Haruhiko Imamoto

A Case of Advanced Breast Cancer Successfully Treated with Primary Endocrine Therapy.

We present a case of a premenopausal woman with advanced hormone-sensitive breast cancer who was successfully treated with primary endocrine therapy consisting of ovarian ablation followed by a combined endocrine regimen of the aromatase inhibitor fadrozole 2 mg daily and tamoxifen 20 mg daily. During the 5 months treatment period, PR evaluation of the loco-regional lesions was performed The patient then underwent mastectomy with axillary lymph node dissection followed by fadrozole and tamoxifen therapy. Throughout the treatment course, no adverse events were encountered and the patient has been enjoying a favorable quality of life.As shown by this case, primary endocrine therapy is a promising treatment option for hormonesensitive breast cancer. However, this modality should be continued to be regarded as experimental.

THERAPEUTIC GUIDELINES ON METASTATIC LYMPH NODES OF THE NECK WITH UNKNOWN PRIMARY ORIGIN

Twenty-five patients with the diagnosis of metastatic lymph nodes of the neck from unknown origin treated at the department beteen January 1983 and December 1993 were subjected to a clinical study. The primary lesion was revealed in twenty-one of these twenty-five patients.The purpose of this study is to consider the management of metastatic lymph nodes of the neck with unknown primary origin, referring to the relationship of the primary to histology and the location of neck tumor of these twenty-one patients. The primary lesions of metastatic tumors in the upper and middle region of the neck were all located in the head and neck region, but the primary lesions of metastatic tumors in the supraclavicura fossa were most ofter found in below the level of the clavicle. Incisional biopsy was performed in mighteen of these twenty-one patients, and eight patients had squamous cell carcinoma and eleven had adenocarcinoma. The primary lesions of metastatic squemous cell carcinomas tended to exist in the head and neck region, while those of adenocarcinoma in below the level of the clavicle. Metastatic tumors in the upper and middle region of the neck should be treated actively involving neck dissection, because these primary lesions most often exist in the head and neck region. Metastatic tumors in the lower region of the neck should be treated with operation if there are no other metastatic lesions, because it is difficult to conjecture these primary. Metastatic tumors in the supraciavicura fossa should be mainly treated with chemotherapy, because these primary lesions commonly exist often existing in below the level of the clavicie.