A 39-year-old woman was admitted to our hospital because a hard mass about 3cm in diameter with a tender was found in a scar of cesarean section. Ultrasonography (US) showed a 22.9×14.9×24.5 mm hypoechoic and heterogeneous mass with an irregular margin. Abdominal contrast-enhanced CT scan showed an enhanced mass in the abdominal wall. The US-guided needle biopsy of the mass was performed for the histological diagnosis and the mass turned out to be endometriosis that was positive staining for vimentin, estrogen receptor and CD10 by immunohistochemistory. Measures available for the treatment of endometriosis are hormone therapy and surgical resection. In our case, surgical resection was performed completely, because preoperative diagnosis of the disease was made from a needle biopsy. It is important to avoid extended operation and to employ appropriate therapies combined with hormone and surgical therapy to maintain the patient's quality of life, because endometriosis is a benign disease per se.

Purpose: No standard therapies are available for the elderly with breast cancer and they tend to refuse to undergo treatment because of complications and shorter-life expectancy. In this study, feasible therapies were examined by evaluating cases we had experienced in our hospital.Methods: We report the results of a study on 12 seniors with breast cancer at age 80 and over in regard to preoperative examinations, operative procedures, histopathological examinations and adjuvant therapies.Results: Preoperative examinations were performed before mammography, ultrasonography (US), computed tomography, enhanced MRI of breast and fine-needle aspiration cytology. Though it was necessary to get their consent for biopsy under local anesthesia, we could perform US-guided core needle biopsy without their objections resistance. The first half of patients underwent mastectomy with lymph node dissection, whereas the second half had less invasive surgeries, such as partial resection of the breast and sentinel lymph node biopsy (SLNB). Histological checks revealed invasive carcinoma in 11 cases and the hormone receptor positive in 11 cases. Adjuvant therapy was performed with endocrine and fluoropyrimidine drugs orally administered. Irradiation to the remaining breast after partial resection was omitted by administering endocrine drugs.Conclusions: Elderly cases were apt to shun undergoing surgery, chemotherapy and radiation therapy, but they were treated with curative therapy by proposing less invasive partial resection, SLNB and adjuvant therapy. We should not omit lymph node dissection and adjuvant therapy just because the patients are elderly. However, less invasive and curative treatment based on the guideline should also be taken into full account.

　　We encountered with a rare case of intraductal apocrine carcinoma of the breast. The patient was a 62-year-old woman who had undergone right mastectomy for invasive ductal carcinoma of the right breast two years previously. This time, she was diagnosed with the left breast cancer (Category4) because left mammography showed pleomorphic and segmental calcifications. Ultrasonography (US) revealed an irregular and low echoic mass. Histopathological examination by US-guided core needle biopsy showed apocrine carcinoma. Mastectomy with sentinel lymph node biopsy for breast cancer of the left breast was performed. Post operative histopathological examination revealed intraductal apocrine carcinoma without lymph node metastasis. Estrogen and progesterone receptors were negative, while androgen receptors were positive, HER2 score was 2+. Adjuvant therapy was not performed. She is under observation as an outpatient now.