[The safety of docetaxel with cyclophosphamide (TC) therapy as adjuvant chemotherapy for Japanese women with operable breast cancer].

The safety of docetaxel (60 mg/m(2)) plus cyclophosphamide (600 mg/m(2)) every three weeks (TC) as adjuvant therapy for Japanese women with operable breast cancer was evaluated. Ehime TC Study Group initiated the randomized control study,which compared the effects of the TC course number (4 cycles versus 8 cycles) in the adjuvant setting on the treatment outcomes of breast cancer patients. Eight patients were investigated on the side effects of TC therapy, four of them were allocated to 4 cycles of TC, and four to eight cycles from May, 2004 to Feb. 2005. Leukocytopenia and neutropenia of grade 3 or 4 were seen in 50% and 63% of the cases, respectively. No febrile neutropenia was seen. Although the non-hematological side effects of grade 3 or 4 were not observed, alopecia, stomatitis, skin toxicities and edema of grade 2 were seen in 100%, 25%, 25%, 13% of cases, respectively. TC therapy was well tolerated. All anticancer drugs could be administered as scheduled. From these preliminary results, TC therapy seems to be able to be safely prescribed postoperatively for Japanese women operated for breast cancer.

HER2-Positive Metaplastic Spindle Cell Carcinoma Associated with Synchronous Bilateral Apocrine Carcinoma of the Breast.

Apocrine carcinoma, which is strictly defined as over 90% of tumor cells showing apocrine differentiation, is a rare variant of breast cancer. Here we report an uncommon case in which apocrine carcinomas developed concurrently in both breasts; in addition, a sarcomatoid spindle cell lesion was coincident in the right breast. Both apocrine carcinomas were immunohistochemically negative for estrogen receptor (ER) and progesterone receptor (PgR), but diffusely positive for androgen receptor (AR), GCDFP-15, and HER2. The presence of intraductal components in bilateral carcinomas and the absence of lymph node metastasis suggested that they were more likely to be individual primary lesions rather than metastatic disease. The spindle cell lesion showed a relatively well-circumscribed nodule contiguous with the apocrine carcinoma. HER2 oncoprotein overexpression was observed not only in the apocrine carcinoma, but also in the spindle cell lesion. Since the spindle cell component was intimately admixed with apocrine carcinoma and had focal cytokeratin expression, we diagnosed it as metaplastic spindle cell carcinoma, which was originated from the apocrine carcinoma. To our knowledge, this is the first case report of a patient with synchronous bilateral apocrine carcinomas coinciding with metaplastic carcinoma.