Breast and Endocrine Surgery

Overview of the department

Chairman Assoc. Prof.  Hiroyuki Maeda

Assoc. Prof.
Hiroyuki Maeda

The Department of Breast and Endocrine Surgery is responsible for the diagnosis and treatment of patients with mammary gland diseases, such as breast cancer, of which the morbidity and mortality rates have recently increased markedly, mastopathy, fibroadenoma, phyllodes tumors, intraductal papilloma, and gynecomastia.

Consultation system/therapeutic strategies

Specialists belonging to the Japan Surgical Society and Japanese Breast Cancer Society perform examinations, surgery, chemotherapy, and endocrine therapy. Furthermore, specialists belonging to the Japan Radiological Society are responsible for radiotherapy. Precise imaging-based and pathological diagnoses are made, and appropriate radical treatment for breast cancer and high-quality medical services to maintain patients’ QOL are provided.
As a rule, breast cancer treatment is performed according to the guidelines established by the Japanese Breast Cancer Society. However, therapeutic strategies, such as breast-conserving surgery, chemotherapy, endocrine therapy, and radiotherapy, are selected by mutual agreement with each patient.
We are making efforts to diagnose and treat diseases in cooperation with various departments, including the Department of Radiology, Department of Anesthesia, Department of Plastic and Reconstructive Surgery, Department of Internal Medicine, and Department of Rehabilitation Medicine. Based on patients’ wishes, breast reconstruction is performed in cooperation with plastic surgeons.

Field of expertise

Appropriate breast cancer diagnosis and treatment

A preoperative diagnosis of breast cancer is made using digital mammography, full-digital breast ultrasonography, helical CT, breast MRI, aspiration biopsy cytology, and needle biopsy to determine whether or not breast-preserving surgery and sentinel lymph node biopsy omitting axillary lymph node dissection should be indicated. The features of individual patients’ tumors are evaluated by pathologically investigating resected specimens. To prevent relapse, anticancer drug therapy, hormonal therapy, antibody treatment, and radiotherapy are conducted according to the guidelines. Before the start of treatment, its contents are explained to patients so that they can fully understand them.

Advanced medical practice

PET with estrogen

It is possible to investigate the expression of estrogen receptors in metastatic breast cancer foci. Although this is still in the phase of a clinical study, an international study reported that the effects of endocrine therapy could be more accurately predicted in comparison with the conventional immunostaining of primary tumors. To improve metastatic breast cancer patients’ QOL, endocrine therapy, which causes few adverse reactions, is selected, if possible, rather than chemotherapy, which induces marked adverse reactions.

Symptoms/diseases treated in our department

In the Department of Breast and Endocrine Surgery, detailed examination is performed in patients with symptoms, such as breast masses/induration, breast pain, breast discomfort, papillary secretion/eczema, and axillary masses, and those with abnormalities on breast cancer screening. Mammary gland diseases, such as breast cancer, mastopathy, mastitis, fibroadenoma, foliaceous tumors, intraductal papilloma, and gynecomastia, are treated in our department.

Primary examinations and explanations

Detailed examination of the breast

1) Digital mammography
2) Full-digital breast ultrasonography
3) Breast MRI
4) Aspiration biopsy cytology
5) Needle biopsy
6) Mammotome biopsy (stereo-guided)
7) VACORA? biopsy (ultrasound-guided)

Systemic examination

1) Helical CT
2) PET-CT with glucose
3) Bone scintigraphy
4) PET with estrogen (clinical studies only)

Genetic counseling (BRCA gene test only for persons who wish to undergo it)