We evaluated the cosmetic outcome of volume replacement with oxidized regenerated cellulose (ORC) after breast-conserving surgery (BCS) and also examined factors that may have influenced the results. Ninety-four patients who underwent BCS with ORC replacement between January 2010 and August 2012 participated in this study. The cosmetic outcomes of these patients were evaluated using scores based on the criteria of the Japan Breast Cancer Society. We evaluated cosmetic scores with regards to several clinical factors and the occurrence of complications after this procedure. The mean score of the cosmetic outcome of all patients was 9.5 points of 12 points. Thirty-seven patients were categorized as “Excellent,” 34 were “Good,” 22 were “Fair,” and 1 was “Poor.” Patient age, body mass index, weight of the specimen, and ORC amount were not significantly different between patients with favorable cosmetic scores and those without. However, the weight of the removed specimen was slightly higher in patients with an unfavorable cosmetic score. Although acute dermatitis and eczema was observed in 15% and 3% of patients, all of them were improved with conservative treatment. Cosmetic scores were significantly higher in patients without complications than in patients with complications. In conclusion, ORC replacement after BCS is a simple and reliable procedure. The selection of indication and prevention of complications are important for obtaining a better cosmetic outcome. This is the first report to cosmetically evaluate a relatively large number of patients that have undergone ORC replacement after BCS.

Taxanes, including paclitaxel (PTX) and docetaxel (DOC), are poorly soluble in water due to their hydrophobic properties and thus, require solvents. However, use of these solvents has been associated with toxic responses, including a hypersensitivity reaction (HSR). Nanoparticle albumin-bound paclitaxel (nab-PTX) is a novel formulation of PTX, which allows reconstitution of the agent with a saline solution instead of solvents and administration without premedication for HSRs. The current study reports the safe administration of nab-PTX to four breast cancer patients considered clinically to have contraindications to PTX or DOC. Two of the patients had previously experienced HSRs to PTX or DOC and the other two patients had contraindications to steroids as a premedication for HSRs, since one patient suffered from diabetes and the other was a carrier of the hepatitis B virus. All 4 patients were safely administered nab-PTX. In conclusion, administration of nab-PTX appears to be effective for patients that have previously experienced HSRs to other taxanes or in those with contraindications to steroids.

Breast-conserving surgery (BCS) has been increasingly performed as a standard operative strategy for patients with breast cancer. The primary purpose of BCS is to acquire both local control and good cosmetic results. An insignifi cant difference in cancer treatment results has been shown between BCS and total mastectomy. However, achieving suffi ciently cosmetic results can be diffi cult, particularly in patients with tumors that are large or localized to the lower quadrant. To avoid breast deformities and asymmetries after BCS, immediate reconstruction using autologous tissue has been accepted as the standard option. Rhomboid skin and adipose fl ap repair is a simple, less invasive procedure than the myocutaneous fl ap, which has primarily been performed in patients with upper quadrant lesions. We herein report the cases of two patients with lower quadrant breast cancer with skin invasion, who underwent BCS with immediate breast repair using a rhomboid fl ap. This procedure is therefore worth considering as one of the fi rst options for immediate repair after BCS.

Moccasin-type tinea pedis(MTTP) is a hardly curable superficial dermatomycosis primarily characterized by hyperkeratosis of the sole. In this study, we compared the usefulness of combination therapy of bifonazole (Mycospor cream) + 10% urea ointment (Urepearl) (overlapping application group = group I) with occlusive dressing therapy with the same agents (group II) in the treatment of MTTP, and obtained the following results. (1) The clinical improvement rate (percentage of "marked improvement" and "moderate improvement") was 60.4% in group I and 83.3% in group II. (2) The mycological eradication rate was 48.7% in group I and 82.1% in group II after 4 weeks of treatment and 90.9 and 96.9%, after 12 weeks of treatment, respectively. (3) The clinical utility rate (percentage of "very beneficial" and "beneficial") was 83.3% in group I and 93.8% in group II. These results indicate the superiority of both combination therapy of bifonazole + 10% urea ointment (overlapping application group) and occlusive dressing therapy with the same agents in terms of efficacy and safety for the treatment of MTTP, and suggest that they can be recommended for treatment of patients for whom it is difficult to use oral antimycotic agents or for patients who fail to respond to oral medications alone.

Abstract. Background: There is no consensus on the need for adjuvant chemotherapy for patients with pathological residual invasive breast cancer (non-pCR) after neoadjuvant chemotherapy (NAC). We evaluated the tolerability and safety of tegafur-uracil (UFT) as adjuvant chemotherapy for patients with human epidermal growth factor receptor 2-negative breast cancer that resulted in non-pCR after NAC. Patients and MethodsNeoadjuvant chemotherapy (NAC) is widely used for both locally advanced and early-stage breast cancer. The advantages of NAC include determining tumor responses to specific treatment regimens in clinical practice and providing an opportunity for down-staging to avoid mastectomy for inoperable tumors or breast-conserving surgery in cases originally requiring mastectomy (1, 2). Anthracyclines and taxanes have been used as the standard chemotherapeutic regimens for breast cancer, however, tumoral estrogen receptor (ER) and human epidermal growth factor receptor 2 (HER2) statuses are important predictors of response to chemotherapy (3)(4)(5). Sensitivity to NAC is lower in ERpositive and HER2-negative cancer than in other subtypes. An earlier study of NAC with anthracyclines and taxanes reported an approximately 25% pathological complete response (pCR) rate in cases of operable breast cancer without taking in mind the ER and HER2 status (6). Furthermore, patients achieving pCR have a more favorable prognosis than patients with pathological residual invasive disease (non-pCR) (6-8). Adjuvant endocrine therapy for ERpositive breast cancer and anti-HER2 therapy (e.g. Trastuzumab) for HER2-positive breast cancer after NAC currently represent the gold-standard of care. There is a lack of consensus regarding the requirement for an adjuvant chemotherapy in cases with non-pCR after NAC; however, further chemotherapy may improve patient outcomes. Adjuvant chemotherapy is typically appropriate in patients with non-pCR because patients with operable breast cancer frequently experience tumor recurrence approximately 2 years after initial surgery (9).Long-term, daily oral treatment with tegafur-uracil (UFT) is widely used as an adjuvant chemotherapy for breast, gastric, and colorectal cancer in Japan. (10). A pooled analysis of six randomized, controlled trials demonstrated the survival benefits of adjuvant UFT plus tamoxifen compared to tamoxifen alone for ER-positive early breast cancer (11). Moreover, two randomized, controlled trials demonstrated that UFT therapy for 2 years had similar efficacy to six cycles of cyclophosphamide, methotrexate, and 5-fluorouracil (CMF) 6505Τhis article is freely accessible online. 10, 12). However, the safety of UFT therapy in patients previously treated with NAC remains unknown. Therefore, we evaluated the tolerability and safety of adjuvant UFT chemotherapy for 2 years in patients with HER2-negative breast cancer with non-pCR after standard anthracycline-and taxane-based NAC to assess the preliminary efficacy of UFT therapy. Patients and MethodsThis present study was conducted...