Shunji Umemoto

A 40-year-old woman was seen at the hospital because of a mass in the right breast. On examination a mass measuring 2 cm was detected in the AC area. The lesion was well-defined and partly cystic. Mammography also showed a well-defined mass without calcification. Aspiration cytology revealed spithelial cells with nucleus of various sizes and prominent nucleolus, and the diagnosis was class IV. Since apocrine cancer was suspected, biopsy was done and the diagnosis was confirmed. Modified radical mastectomy was performed under the diagnosis of T_2aN₀M₀ and Stage II. No lymph node metastases were noted in the resected surgical materials and the postoperative course has been unevntful. The patient is currently being followed up on an ambulant basis.<br> Apocrine mammary cancer is classified histologically as invasive cancer of a special type according to the Japanese rules for classifying breast cancer. In Japan, 56 patients with this disease have been reported. The average age of these patients was 57 years, being slightly higher than that of patients with ordinary breast cancer. The patients capable of being diagnosed as having a cancer by aspiration cytology represented 44% of all patients undergoing the cytology, and those diagnosed as having apocrine mammary cancer represented only 28% including suspected patients. It is thought that a great amount of skill may be required to diagnose this disease by aspiration cytology alone.

In two prospective randomized studies, the effectiveness of adjuvant chemotherapy with mitomycin C (MMC), 5-fluorouracil (5-FU) and tegafur (FT) after surgical resection of colorectal carcinoma was evaluated. 1) 130 patients with colon cancer, who underwent macroscopically curative resection, were devided into two groups. In colon group A, chemotherapy consisted of intraluminal administration of MMC (50mg/100 ml saline) during operation, followed by oral or intrarectal administration of FT (600-1, 000 mg/day for a year). In colon group B, 5-FU (1, 500 mg/100 ml saline) was administrated intraluminally during operation and others were the same with colon group A. No serious adverse effects were observed in each groups. There was no significant differences in both five year survival rate and recurrence rate between two groups. 2) 158 patients with rectal cancer, who underwent macroscopically curative resection, were also devided into two groups. In rectum group A, chemotherapy consisted of intraoperative intraarterial (inferior mesenteric artery) and postoperative intravenous intermittent administration of MMC (10-4 mg/body/a injection), followed by oral administration of FT (600-800 mg/day for a year). In rectum group B, chemotherapy consisted of postoperative intravenous administration of 5-FU (250 mg/body/day for two weeks ), followed by oral administration of FT (600-800 mg/day for a year). No serious adverse effects were observed in both groups. The five year servival rate was better in group B than in group A, but the difference did not reach statistical significance (p=0.056). In patients with rectal cancer at Dukes class C, five year survial rate was significantly higher in group B than in group A (p=0.047).