OK-432 (picibanil), a streptococcal preparation, has a strong biological response modifier (BRM) function and is expected to produce clinical improvement and prolongation of survival in treated cancer patients in Japan. We were interested in whether OK-432 augments estrogen receptor (ER) levels in breast cancer. To investigate the effect of the BRMs on cellular growth and the characteristics of ER and progesterone receptors (PgR) in the human breast cancer cell line MCF-7, we used OK-432, Krestin (PSK), a protein-bound polysaccharide extracted from Coriolus versicolor, and lentinan, a fungal branched (1 ...3)-beta-Z)-glycan. OK432 and PSK dose dependently inhibited DNA synthesis of MCF-7 cells, and the 50% inhibitory concentrations of OK-432 and PSK were 1.2 KE (klinische Einheit, clinical unit)/ml and 200 ug/ml, respectively. Lentinan showed no direct anticancer effect in vitro. We found that OK-432 induced a 2-fold increase in ER levels in MCF-7 cells at 0.005 KE/ml, but not in PgR. Lentinan and low-dose PSK did not change ER or PgR levels, but high-dose PSK decreased ER and PgR. We also studied the combined effect of OK-432 and antiestrogens, tamoxifen (TAM) and DP-TAT-59. The combined treatment with OK-432 and TAM showed an additive inhibitory effect on MCF-7 cells. These results suggest that OK-432 may augment the therapeutic effect of TAM in breast cancer.

A case of breast cancer that was only detected by contact thermography is presented. The 50year-old patient had no distinct breast tumor and had only multiple indurations of the left breast. Mammography revealed no tumor. However, thermography showed a prominent pattern of abnormal hyperthermic vessels and a hyperthermic region in the upper inner quadrant of the breast. Biopsy of this region revealed an invasive ductal carcinoma which was 0.8cm in maximum diameter. Contact thermography appears useful for detecting early breast cancer.

Preoperative induction chemotherapy employing anthracycline agents was performed in 21 patients with locally advanced breast cancer. The response rate of this group receiving preoperative induction chemotherapy was higher than that of 18 historical control patients receiving preoperative endocrine therapy or radiotherapy (48% vs. 28%, p<0.10). Standard radical mastectomy or extended radical mastectomy was carried out after induction chemotherapy, and 90% of the patients with stage III and inflammatory breast carcinoma underwent curative resection. There was no significant difference in survival between the two groups.However, the 50% survival duration was longer in the preoperative induction chemotherapy group than in the control group (118 months vs. 23 months). Anthracycline agents (adriamycin, epirubicin, and THP-adriamycin) were used alone or in combination with other agents for the preoperative chemotherapy. The side effects were tolerable. Systemic induction chemotherapy using anthracyclines is effective for locally advanced breast cancer as a component of multidisciplinary therapy.

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