toremifene and Carcinoma--Ductal--Breast

The relation between the use of tamoxifen and gynecologic tumors has been documented. In this case, a 58-year-old postmenopausal woman had been treated with tamoxifen for 5 years followed by toremifene for 1.5 years due to the presence of stage II estrogen receptor-positive breast cancer. The patient was found to have a stage Ic granulosa cell tumor of the ovary despite undergoing annual gynecologic examinations. This report presents a case of granulosa cell tumor of the ovary after the long-term use of tamoxifen and toremifene.

Topics: Antineoplastic Agents, Hormonal; Breast Neoplasms; Carcinoma, Ductal, Breast; Female; Granulosa Cell Tumor; Humans; Middle Aged; Neoplasms, Second Primary; Ovarian Neoplasms; Tamoxifen; Toremifene

Male breast cancer (MBC) in China usually has been studied retrospectively with small sample size, and studies analyzing the prognostic factors are rare. This study was to investigate the prognostic factors of Chinese patients with MBC based on the data from a single institute with a relatively large sample.. Clinical data of 72 patients with histopathologically confirmed MBC who received treatment at Sun Yat-sen University Cancer Center between January 1969 and March 2009, were collected. Kaplan-Meier, log-rank test and Cox regression model were used for statistical analysis.. The 5-year overall survival rate was 72.4%, and the survival rates for stage I, II, III, and IV were 100%, 74.2%, 57.2%, and 0%, respectively. Univariate analysis showed that the tumor size (P < 0.001), axillary lymph node status (P = 0.001), TNM stage (P = 0.001), operation model (with vs. without: P < 0.001; classic radical resection vs. modified radical resection, P = 0.336) and endocrine therapy(P = 0.02) significantly influenced the survival. Multivariate Cox regression showed that TNM stage (P = 0.035), operation model (P = 0.021) and endocrine therapy (P = 0.019) were independent prognostic factors for MBC.. Early diagnosis and comprehensive treatment strategy consisting of surgery and endocrine treatment is essential to improve the survival of the patients with MBC, and TNM stage, operation and endocrine treatment are the significant prognostic factors for MBC.

Topics: Adult; Aged; Aged, 80 and over; Antineoplastic Agents, Hormonal; Bone Neoplasms; Breast Neoplasms, Male; Carcinoma, Ductal, Breast; Carcinoma, Intraductal, Noninfiltrating; Carcinoma, Lobular; Chemotherapy, Adjuvant; Follow-Up Studies; Humans; Lymphatic Metastasis; Male; Mastectomy; Middle Aged; Neoplasm Recurrence, Local; Neoplasm Staging; Proportional Hazards Models; Radiotherapy, Adjuvant; Retrospective Studies; Survival Rate; Tamoxifen; Toremifene; Tumor Burden

The patient was a 76-year-old woman, who found a mass in her left breast around summer of 2003 but ignored it. She visited our hospital in April 2004 because of dyspnea and low-back pain. As there was a mass accompanied by partial ulceration all over the left precordium and bilateral pleural effusion, she was admitted for further evaluation and treatment. The patient was judged to be almost in a life-threatening condition, and thus thoracentesis was performed to remove pleural fluid, and chemotherapy with FEC was also performed. In addition, the patient was placed on oral exemestane (EXE). After four courses of therapy with FEC were completed, the drug was changed to paclitaxel (PTX) and chemotherapy was continued for another 3 months. It was confirmed that the tumor size had been reduced markedly and that the volume of pleural effusion had not increased. The patient was in a state of remission for a short time, but subsequently the tumor size increased again and the tumor bled continually in small amounts. The chemotherapeutic drug was changed to capecitabine, while EXE, which had been continued, was withdrawn and oral administration of 120 mg/day of toremifene (TOR) was started. However, the tumor size was not reduced. TOR was continued, while capecitabine was changed to docetaxel (DOC). Then, the tumor size was reduced again, until the breast became almost flat after 3 months and the patient no longer bled from the tumor. The volume of pleural effusion did not increase, nor did the patient have any more dyspnea. At present, she has been in a state of remission and is living at home with a certain QOL.

Topics: Aged; Androstadienes; Antineoplastic Combined Chemotherapy Protocols; Bone Neoplasms; Breast Neoplasms; Carcinoma, Ductal, Breast; Cyclophosphamide; Docetaxel; Drug Administration Schedule; Epirubicin; Female; Fluorouracil; Humans; Paclitaxel; Pleural Effusion, Malignant; Pleural Neoplasms; Quality of Life; Remission Induction; Taxoids; Toremifene

Female breast cancer is one of the major causes of death among women while male breast cancer is relatively uncommon and accounts for about 1% of all breast cancers in both sexes. Influencing factors are: gynecomasty, familiarity for male breast cancer, Jewish and African-American male population. From the histological point of view, it is not different from the female breast cancer, except for the infiltrant ductal carcinoma, but with a much severe prognosis. Breast cancer metastases to the jaws are rare, only 1%; the most common sites of metastases are: lungs(59-69%), liver (58-65%), bone (44-71%), pleura (23-37%), brain (9-22%) and kidney (4-17%). At present, based on a literature research (May 2006), there have been just two other case reports of male breast cancer metastasis to the maxillofacial region, both to the mandible. The case of a 69-year-old white man who in 2001 underwent a radical mastectomy due to ductal breast cancer is reported. In 2005 the patient was referred to our department by his oncologist for multiple oral fistula. A mandibular TC revealed osteolytic lesions and the patient underwent mandibular surgery to remove the lesions and clean up the area. The histological examination was consistent with that of a metastatic deposit of adenocarcinoma of the breast. In June 2006 the patient died due to worsening of the general clinical conditions, in particular due to ascites and hepatic insufficiency.

Topics: Aged; Androstadienes; Antimetabolites, Antineoplastic; Antineoplastic Agents, Hormonal; Antineoplastic Combined Chemotherapy Protocols; Bone Density Conservation Agents; Bone Neoplasms; Brain Neoplasms; Breast Neoplasms, Male; Carcinoma, Ductal, Breast; Cortisone; Cyclophosphamide; Diphosphonates; Docetaxel; Fatal Outcome; Fluorouracil; Furosemide; Humans; Imidazoles; Liver Neoplasms; Male; Mandibular Neoplasms; Mastectomy, Modified Radical; Methotrexate; Omeprazole; Osteolysis; Phenobarbital; Taxoids; Toremifene; Vinblastine; Vinorelbine; Zoledronic Acid

We report a 64-year-old woman who underwent mastectomy for stage II (T2N1M0) advanced breast cancer, in whom multiple spine metastases developed 18 months postoperatively. She received 6 cycles of CA (cyclophosphamide 500 mg/m2, ADM 50 mg/m2 3 wq) therapy and oral tamoxifen (20 mg/body) administration for adjuvant therapy. The multiple bone metastases of the spine were revealed by technetium bone scan. The level of serum tumor marker CA15-3 increased two times over the normal range 18 months after surgery. She also developed osteoporosis a few years later, so we selected high-dose toremifene administration (120 mg/body) as a second-line therapy. No adverse effects have occurred and bone metastases disappeared. Moreover, the tumor marker was also normalized 6 months after toremifene therapy started. It was shown that high-dose treatment of toremifene was useful for recurrent breast cancer with bone metastasis.

Topics: Antineoplastic Agents, Hormonal; Bone Neoplasms; Breast Neoplasms; Carcinoma, Ductal, Breast; Chemotherapy, Adjuvant; Dose-Response Relationship, Drug; Drug Administration Schedule; Female; Humans; Mastectomy; Middle Aged; Remission Induction; Toremifene