Mai Mishima

Advanced chemoresistant breast cancer responding to multidisciplinary treatment with hyperthermia, radiotherapy, and intraarterial infusion.

We employed multidisciplinary therapy, consisting of hyperthermia, radiotherapy, and intraarterial infusion, for a patient with progressive advanced breast cancer that was resistant to epirubicin hydrochloride and cyclophosphamide (EC) therapy as well as being resistant to docetaxel hydrate, and obtained a good therapeutic response. Because estrogen and progesterone receptors were both negative and HER2 was 3(+), administration of trastuzumab was started, and this patient has shown no signs of recurrence at 33 months after our treatment. The results suggested that our multidisciplinary therapy can be an effective method for the treatment of progressive breast cancer showing resistance to major chemotherapy agents such as anthracyclines and taxanes.

P223 Image-guided sentinel lymph node detection using near-infrared fluorescence in breast cancer

Goals: To evaluate the usefulness of color charge coupled device (CCD) camera system (HyperEye medical system:HEMS), for the intraoperative detection of sentinel lymph nodes (SLN) in breast cancer (BC) patients. Methods: Intraoperative detection of SLN was performed using conventional blue dye technique combined with HEMS for mapping of SLNs. Indigo carmine (blue dye) mixed with Indocyanine green (ICG) was injected via the subareolar plexus, the search of SLN was guided by HEMs for stained lymphatic channels leading to stained LNs. All bright LNs with lighting near-infrared fluorescence and LNs at the end of a lymphatic channel are removed and designated as SLNs. Results: SLN identification was successful in 140 of 144 patients (detection rate: 97.3%). There were four false-negative cases in 144 patients (2.8%). After a median follow-up of 2.5 years none of the patients presented with axillary recurrence. No severe adverse events were observed. Conclusion: HEMS provides color imaging and that recognizes the lymphatic mapping and the location of SLN without the problem of a limited irradiation. This technique might be safety and effective in SLN identification. Disclosure of Interest: No significant relationships.

Treatment outcome in patients with stage III breast cancer treated with neoadjuvant chemotherapy

Despite the good responses of patients (pts) with stage III breast cancer to neoadjuvant chemotherapy (NAC), most eventually relapse and have a poor prognosis. We investigated the prognostic indicators in pts with stage III breast cancer treated with NAC, using epirubicin and/or docetaxel. A total of 22 women with stage III breast cancer underwent NAC between January 2005 and May 2011. The regimens of NAC comprised ED (epirubicin 60 mg/m2 and docetaxel 60 mg/m2) in 10 cases, FEC (fluorouracil 500 mg/m2, epirubicin 75–100 mg/m2 and cyclophosphamide 500 mg/m2) in 10 cases and EC (epirubicin 60 mg/m2 and cyclophosphamide 600 mg/m2) in two cases. Following four cycles of each regimen, a further four cycles of D (docetaxel 70 mg/m2) were undertaken in nine cases. Subsequent to the completion of NAC and surgery, we assessed the clinicopathological results and performed prognostic analyses. Statistical analyses concerning disease-free survival (DFS) or overall survival (OS) were conducted by a Cox proportional hazard model. The median survival time was 66 months and there were 12 distant metastases and two local recurrences. Multivariate analyses showed the number of metastatic axillary lymph nodes (ALNs) [hazard ratio (HR), 1.079; P=0.023] was correlated with DFS, while the Ki-67 labeling index (HR, 1.109; P=0.042) and the number of meta-static ALNs (HR, 1.087; P=0.023) were correlated with OS. In conclusion, even if pts with stage III breast cancer show good responses to NAC using epirubicin and/or docetaxel, the majority eventually relapse and have a poor prognosis. The Ki-67 labeling index and the number of involved ALNs are suggested as prognostic indicators in stage III breast cancer.