The Cancer Institute Hospital of JFCR

Our Treatments ｜ Features of the Center ｜ Doctors and Staff

Our Treatments

The Breast Oncology Center dedicates to provide diagnosis and treatment of various diseases of the mammary glands such as breast cancer. In this center, we hold thorough discussions with doctors in various fields such as surgeons, medical oncologists, radiation oncologists and pathologists. We established a second-opinion outpatient clinic for patients receiving treatment in other hospitals, and we take time to provide them with consultation on current treatment and diagnosis.
We also actively perform breast reconstruction in cooperation with the Department of Plastic and Reconstructive Surgery, in deep consideration of the quality of life of patients. In addition, we provide psychological care to patients diagnosed with breast cancer in cooperation with the Division of Psycho-Oncology. The Division of Palliative Care and Palliative Care Ward also play an important role in the treatment of breast cancer, mainly in pain management after recurrence.
Rehabilitation is provided by specialized physical therapists. In addition, swelling after breast cancer surgery is taken care of by certified breast cancer nurses and therapists in the lymphedema outpatient clinic.
Recently, we also actively conduct research on hereditary breast cancer and provide diagnosis and treatment of this disease in cooperation with the Department of Clinical Genetic Oncology and Genome Center of the Cancer Institute. We also built a system in which prophylactic treatment can be provided.

Diagnosis

We perform the following examinations and diagnoses:

Ultrasonography
Fine needle aspiration cytology
Core needle biopsy
Vacuum assisted breast biopsy (Mammotome biopsy)
Surgical biopsy
Breast duct endoscopy
Breast MRI

*For mammography, a digital mammography device, which enables the rapid testing using a high-resolution monitor, was introduced ahead of other hospitals in Japan. The diagnosis with this device is made by physicians rated “rank A” in the mammogram reading test of the Japan Central Organization on Quality Assurance of Breast Cancer Screening. Another new device (tomosynthesis) will be also introduced in 2015, for breast tomography. When calcification which we cannot palpate is found, a Mammotome biopsy is performed using a specialized stereo device. When a lesion can be confirmed by ultrasonography, we perform needle biopsy or biopsy using a handy Mammotome while watching ultrasonographic images.

*“We hold calcification outpatient clinic (on Thursday) and Nipple discharge outpatient clinic (on Tuesday), aiming at accurate and efficient diagnosis by specialists of mammographically detected calcification and nipple discharge.

Treatment

Treatment of breast cancer can be roughly divided into 3 categories. According to each patient’s cancer condition, the following treatment methods are applied alone or in combination.

Surgical treatment (treatment mainly by surgery)
Chemotherapy (treatment by anticancer drugs, hormonal agents, and molecular targeted agents)
Radiotherapy (treatment in which radiation is delivered to lesions)

Chemotherapy is preformed in the Ambulatory Therapy Center (ATC) located in front of the Breast Oncology Center.

Breast Reconstruction

It is sometimes difficult to maintain and preserve the natural shape of the breast in treatment, depending on the breast cancer progression and extent of cancer in each patient. In such cases, breast reconstruction is actively performed in cooperation with the Department of Plastic and Reconstructive Surgery.

Features of the Center

Most Suitable Treatment by Specialists in Various Fields

To provide suitable treatment to each of more than 1,000 breast cancer patients every year, we have worked as a team of specialists in radiodiagnosis, surgery, chemotherapy and radiotherapy. In particular, the Department of Pathology has played a central role in breast cancer histology in Japan, and treatment plans are established based on detailed and accurate histology.

In addition, in recent breast cancer treatment, chemotherapy has become increasingly important. We perform all procedures from preoperative chemotherapy to postoperative adjuvant chemotherapy and provide outpatient care, according to the condition of the patient. In the cases of advanced or recurrent cancers, breast physicians and radiotherapists in the Center cooperate with the aim of providing suitable treatment depending on the condition of each patient. If any treatment plan is chosen, we provide safe and high-quality medical care. Thereby we make every effort to provide treatment carefully without neglecting each patient, based on the close cooperation among surgeons, medical oncologists, radiation oncologists and pathologists.

The Compatibility of a Reduction in Physical Burden and Safety

Breast-conserving therapy and sentinel node biopsy (SNB) have become widely used worldwide, and we also actively perform these treatments. In cooperation with the Department of Plastic and Reconstructive Surgery, we present an option of simultaneous breast reconstruction with artificial materials to patients for whom breast-conserving surgery is unsuitable. We performed more than 200 cases of simultaneous breast reconstruction with expanders in 2013. For breast reconstruction, health insurance coverage was approved in 2013. Thereby we became able to reasonably provide breast-conserving surgery to patients with Japanese National Health Insurance holders in whom safe, less-deforming partial resection is possible. We also became able to provide total resection with simultaneous reconstruction to the patients to whom partial resection can’t provide.

In addition, pathologists strictly check specimens removed by breast-conserving surgery by the methods used at our center. When the specimens clear strict checks and we assure the patient that the cancer is completely resected, we will present an option of not irradiating the conserved breast. So far, 1,462 patients who met these strict criteria underwent non-irradiated breast-conserving treatment, and the intra-breast recurrence rate is only 0.84% a year. This outcome is equivalent to that of patients who underwent usual breast-conserving therapy with radiation.

SNB is performed using a dye and radioisotope (RI) in patients without swollen axillary lymph nodes before surgery. If the intraoperative pathological diagnosis shows negative SNB results, we do not dissect the lymph nodes. In addition, we conducted a clinical observational study from 2014 not to dissect the lymph nodes when the metastasis is very limited, if any.

Patients are basically hospitalized on the day before surgery. If they do not have lymph node dissection, they are discharged 4 days after breast-conserving surgery. If they have lymph node dissection, they are discharged one week (on average) after the mastectomy or lymph node dissection.