[A Case of Ductal Carcinoma In Situ(DCIS)Diagnosed by Excisional Biopsy with Benign Cytology Findings of Fine-Needle Aspiration].

Nipple discharge is a common symptom and frequently results from benign tumors. However, there is a 5-30% risk of malignancy. A 65-year-old woman presented at the hospital because of bloody nipple discharge in her right breast. She had noticed an abnormal nipple discharge for several months. Mammography showed focal asymmetric densities without calcification in the middle outer quadrant of her right breast. Ultrasonography indicated a 1.5×1.1 cm sized cyst with fluid-fluid level. Breast MRI showed a simple cyst with a benign contrast enhancement pattern. No malignant cells were observed by fine-needle aspiration. Considering the low sensitivity of mammography and breast MRI to DCIS, we performed an excisional biopsy. Histological examination revealed that the lesion was DCIS. The patient underwent right total mastectomy and was diagnosed with low grade DCIS(ER-positive, PgR-positive, HER2-negative). She continues endocrine therapy with an aromatase inhibitor.

Five-year follow-up of treatment outcomes in patients with early-stage breast cancer and clinically negative axillary nodes treated with no lymph node dissection or axillary clearance.

BACKGROUND: Sentinel lymph node biopsy has steadily replaced axillary lymph node dissection (ALND) for staging clinically node-negative breast cancer. However, ALND remains standard management of the axilla when a tumor-positive sentinel lymph node is identified. METHODS: We identified 460 patients with breast cancer (clinically T1/T2N0M0) from the database for 1999-2004. Patient age ranged from 26 to 81 (median 50) years. Patients who underwent mastectomy or breast-conserving surgery with or without ALND were compared for regional recurrence, disease-free survival, and overall survival. RESULTS: Patients with ALND (n = 308) were compared with the no ALND group (n = 152). Five-year overall survival and disease-free survival were not significantly different between the two groups, while there was a significant difference between them for regional recurrence. Of the 152 patients who did not undergo axillary dissection, four developed ipsilateral axillary disease, most of whom were rescued by delayed axillary dissection. Further, the criterion for identifying lymphedema was used, ie, a 2 cm circumferential change at any measured location. As a result, the incidence of lymphedema in the ALND group was 12.7%, while it was not seen in the non ALND group. CONCLUSION: There is a possibility that ALND may be omitted for cT1/T2N0M0 breast cancer through a combination of hormone therapy and adjuvant chemotherapy.

[A case of interstitial pneumonitis induced by S-1].

S-1, an oral fluoropyrimidine derivative, has been identified as an effective agent for the treatment of breast cancer. We present here a case of interstitial pneumonitis that occurred after S-1 treatment. A n 80-year-old woman was diagnosed with stage III infiltrating ductal carcinoma of the left breast and underwent a modified radical mastectomy in November 2001, followed by six courses of paclitaxel. In October 2008, metastatic disease was detected in her skeletal system. Therefore, S-1 chemotherapy was initiated (100 mg/body). Five days after starting S-1, she developed severe eruptions along with dyspnea. X-rays and CT scan showed diffuse ground glass shadow. Both her symptoms and the radiographic findings resolved dramatically after the start of high-dose corticosteroid therapy. Clinicians should be aware that S-1 has the potential to cause lung injury when it is included in chemotherapy.