analyzed 174 mastectomy cases, revealing a low incidence of NS (1.7%) through clinical evaluation, and identified challenges in excising biopsy scars when NS was not clinically evident.
- It emphasizes the need for careful preoperative assessment of NS and suggests that excising biopsy scars should be considered, even if NS isn't clinically apparent, to minimize complications in reconstructive surgery.
Background: The efficacy of adjuvant endocrine therapy for hormone receptor-positive breast cancer has been previously established. However, significant adverse events related to endocrine therapy cannot be ignored. T1 breast cancer is expected to have a good prognosis.
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- Advance care planning (ACP) helps adults express their values and preferences for future medical care, especially in the context of metastatic breast cancer, but there's variability in how oncologists engage in these discussions.
- A survey of 118 physicians from 41 oncology institutions revealed that 72% engaged in ACP, but only a small percentage used structured methods or had clear triggers for initiating conversations.
- Improved training in communication skills was linked to higher engagement in ACP discussions, yet there still remained inconsistencies in how frequently and effectively these conversations were conducted among oncologists.
Background: Bevacizumab is an antiangiogenic agent, and that synergizes with chemotherapeutic drugs. When used in combination therapies, Bevacizumab is associated with adverse events such as hemorrhage, gastrointestinal perforation, delayed wound healing, and pneumothorax. However, the molecular mechanisms underlying these adverse events are not fully understood.
View Article and Find Full Text PDFThe utility of regional nodal irradiation (RNI) is being considered in cases of 1-3 axillary node metastases after breast-conserving surgery (BCS) with axillary lymph-node dissection (ALND). Therefore, we examined the necessity of RNI by examining the sites of recurrences in cases at our institution. We retrospectively analyzed 5,164 cases of primary breast cancer between January 2000 and December 2014 at the Aichi Cancer Centre, identifying local and distant recurrences in 152 patients with primary breast cancer treated with BCS and ALND and who had 1-3 positive axillary nodes.
View Article and Find Full Text PDFBackground: Immediate breast reconstruction (IBR) has been become a standard treatment for patients with breast cancer undergoing mastectomy. However, whether IBR is appropriate in patients undergoing neoadjuvant chemotherapy (NAC) is still unclear. Therefore, in this study we examined the rates of operative adverse events (AEs), risk factors for operative AEs, and effects on chemotherapy and radiotherapy of IBR with NAC.
View Article and Find Full Text PDFObjective: The relationship between the body mass index (BMI) at the time of breast cancer diagnosis and the prognosis of breast cancer patients has not yet been clarified. We investigated the impact of obesity for clinical outcomes in Japanese breast cancer patients.
Methods: Women with primary breast cancer operated between 2002 and 2014 were identified.