Challenges in breast and cervical cancer control in Japan.

Since the mid-1990s, there has been an increasing incidence of, and mortality from, cervical and breast cancers in Japan. Such an increase has raised concerns over the efficiency of Japan's screening programmes for these cancers. Although citizens benefit from universal health coverage, the Japanese health insurance system mostly focuses on tertiary prevention and disease treatment, while secondary prevention (screening) is low priority.

A randomized, double-blind, controlled study of exemestane versus anastrozole for the first-line treatment of postmenopausal Japanese women with hormone-receptor-positive advanced breast cancer.

The aromatase inhibitors exemestane and anastrozole are approved in Japan for first-line treatment of postmenopausal patients with advanced, hormone-receptor-positive breast cancer. This phase 3, randomized, double-blind study directly compared time to progression (TTP) for exemestane and anastrozole therapy in this patient population. Eligible patients were randomized to receive exemestane 25 mg or anastrozole 1 mg, each once daily.

Promotion of quality-controlled mammography alone as a screening modality in Japan.

Background: The rate of breast cancer screening in Japan has not increased, and it is thought that one of the reasons is the principle that mammography (MMG) and clinical breast examination (CBE) be carried out in combination. Nationwide, there is a shortage of physicians qualified to perform CBE, and in some regions mass-screening is performed by MMG alone out of a mobile MMG bus. In Shikoku, MMG is performed alone as a screening examination in Kochi and Ehime Prefectures.

Basic study of a diagnostic modality employing a new electrical impedance tomography (EIT) method for noninvasive measurement in localized tissues.

The objective of this study is to develop a device for noninvasive local tissue electrical impedance tomography (EIT) using divided electrodes with guard electrodes and to validate its effectiveness using bioequivalent phantoms. For this purpose, we prepared a measurement device and bioequivalent phantoms, measured the electrical characteristics of the phantoms, and validated the method using the phantoms. Monolayer phantoms mimicking the brain and muscle and bilayer phantoms consisting of muscle and brain layers were prepared.

International exchange activities with East Asian countries through mammography.

The Japanese NPO Central Committee on Quality Control of Mammographic Screening has initiated international exchange activities regarding quality control of mammographic screening with the concerned organizations in East Asian countries with the objective of contributing to reducing breast cancer mortality in the region. This paper describes the status of the international exchanges that are being carried out in various East Asian countries in relation to mammography and also discusses future aspects.

Current status of breast cancer screening in the world.

The mortality associated with breast cancer is decreasing in Europe and the United States. There are various reasons for these trends, including an increase in detection of early-stage breast cancers due to increased use of mammographic screening and the establishment of standardized systemic treatments based on evidence-based medicine. However, in Japanese women, both the morbidity and the mortality of breast cancer are increasing.

Bilateral male breast cancer with male potential hypogonadism.

Background: Male breast cancer is a comparatively rare disease, and simultaneous bilateral male breast cancer is considered to be an extremely rare event. Risk factors are said to be genetic factors and hormonal abnormalities due to obesity or testicular diseases.

Case Presentation: The patient was a 47-year-old Japanese male.

Chromosomal aneusomy (chr 1, 11, 17) detected by fluorescence in situ hybridization may be a prognostic factor in breast cancer.

The relationship between clinicopathological findings and the long-term prognosis was investigated in 42 breast cancer patients in whom aneusomy was detected for chromosomes 1, 11 and 17. The frequencies of aneusomy of those chromosomes were 78.6%, 47.

Current status of sentinel lymph node navigation surgery in breast and gastrointestinal tract.

Sentinel lymph node biopsy (SLNB) has been developed as a new diagnostic and therapeutic modality in melanoma and breast cancer surgery. The purpose of the SLNB include preventing the operative morbidity and improving the pathologic stage by focusing on fewer lymph nodes using immunocytochemic and molecular technology has almost achieved in breast cancer surgery. The prognostic meaning of immunocytochemically detected micrometastases is also evaluating in the SLN and bone marrow aspirates of women with early-stage breast cancer.

A fundamental study on parameter estimation of layerd local tissue impedance for EIT.

Electrical Impedance Tomography (hereinafter referred to as EIT) is 2-D or 3-D image of electrical impedance distribution in a living tissue. Unlike usual imaging methods, i.e.

False-positives in fine-needle aspiration cytology of breast disease can be reduced with p63 immunostaining--a preliminary report.

Myoepithelial cells of the mammary gland are considered to be a key to distinguishing benign from malignant disease in fine-needle aspiration (FNA) cytology. However, identification of these cells with Papanicolaou staining is not easy. The identification of myoepithelial cells was investigated using p63 antibodies to carry out immunostaining of FNA specimens that had been used at the time of Papanicolaou staining for 37 patients who yielded false-positives in FNA.

[Evaluation of safety and efficacy for bi-weekly Docetaxel and 5'-DFUR combination therapy in patients with advanced or recurrent breast cancer--Phase I study].

Background: A clinical trial of Docetaxel was performed by tri-weekly administration in patients with advanced or recurrent breast cancer. However, careful observation is necessary for outpatients because serious neutropenia often occurs during the therapy. A bi-weekly schedule is recommended since weekly administration requires more visits to the hospital.

[Late phase II clinical study of KW-2307 in advanced/recurrent breast cancer patients (II)].

A late phase II clinical study (II) of a novel vinca alkaloid derivative KW-2307 (vinorelbine ditartrate) in advanced/recurrent breast cancer patients was performed at 22 institutions throughout Japan. An intravenous dose of KW-2307, 20 mg/m2, was administered once a week. Of the 60 patients enrolled in the study, 58 were eligible and 56 were evaluable.

Basic study of new diagnostic modality according to non-invasive measurement of the electrical conductivity of tissues.

The purposes of this study were to estimate the electrical conductivity of tissues by non-invasively measuring the electrical bio-impedance, to develop a new method for tissue diagnosis, i.e., electrical impedance tomography (EIT).

Current status and goals of mammographic screening for breast cancer in Japan.

In Europe and the United States, the proportion of women receiving mammographic screening for breast cancer has increased to 60-80%, resulting in an increase in the detection of early-stage cancer and a reduction in the mortality rate. The objectives of breast cancer screening have thus already been achieved there. In Japan, both the incidence and mortality of breast cancer have increased recently.

3-dimensional computed tomography lymphography-guided identification of sentinel lymph nodes in breast cancer patients using subcutaneous injection of nonionic contrast medium: a clinical trial.

Objective: Simple and reliable identification methods for sentinel lymph nodes (SLNs) which do not use radioisotope are essential for early breast cancer patients in community hospitals in Japan. The purpose of this paper is to demonstrate the feasibility and efficacy of computed tomography (CT) lymphography for SLN detection.

Methods: The study included 15 cases with T1 or T2 breast cancer.

Evaluation of a new rehabilitation program for postoperative patients with breast cancer.

The purpose of the present study was to evaluate the efficacy of a newly designed rehabilitation program for postoperative patients with breast cancer. This was achieved through examinations to clarify the range of motion (ROM) of the shoulder joint, postoperative pain and recovery of activities of daily living (ADL). The ROM of the shoulder joint was evaluated with respect to five items and determinations were carried out five times.

Axillary 3D CT imaging with lymphoscintigraphy is useful for sentinel node biopsy in breast cancer.

Background: This study examined whether 3D CT imaging with lymphoscintigraphy (LSG) is useful when performing sentinel node biopsy (SNB) in a community hospital where radioisotope with gamma-probe (RI method) is unavailable.

Materials And Methods: From June to November 2002, 35 T1/T2 clinically node-negative breast cancer patients underwent LSG in a university nuclear medicine department. Skin areas above LSG hot spots were marked, helical CT scanning was performed and axillary 3D images were created in our hospital.

Randomized controlled trial comparing oral doxifluridine plus oral cyclophosphamide with doxifluridine alone in women with node-positive breast cancer after primary surgery.

Purpose: We compared the therapeutic usefulness of doxifluridine (5'-DFUR) alone and a combination of 5'-DFUR plus cyclophosphamide (CPM), both of which are considered effective against advanced and recurrent breast cancer, to determine which treatment is more beneficial as postoperative adjuvant chemotherapy.

Patients And Methods: A total of 1,131 women with node-positive primary breast cancer were randomly assigned after primary surgery to receive 5'-DFUR alone or 5'-DFUR plus CPM. All patients initially received 5'-DFUR in an oral dose of 1,200 mg/d for 4 weeks, starting 4 weeks after surgery.

Case reports of malignant mucocele-like lesions.

Mucocele-like lesions (MLL) of the breast have been reported as extremely rare as well as benign, but now it is believed they can be both malignant and benign. This paper describes two cases of malignant MLL, both subjected to immunohistochemical staining. Case 1: A 42-year-old woman with multiple malignant MLLs without evidence of a mass at presentation to our hospital after biopsy, but whose ultrasonogram showed small multiple hypoechoic lesions.

Immunohistochemical expression of uPA, PAI-1, cathepsin D and apoptotic cells in ductal carcinoma in situ of the breast.

Background: We examined the relationship between biological markers, apoptotic indices and pathologic subtypes of ductal carcinoma in situ (DCIS) of the breast. The tumor-biological factors can be divided into invasive and proliferative markers. We chose urokinase-type plasminogen activator (uPA), plasminogen activator inhibitor type 1 (PAI-1) and Cathepsin D as invasive markers, and Ki-67 and C-erbB2 oncoproteins as proliferative factors for our study.

The effect of adjuvant 5'-deoxy-5-fluorouridine in early stage breast cancer patients: results from a multicenter randomized controlled trial.

To assess the efficacy of 5'-DFUR, an intermediate of capecitabine, for adjuvant treatment of early breast cancer, we conducted an open-labeled multi-center randomized controlled trial to compare postoperative 5'-DFUR treatment with surgery alone. We enrolled 1217 primary breast cancer patients and randomly assigned them into two treatment groups; one received six-month postoperative 5'-DFUR treatment by consecutive or intermittent administration, and the other surgery alone. Follow-up surveys were conducted once a year for all subjects simultaneously and examined their outcome/presence or absence of the cancer recurrence.

Neither gynecomastia nor galactorrhea is a common side effect of neuroleptics in male patients.

OBJECTIVE: Gynecomastia is known to be a side effect of neuroleptics. The authors investigated the prevalence of gynecomastia and galactorrhea in a group of regularly neuroleptic-treated male patients. METHODS: Gynecomastia was defined as a palpable, discrete button of firm subareolar tissue measuring at least 2 cm in diameter.