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Naoto Ueno, MD, PhD
naotoueno (Physician - Oncology - Hematology/Oncology (Verified) )| Communities: Breast Cancer | Answers: 23 |
| Member Since: Aug. 2011 |
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Professional Statement
I am a breast cancer specialist. I am also a cancer researcher and a cancer survivor. My vision is to reduced the suffering of breast cancer patients through hypothesis-driven translational research and research-driven medicine.
I see mostly inflammatory breast cancer and metastatic breast cancer. My vision is to reduce the suffering of breast cancer through translation research by developing targeted therapies and biomarkers.
I see mostly inflammatory breast cancer and metastatic breast cancer. My vision is to reduce the suffering of breast cancer through translation research by developing targeted therapies and biomarkers.
Professional Info
Credential: MD
Primary specialty: Oncology - Hematology/Oncology
Secondary specialty: Internal Medicine
State Licenses: Texas
Languages: English, Japanese
Gender: Male
Medical school: Wakayama Medical College
Residency: Univeristy of Pittsburgh
Internship: US Naval Hospital, Yokosuka
Board certifications: Internal Medicine, Medical Oncology
Professional memberships: ASCO, AACR
Areas of expertise:
Breast Cancer, Inflammatory Breast Cancer, Bone Metastasis, Triple Negative Breast Cancer
Research interests:
Inflammatory Breast Cancer, Bone Metastasis, Triple Negative Breast Cancer
Hospital affiliation: The University of Texas MD Anderson Cancer Center
Practice name: The University of Texas MD Anderson Cancer Center
Practice address:
1515 Holcombe Blvd Unit 1354
Houston, TX
77030
Practice phone number: 713-792-8754
Webpage:
http://www.mdanderson.org/
naotoueno Activities
Immediate breast reconstruction is not recommended for inflammatory breast cancer. It is contraindicated for two reasons.
1. There is a need radiation therapy soon after modified radial mastectomy for primary inflammatory breast cancer.
2. There remains to have high risk for recurrence.
So when is the best timing for reconstruction? I usually ask for one year after completion of radiation therapy. This is completely my personal bias, simply to make sure that there is no sign of recurrent disease.
At the end it is a personal choice.
1. There is a need radiation therapy soon after modified radial mastectomy for primary inflammatory breast cancer.
2. There remains to have high risk for recurrence.
So when is the best timing for reconstruction? I usually ask for one year after completion of radiation therapy. This is completely my personal bias, simply to make sure that there is no sign of recurrent disease.
At the end it is a personal choice.
New answer by naotoueno (Physician - Oncology - Hematology/Oncology (Verified))
1
Answer |
1 year ago
This is a very good questions. Yes, if there is a suspicious nodule, this will be the first area to biopsy. If there is no clear area of a mass, then the most prominent engorged breast area should be biopsied.
Suspicious lymph nodes should also be biopsied. Once again, this requires an experienced doctor to select the area to be biopsied.
Suspicious lymph nodes should also be biopsied. Once again, this requires an experienced doctor to select the area to be biopsied.
New answer by naotoueno (Physician - Oncology - Hematology/Oncology (Verified))
1
Answer |
1 year ago
We are hoping that in 5-10 years, genetic testing or other forms of biomarker testing will be standard to identify those patients who will respond to targeted therapy. MD Anderson Cancer Center for breast cancer currently has a program to test these genetic changes which will provide clinical grade information whether the breast cancer has any genetic changes. These tests are done under clinical trials and the information are placed into the patients' electronic medical record. These genetic findings will not always lead to a specific treatment but it may guide the doctors to identify appropriate clinical trials for patients to participate.
New answer by naotoueno (Physician - Oncology - Hematology/Oncology (Verified))
1
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1 year ago
Yes, there are many potential markers that are noted over the last 10 years. Some of the biomarkers have been prognostic, tells you the outcome. But, how unique they are and their clinical relevancy are not established. Therefore, the only biomarkers that are prognostic are HER2 and ER.
What is truly more important for biomarkers in breast cancer are predictive biomarkers, which can predict the outcome of the provided treatment. There are no predictive biomarkers for inflammatory breast cancer that can be used in clinic for now. There is a need for more research. Our group at MD Anderson is spending major effort to identify these predictive markers that are unique to inflammatory breast cancer.
What is truly more important for biomarkers in breast cancer are predictive biomarkers, which can predict the outcome of the provided treatment. There are no predictive biomarkers for inflammatory breast cancer that can be used in clinic for now. There is a need for more research. Our group at MD Anderson is spending major effort to identify these predictive markers that are unique to inflammatory breast cancer.
New answer by naotoueno (Physician - Oncology - Hematology/Oncology (Verified))
1
Answer |
1 year ago
Yes, I have heard about this work but I do not know the details of the work to really comment.
I can only answer in a general terms. The question remains what does this mean. Virus causing cancer is a fascinating process that is true with some of the tumors.
However, also we know that as long as human exists, viral component can be integrated into human tissue.
That said, these findings are very interesting but it does not conclude that inflammatory breast cancer is caused virus. There are need for two things. One you need to show that the virus truly can trigger inflammatory breast cancer in an animal model. Second, we need o think whether these virus is a trigger or what other factors are needed. Third, we need to validate truly that this has an epidemiological significance.
We will continue to see what will evolve out of this kind of research.
I can only answer in a general terms. The question remains what does this mean. Virus causing cancer is a fascinating process that is true with some of the tumors.
However, also we know that as long as human exists, viral component can be integrated into human tissue.
That said, these findings are very interesting but it does not conclude that inflammatory breast cancer is caused virus. There are need for two things. One you need to show that the virus truly can trigger inflammatory breast cancer in an animal model. Second, we need o think whether these virus is a trigger or what other factors are needed. Third, we need to validate truly that this has an epidemiological significance.
We will continue to see what will evolve out of this kind of research.
New answer by naotoueno (Physician - Oncology - Hematology/Oncology (Verified))
2
Answers |
1 year ago
The use of trastuzumab plus paclitaxel followed by trastuzumab plus FEC chemotherapy is the standard preoperative systemic therapy for HER2 positive primary inflammatory breast cancer.
The role of lapatinib in primary inflammatory breast cancer is unknown despite that there are data suggesting lapatinib may have a response in trastuzumab-resistant HER2 positive metastatic breast cancer.
HER2+ metastatic breast cancer can be treated with lapatinib plus capecitabine, and trastuzumab plus chemotherapy.
Once again if opportunities are available it is important to participate in clinical trials. At MDACC , we have several clinical trials related to HER2 positive inflammatory breast cancer.
The role of lapatinib in primary inflammatory breast cancer is unknown despite that there are data suggesting lapatinib may have a response in trastuzumab-resistant HER2 positive metastatic breast cancer.
HER2+ metastatic breast cancer can be treated with lapatinib plus capecitabine, and trastuzumab plus chemotherapy.
Once again if opportunities are available it is important to participate in clinical trials. At MDACC , we have several clinical trials related to HER2 positive inflammatory breast cancer.
New answer by naotoueno (Physician - Oncology - Hematology/Oncology (Verified))
1
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1 year ago
There are limited data about targeting vasculolymphatic processes. There are studies using bevacizumab with possible favorable response rate in primary IBC. However, there are no data to suggest that this can be used in the standard of care. Any target in vasculolymphatic process in primary IBC must be conducted under clinical trials. We do think that vasculolymphatic channels is important target so further research is needed.
New answer by naotoueno (Physician - Oncology - Hematology/Oncology (Verified))
1
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1 year ago
Surgery is required for treatment of newly diagnosed primary IBC. Surgery for IBC must be after preoperative systemic therapy, chemotherapy with or without targeted therapy. Surgery needs to be modified radical mastectomy. IBC is contraindicated for a skin sparing mastectomy or a lumpectomy.
Surgery is not required for diagnosis but it is contraindicated. Sampling of tissue needs to be a core biopsy of the breast tissue not surgery.
Surgery is not required for diagnosis but it is contraindicated. Sampling of tissue needs to be a core biopsy of the breast tissue not surgery.
New answer by naotoueno (Physician - Oncology - Hematology/Oncology (Verified))
1
Answer |
1 year ago
In general, surgery is not indicated for a recurrent inflammatory breast cancer. However, there is always an exception depending on the clinical situation. This case is something that we should not be commenting based on the information provided on the net. I recommend to see a multidisciplinary team with a experience in inflammatory breast cancer.
New answer by naotoueno (Physician - Oncology - Hematology/Oncology (Verified)) in topic(s) Breast Cancer Recurrence, Inflammatory Breast Cancer, Breast Cancer, Recurrence, Surgery
1
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1 year ago
Yes, I can except that I cannot give a specific. Angiogenesis is triggered by three main receptor VEGFR 1, VEGFR 2, and VEGFR 3. You can inhibit one of these receptor or two receptors, or three receptors. Further, some people approach inhibit the ligand (stimulant of receptor). Stopping the ligand is the approach of Bevacizumab (Avastin).
So the main question is wether the ligands or the receptors important in creating new blood vessels that can nurture the cancer more. The answer is that we do not have a clear cut answer. Therefore, the thought is why not inhibit all three receptors. Because we speculate that all three receptors promote inflammatory breast cancer to be aggressive, we feel that is worth testing a drug that inhibit all three receptors.
So the main question is wether the ligands or the receptors important in creating new blood vessels that can nurture the cancer more. The answer is that we do not have a clear cut answer. Therefore, the thought is why not inhibit all three receptors. Because we speculate that all three receptors promote inflammatory breast cancer to be aggressive, we feel that is worth testing a drug that inhibit all three receptors.
New answer by naotoueno (Physician - Oncology - Hematology/Oncology (Verified)) in topic(s) Inflammatory Breast Cancer, Inflammatory Breast Cancer Research, Breast Cancer Research, Inhibitors, Research
1
Answer |
1 year ago
Unfortunately, this is most likely consider as a stage IV. It is very important that you seek second opinion at Breast Center specializing in inflammatory breast cancer such as at MD Anderson Cancer Center and/or Phase I/II program that provide multiple clinical trial options. As long as feeling well, there are many choices to explore.
New answer by naotoueno (Physician - Oncology - Hematology/Oncology (Verified)) in topic(s) Inflammatory Breast Cancer, Stage IV Breast Cancer Diagnosis, Staging Breast Cancer, Stage IV (Stage 4) Breast Cancer, Breast Cancer Diagnosis, Staging Cancer
1
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1 year ago
This is a very controversial topics. Triple negative breast cancer does not mean automatically chemotherapy. The very very small tumors with no lymph node many not have an indication of chemotherapy depending on the patient's general health condition or age. So question is what is small small? This is where split opinions do exist. This is something that we can not truly discuss unless we see each case in the clinic.
New answer by naotoueno (Physician - Oncology - Hematology/Oncology (Verified)) in topic(s) Triple Negative, Triple Negative Breast Cancer, Tumor, Breast Cancer Treatments, Tumor Size, Triple Negative Treatments, Chemotherapy
2
Answers |
1 year ago
Widespread use is something that will not happen easily in any research related to cancer. Sorry.
Most of the advancement in cancer research is an increment. Step by step. Further, IBC is under funded so it makes the situation more difficult.
MD Anderson Cancer Center focuses now on targeting EGFR, HDAC, VEGFR, c-Met, HER2, IGFR and etc. There are many targeted therapy trials conducted specially targeting IBC or including IBC.
Most of the advancement in cancer research is an increment. Step by step. Further, IBC is under funded so it makes the situation more difficult.
MD Anderson Cancer Center focuses now on targeting EGFR, HDAC, VEGFR, c-Met, HER2, IGFR and etc. There are many targeted therapy trials conducted specially targeting IBC or including IBC.
New answer by naotoueno (Physician - Oncology - Hematology/Oncology (Verified)) in topic(s) Biomarkers, Targeted Treatments, Inflammatory Breast Cancer Research, Breast Cancer Research, Research
1
Answer |
1 year ago
Sorry to hear about side effects. This is a common issues with any form of systemic therapy. The more you receive different form of systemic therapy, in particular, chemotherapy, the body is getting hits. This means that even if you did not experience a server toxicities from chemotherapy. The more you receive chemotherapy, you will feel strong fatigue, and the side effects may present with a stronger scale.
There is no good answer how to deal with these issues. But, keeping up energy level does no come from anti-cancer treatment. It is more important to focus on eating well, sleeping well, and exercise. They make a big difference for the side effect outcome.
There is no good answer how to deal with these issues. But, keeping up energy level does no come from anti-cancer treatment. It is more important to focus on eating well, sleeping well, and exercise. They make a big difference for the side effect outcome.
New answer by naotoueno (Physician - Oncology - Hematology/Oncology (Verified)) in topic(s) Chemotherapy Side Effects, Dealing With Side Effects, Side Effects, Chemotherapy
2
Answers |
1 year ago
Yes, in general. When inflammatory breast cancer comes back it usually comes to a location outside of the original area (distant metastasis). All metastasis is consider Stage IV. Whether inflammatory breast cancer metastatic disease behaves differently from non-inflammatory breast cancer behaves differently is controversial. But, there is an intensive research going on to understand the biology of IBC metastasis.
New answer by naotoueno (Physician - Oncology - Hematology/Oncology (Verified)) in topic(s) Breast Cancer Recurrence, Inflammatory Breast Cancer, Breast Cancer, Cancer Staging, Staging, Inflammatory Breast Cancer Recurrence, Breast Cancer Staging, Recurrence
2
Answers |
1 year ago
If you are looking for serious medical articles, you can go to a medical library and ask for the followng articles to be pulled. I hope that this will guide you.
The other is for you to learn how to use PubMed (http://www.ncbi.nlm.nih.gov)
And do a search by inflammatory breast cancer.
The other website for the latest update related to inflammatory breast cancer is
http://www.facebook.com/InflammatoryBreastCancer
Inflammatory breast cancer: the disease, the biology, the treatment.
Robertson FM, Bondy M, Yang W, Yamauchi H, Wiggins S, Kamrudin S, Krishnamurthy S, Le-Petross H, Bidaut L, Player AN, Barsky SH, Woodward WA, Buchholz T, Lucci A, Ueno NT, Cristofanilli M.
CA Cancer J Clin. 2010 Nov-Dec;60(6):351-75. Epub 2010 Oct 19. Review. Erratum in: CA Cancer J Clin. 2011 Mar-Apr;61(2):134. Ueno, Naoto [corrected to Ueno, Naoto T].
PMID: 20959401 [PubMed - indexed for MEDLINE] Free Article
Related citations
2.
International expert panel on inflammatory breast cancer: consensus statement for standardized diagnosis and treatment.
Dawood S, Merajver SD, Viens P, Vermeulen PB, Swain SM, Buchholz TA, Dirix LY, Levine PH, Lucci A, Krishnamurthy S, Robertson FM, Woodward WA, Yang WT, Ueno NT, Cristofanilli M.
Ann Oncol. 2011 Mar;22(3):515-23. Epub 2010 Jul 5.
PMID: 20603440 [PubMed - indexed for MEDLINE]
Related citations
3.
Molecular targets for treatment of inflammatory breast cancer.
Yamauchi H, Cristofanilli M, Nakamura S, Hortobagyi GN, Ueno NT.
Nat Rev Clin Oncol. 2009 Jul;6(7):387-94. Epub 2009 May 26. Review.
PMID: 19468291 [PubMed - indexed for MEDLINE]
Related citations
4.
The medical treatment of inflammatory breast cancer.
Dawood S, Ueno NT, Cristofanilli M.
Semin Oncol. 2008 Feb;35(1):64-71. Review.
The other is for you to learn how to use PubMed (http://www.ncbi.nlm.nih.gov)
And do a search by inflammatory breast cancer.
The other website for the latest update related to inflammatory breast cancer is
http://www.facebook.com/InflammatoryBreastCancer
Inflammatory breast cancer: the disease, the biology, the treatment.
Robertson FM, Bondy M, Yang W, Yamauchi H, Wiggins S, Kamrudin S, Krishnamurthy S, Le-Petross H, Bidaut L, Player AN, Barsky SH, Woodward WA, Buchholz T, Lucci A, Ueno NT, Cristofanilli M.
CA Cancer J Clin. 2010 Nov-Dec;60(6):351-75. Epub 2010 Oct 19. Review. Erratum in: CA Cancer J Clin. 2011 Mar-Apr;61(2):134. Ueno, Naoto [corrected to Ueno, Naoto T].
PMID: 20959401 [PubMed - indexed for MEDLINE] Free Article
Related citations
2.
International expert panel on inflammatory breast cancer: consensus statement for standardized diagnosis and treatment.
Dawood S, Merajver SD, Viens P, Vermeulen PB, Swain SM, Buchholz TA, Dirix LY, Levine PH, Lucci A, Krishnamurthy S, Robertson FM, Woodward WA, Yang WT, Ueno NT, Cristofanilli M.
Ann Oncol. 2011 Mar;22(3):515-23. Epub 2010 Jul 5.
PMID: 20603440 [PubMed - indexed for MEDLINE]
Related citations
3.
Molecular targets for treatment of inflammatory breast cancer.
Yamauchi H, Cristofanilli M, Nakamura S, Hortobagyi GN, Ueno NT.
Nat Rev Clin Oncol. 2009 Jul;6(7):387-94. Epub 2009 May 26. Review.
PMID: 19468291 [PubMed - indexed for MEDLINE]
Related citations
4.
The medical treatment of inflammatory breast cancer.
Dawood S, Ueno NT, Cristofanilli M.
Semin Oncol. 2008 Feb;35(1):64-71. Review.
New answer by naotoueno (Physician - Oncology - Hematology/Oncology (Verified)) in topic(s) Inflammatory Breast Cancer, Inflammatory Breast Cancer Research, Inflammatory Breast Cancer Articles, Breast Cancer Research, Research, Articles, Breast Cancer Articles
1
Answer |
1 year ago
I am guessing that you are asking how you develop a novel biomarkers or a new targeted therapy for breast cancer or inflammatory breast cancer.
There are several ways to approach this issues.
1. You collect large amoung of tissue and blood samples from breast cancer. Then you do a comprehensive analysis of genetic and protein changes (DNA, RNA, and protein). You link this data to a clinica data and find the one or them that can impact surveil or disease recurrence.
2. The other approach is discovery from basic research needs to be mined. And take their knowledge to apply by conducting a hypothesis oriented research. This means that you build up the puzzle one by one to prove the target is truly relevant in breast cancer.
Both approaches are important. Therefore, we do both and spend tremendous amount of time an money to come out with a strong scientific rationale before we can test this in human being. The problem we face is that there is not enough money and those who qualified to do this type of research.
Please asks me a more specific question. This may help me to answer this more accurately.
There are several ways to approach this issues.
1. You collect large amoung of tissue and blood samples from breast cancer. Then you do a comprehensive analysis of genetic and protein changes (DNA, RNA, and protein). You link this data to a clinica data and find the one or them that can impact surveil or disease recurrence.
2. The other approach is discovery from basic research needs to be mined. And take their knowledge to apply by conducting a hypothesis oriented research. This means that you build up the puzzle one by one to prove the target is truly relevant in breast cancer.
Both approaches are important. Therefore, we do both and spend tremendous amount of time an money to come out with a strong scientific rationale before we can test this in human being. The problem we face is that there is not enough money and those who qualified to do this type of research.
Please asks me a more specific question. This may help me to answer this more accurately.
New answer by naotoueno (Physician - Oncology - Hematology/Oncology (Verified)) in topic(s) Targeted Therapies, Biomarkers, Inflammatory Breast Cancer, Breast Cancer, Inflammatory Breast Cancer Research, Breast Cancer Research, Research, Translational Research
1
Answer |
1 year ago
Unfortunately, there is no IBC specific chemotherapy for now. But in general, it is anthracycline (adriamycin, epirubicin) based or taxane (paclitaxel or docetaxel) based. For newly diagnosed IBC, both are used in sequence. Weekly paclitaxel followed by FAC (FEC) is our standard at MD Anderson Cancer Center IBC program.
New answer by naotoueno (Physician - Oncology - Hematology/Oncology (Verified)) in topic(s) Chemotherapy Agents, Breast Cancer Treatments, Inflammatory Breast Cancer, Inflammatory Breast Cancer Treatments, Breast Cancer, Treatments, Chemotherapy
1
Answer |
1 year ago
Currently, there are no exception for the sequence of how the inflammatory breast cancer should be treated. The newly diagnosed inflammatory breast cancer without metastasis needs to receive systemic therapy (chemotherapy and/or targeted therapy), followed by surgery, and radiation. The surgery must be modified radical mastectomy. It is very important to see the IBC specialists.
New answer by naotoueno (Physician - Oncology - Hematology/Oncology (Verified)) in topic(s) Breast Cancer Treatments, Inflammatory Breast Cancer, Inflammatory Breast Cancer Treatments, Breast Cancer, Treatment Order, Treatments, Cancer
1
Answer |
1 year ago
Inflammatory breast cancer is suspected when you have a very red breast, the breast will become big, and this will happen within one to two month. Sometime it could be faster. You do not have to feel a mass. Therefore, it is commonly misdiagnosed as mastitis (infection of the breast). The only way to make the diagnosis of the IBC is to have a biopsy and look under the microscope. Combination of the biopsy and clinical presentation confirms the diagnosis of IBC.
New answer by naotoueno (Physician - Oncology - Hematology/Oncology (Verified)) in topic(s) Cancer Diagnosis, Inflammatory Breast Cancer Diagnosis, Breast Cancer Diagnosis, Diagnosis
1
Answer |
1 year ago
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