Clinical courses of the cases
Case 1:
The patient was a 47-year-old woman who visited our hospital with a rapidly growing lump in her right breast. Diagnostic imaging revealed two tumors 6.0 and 3.3 cm in diameter, respectively, in the upper lateral quadrant of the right breast, and swollen right axillary lymph nodes. No other lesions were detected during systemic screening. Core needle biopsy revealed squamous cell carcinoma with focal invasive ductal carcinoma (NST). Fine needle aspiration cytology of the right axillary lymph node indicated axillary involvement. The lesion was resected by modified radical mastectomy (Bt+Ax) followed by skin grafting. The patient was treated with four courses of FEC (5-fluorouracil, epirubicin, cyclophosphamide) but developed local recurrence 4 months after surgery. She underwent resection of the local recurrence following radiotherapy, gemcitabine with carboplatin, and weekly paclitaxel and gemcitabine. However, these were ineffective and her disease progressed, resulting in death due to cancer 2 years after the initial surgery.
Case 2:
The patient was 52-year-old woman who was referred to our hospital with a lump in her left breast. Examination revealed a 6.8 × 6.0 cm mass in the upper lateral quadrant of her left breast. She underwent modified mastectomy followed by six courses of EC (epirubicin, cyclophosphamide) and 5 years of endocrine therapy. The patient was alive without recurrence 11 years after surgery.
Case 3:
The patient was 62-year-old woman who visited our hospital with left breast cancer diagnosed atanother medical clinic. Simple mastectomy and sentinel lymph node biopsy were conducted followed by four cycles of FEC, four cycles of docetaxel with trastuzumab, and 14 cycles of trastuzumab. The patient was alive without recurrence 6 years after surgery.
Case 4:
A 74-year-old woman visited her local hospital with a lump in her left breast and was diagnosed with squamous cell carcinoma and subsequently referred to our hospital. Diagnostic imaging revealed two tumors 3.3 cm in diameter in the lower inner quadrant of her left breast. No other lesions were detected during systemic screening. The patient underwent simple mastectomy and sentinel lymph node biopsy. No recurrence was detected at 3 months after surgery.
Case 5:
The patient was a 60-year-old woman who visited our hospital with a lump in her right breast. Diagnostic imaging revealed a tumor 2.3 cm in diameter in the upper inner quadrant of her right breast. No other lesions were detected during systemic screening. Core needle biopsy revealedinvasive ductal carcinoma (NST), and fine needle aspiration cytology of the right axillary lymph node showed no axillary involvement. After the one cycle of FEC and three cycles of EC as neoadjuvant chemotherapy, the tumor had shrunk to 5 mm in diameter. However, during four cycles of docetaxel, the tumor enlarged to 14 mm in diameter and was resected by partial resection of the breast and sentinel lymph node biopsy. The patient underwent breast irradiation and endocrine therapy and remained alive without recurrence 2 years after surgery.