論文

• Impact of breast tumor size discrepancy between contrast-enhanced and conventional ultrasonography on axillary node metastasis: a retrospective cohort study.
  Oshino T, Shimizu H, Sato M, Nishida M, Horie T, Tsuneta S, Kato F, Hosoda M, Yokota I, Kudo K, Takahashi M
  BMC cancer, 2025年11月05日
  研究論文（学術雑誌）,

  Background

  Conventional ultrasonography (cUS) and contrast-enhanced ultrasonography (CEUS) are used to evaluate breast cancer tumors and axillary lymph nodes (ALN), by which the treatment strategy for breast cancer is determined. A breast tumor size discrepancy on CEUS compared with cUS is often observed, for which the reasons are unclear. We hypothesized that this discrepancy reflects the metastatic potential, and this study investigated the association between size discrepancies on cUS and CEUS in relation to ALN metastasis in breast cancer.

  Methods

  This retrospective study enrolled 259 patients who underwent surgery for breast cancer after preoperative cUS and CEUS examinations. Patients were grouped into a DISCR (i.e., tumor size discrepancy ≥ 4.0 mm between CEUS and cUS measurements) and non-DISCR group. The primary outcome was ALN metastasis, defined by pathological evaluation. Secondary outcomes were the 5-year recurrence-free survival rates.

  Results

  There were 94 patients in the DISCR and 165 in the non-DISCR groups. No tumor size differences measured by cUS were observed between two groups (p = 0.82), whereas the DISCR group had a significantly higher rate of ALN metastasis (p < 0.01). Multivariate analyses showed a discrepancy of ≥ 4.0 mm was a risk for ALN metastasis (odds ratio: 5.838, 95% confidence interval [CI]: 2.408-14.155). The 5-year recurrence-free survival rate was lower in the DISCR (0.750, 95% CI: 0.632-0.868) than in the non-DISCR (0.924, 95% CI; 0.870-0.978) group.

  Conclusion

  An increase in contrast-enhanced ultrasonography tumor size is helpful for assessing axillary lymph node metastasis and prognosis.
• Artificial intelligence can extract important features for diagnosing axillary lymph node metastasis in early breast cancer using contrast-enhanced ultrasonography.
  Oshino T, Enda K, Shimizu H, Sato M, Nishida M, Kato F, Oda Y, Hosoda M, Kudo K, Iwasaki N, Tanaka S, Takahashi M
  Scientific reports, 2025年02月15日
  研究論文（学術雑誌）, Contrast-enhanced ultrasound (CEUS) plays a pivotal role in the diagnosis of primary breast cancer and in axillary lymph node (ALN) metastasis. However, the imaging features that are clinically crucial for lymph node metastasis have not been fully elucidated. Hence, we developed a bimodal model to predict ALN metastasis in patients with early breast cancer by integrating CEUS images with the annotated imaging features. The model adopted a light-gradient boosting machine to produce feature importance, enabling the extraction of clinically crucial imaging features. In this retrospective study, the diagnostic performance of the model was investigated using 788 CEUS images of ALNs obtained from 788 patients who underwent breast surgery between 2013 and 2021, with the ground truth defined by the pathological diagnosis. The results indicated that the test cohort had an area under the receiver operating characteristic curve (AUC) value of 0.93 (95% confidence interval: 0.88, 0.98). The model had an accuracy of 0.93, which was higher than the radiologist's diagnosis (accuracy of 0.85). The most important imaging features were heterogeneous enhancement, diffuse cortical thickening, and eccentric cortical thickening. Our model has an excellent diagnostic performance, and the extracted imaging features could be crucial for confirming ALN metastasis in clinical settings.
• General Anesthesia Surgery for Early Breast Cancer in a Patient with Severe Heart Failure due to Dilated Cardiomyopathy: A Case Report
  Tomohiro Oshino, Karin Shikishima, Yumi Moriya, Mitsuchika Hosoda, Kiwamu Kamiya, Toshiyuki Nagai, Toshihisa Anzai, Masato Takahashi
  Surgical Case Reports, 2025年
  研究論文（学術雑誌）
• Significant improvement in paraneoplastic neurological syndromes without identifiable anti-neural antibodies in patients with breast cancer after breast surgery.
  Oshino T, Shikishima K, Moriya Y, Ishikawa K, Abe M, Yaguchi H, Hosoda M, Tanaka K, Yabe I, Takahashi M
  International cancer conference journal, 2024年04月13日
  研究論文（学術雑誌）, Paraneoplastic neurological syndromes (PNS) are neurological disorders that occur in close association with tumors without direct metastasis or invasion of the tumors and in which anti-neural antibodies may be present. Cerebellar ataxia is a common form of PNS in patients with breast cancer. However, reports of symptom improvement with breast cancer treatment are more common in patients with positive anti-neural antibodies and are rarely seen in those with negative anti-neural antibodies. In addition, there have been few quantitative evaluations of symptom improvement. We report a case in which neurological symptoms significantly improved after surgical treatment for breast cancer. The patient was a 78-years-old woman with subacute progressive cerebellar ataxia. A subsequent diagnosis of breast cancer led to the diagnosis of "PNS probable". A comprehensive search for anti-neural antibodies was negative in all cases. The quantitative index of the Scale for the Assessment and Rating of Ataxia (SARA) score, a standard evaluation method for ataxia in spinocerebellar degeneration, improved after breast cancer surgery. This case may provide a rationale for treating breast cancer patients negative for anti-neural antibodies, with the possibility of improving neurological symptoms.