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Kim M, Cheol Lim M, Ji Nam E, Huang D, Kim S, Jong Yoo H, Lee YY, Chang YJ. Awareness of genetic counseling and genetic testing for hereditary gynecologic cancers among Korean healthcare providers: A survey. J Genet Couns 2021; 31:546-553. [PMID: 34674340 DOI: 10.1002/jgc4.1524] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/08/2020] [Revised: 09/24/2021] [Accepted: 10/11/2021] [Indexed: 11/11/2022]
Abstract
We conducted a survey to evaluate the awareness of genetic counseling and testing for hereditary gynecologic cancers among Korean healthcare providers. We performed an on-the-spot survey using 29 questions on respondents' basic information, awareness of pre/post-test genetic counseling, genetic information management, and related social issues. We surveyed healthcare providers who attended the 2019 Hereditary Gynecologic Cancer Symposium organized by the Korean Society of Gynecologic Oncology. Of the 108 attendees, 85 (78.7%) participated in the survey. Among them, 45% (37/83) and 40% (33/83) did not have a separate clinic and had a dedicated team for genetic counseling in their institutions, respectively. Most respondents (60/76, 79%) recommended genetic testing for all women diagnosed with epithelial ovarian cancer. Many respondents simultaneously (20/85, 24%) or sequentially (45/85, 53%) tested for both pathogenic somatic and germline variants, whereas a few respondents (2/85, 2%) checked for only pathogenic somatic variants using tissue samples. Only 20% (17/85) of the respondents recommended genetic testing for all women with endometrial cancer; meanwhile, 68% (58/86) offered the test based on the results of the screening test or family history. Risk-reducing salpingo-oophorectomy was recommended to unaffected women with pathogenic BRCA1/2 variants by 69.4% of the respondents (59/85). Most respondents (73/85, 85.9%) needed a manual on bioethics law; a few required a clinical update of hereditary cancer (73/85, 85.9%). The awareness of genetic counseling and testing and the pattern of clinical practice for hereditary gynecologic cancers differ among institutions and regions in Korea. A discussion on these issues and the development of an integrated manual for healthcare providers are required.
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Affiliation(s)
- Miseon Kim
- Department of Obstetrics and Gynecology, CHA Gangnam Medical Center, CHA University School of Medicine, Seoul, South Korea
| | - Myong Cheol Lim
- Division of Tumor Immunology, Center for Gynecologic Cancer, National Cancer Center, Research Institute and Hospital, Goyang, South Korea
| | - Eun Ji Nam
- Department of Obstetrics and Gynecology, Women's Cancer Center, Institute of Women's Life Medical Science, Yonsei University College of Medicine, Seoul, South Korea
| | - Dan Huang
- Division of Cancer Control & Policy, National Cancer Center, National Cancer Control Institute, Goyang, South Korea
| | - Sue Kim
- Mo-Im Kim Nursing Research Institute, College of Nursing, Yonsei University, Seoul, South Korea
| | - Heon Jong Yoo
- Department of Obstetrics and Gynecology, Chungnam National University School of Medicine, Dajeon, South Korea
| | - Yoo-Young Lee
- Department of Obstetrics and Gynecology, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, South Korea
| | - Yoon-Jung Chang
- Division of Cancer Control & Policy, National Cancer Center, National Cancer Control Institute, Goyang, South Korea
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Causal Attributions in Breast Cancer Patients Planning to Undergo Adjuvant Endocrine Therapy. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2021; 18:ijerph18115931. [PMID: 34073064 PMCID: PMC8198340 DOI: 10.3390/ijerph18115931] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 03/03/2021] [Revised: 05/24/2021] [Accepted: 05/28/2021] [Indexed: 12/24/2022]
Abstract
The aim of this study was to explore causal attributions among Korean breast cancer patients who were planning to undergo adjuvant endocrine therapy (AET) as well as the relationships between patient demographic and clinical characteristics and their causal attributions. Causal attributions were assessed with an open-ended response item, which asked patients to list what they thought were the three most important causal factors of their illness. The relationships between patient characteristics and causal attributions were determined through univariate analysis, and the relationships between causal attributions were obtained using social network analysis. A total of 299 participants provided 707 responses. Stress, diet, and exercise were believed to be the three most likely causes of breast cancer. There were no significant differences between causal attributions and the age, education level, marital status, or cancer stage of patients. However, there were differences in the associations between personality, genetics, and reproductive history and patient-identified causal attributions according to the patients' family history of cancer. Patients with a family history of cancer were more likely to believe that personality and genetics/family history were causes of breast cancer compared to patients without such a history. Therefore, it is necessary to educate patients to perceive stress and lifestyle-related factors as modifiable causal factors in order to have a positive effect on their adherence to AET.
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Lee SH, Lee H, Lim MC, Kim S. Knowledge and Anxiety Related to Hereditary Ovarian Cancer in Serous Ovarian Cancer Patients. KOREAN JOURNAL OF WOMEN HEALTH NURSING 2019; 25:365-378. [PMID: 37679908 DOI: 10.4069/kjwhn.2019.25.4.365] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/08/2019] [Revised: 11/22/2019] [Accepted: 11/25/2019] [Indexed: 09/09/2023] Open
Abstract
PURPOSE The awareness of hereditary breast and ovarian cancer (HBOC) and BRCA testing is increasing in Korea. Compared to the sizable research on HBOC knowledge among breast cancer women, studies in the ovarian cancer population are limited. This paper aimed to investigate the level of knowledge of hereditary ovarian cancer and anxiety in women diagnosed with serous ovarian cancer in Korea and determine differences in the knowledge and anxiety according to whether genetic testing was undertaken and whether BRCA1 or BRCA2 mutations were present. METHODS Using a descriptive research design, a cross-sectional survey was conducted on 100 women diagnosed with serous ovarian cancer at N hospital in Gyeonggi-do, Korea, from July to November 2018. The collected data were analyzed by descriptive statistics, independent t-tests, one-way analysis of variance, and Pearson's correlation coefficient using the SPSS 21.0 program. RESULTS The hereditary ovarian cancer-related knowledge score was mid-level (mean score 8.90±3.29 out of a total of 17), as was the state anxiety level was mid-level (mean score 47.96±3.26 out of possible score range of 20-80). Genetic knowledge of hereditary ovarian cancer was associated with age, education, occupation, genetic counseling, and BRCA mutations. There were no statistically significant factors related to anxiety and there were no statistically significant correlations between knowledge level and anxiety. CONCLUSION More comprehensive education on gene-related cancer is needed for ovarian cancer patients, especially for items with low knowledge scores. A genetic counseling protocol should be developed to allow more patients to alleviate their anxiety through genetic counseling.
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Affiliation(s)
- Sang Hee Lee
- Student, College of Nursing, Yonsei University, Seoul, Korea
| | - Hyangkyu Lee
- Student, College of Nursing, Yonsei University, Seoul, Korea
| | - Myong Cheol Lim
- Student, College of Nursing, Yonsei University, Seoul, Korea
| | - Sue Kim
- Student, College of Nursing, Yonsei University, Seoul, Korea
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Perceptions of Prophylactic Mastectomy in Korea. Arch Plast Surg 2016; 43:53-8. [PMID: 26848446 PMCID: PMC4738129 DOI: 10.5999/aps.2016.43.1.53] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/21/2015] [Revised: 09/23/2015] [Accepted: 09/24/2015] [Indexed: 11/15/2022] Open
Abstract
Background Increasingly, prophylactic mastectomy has been evaluated as a treatment of breast cancer. Hereditary breast cancer now accounts for approximately 5%–10% of all cases of breast cancer, meaning that the widespread implementation of prophylactic mastectomy may significantly reduce the occurrence of breast cancer. However, prophylactic mastectomy is rarely performed in Korea. Therefore, in this study, we assessed Koreans' attitudes toward and awareness of preventive mastectomy. Methods This was a prospective study of a cohort of patients attending outpatient clinics and their relatives. Data were collected using self-administered questionnaires assessing sex, age, educational level, knowledge of breast cancer, understanding of prophylactic mastectomy, attitudes toward prophylactic mastectomy, and reasons for choosing prophylactic mastectomy. Results Sixty-five patients were included. Most patients (36.9%) were between 40 and 49 years of age and 58.4% were college graduates. Only six respondents (9%) understood prophylactic mastectomy, and 17 respondents (27%) stated that they would agree to undergo prophylactic mastectomy if necessary. Reasons given for refusing prophylactic mastectomy included aesthetic concerns (38%), the perception that it would not cure the disease (26%), possible surgical complications (24%), and financial cost (6%). Conclusions In this study, most of the respondents showed a poor knowledge of prophylactic mastectomy. Ultimately, it will be necessary to establish medical guidelines for patients with a high risk of breast cancer, with the objective of providing accurate information and proper treatment at hospitals.
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Heo J, Chun M, Lee KY, Oh YT, Noh OK, Park RW. Effects of a smartphone application on breast self-examination: a feasibility study. Healthc Inform Res 2013; 19:250-60. [PMID: 24523989 PMCID: PMC3920037 DOI: 10.4258/hir.2013.19.4.250] [Citation(s) in RCA: 25] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/01/2013] [Revised: 12/22/2013] [Accepted: 12/24/2013] [Indexed: 11/30/2022] Open
Abstract
Objectives The aims of this study were to develop a smartphone application to encourage breast self-examination (BSE), and to evaluate the effects of this application in terms of modifying BSE behavior. Methods A smartphone application, based on the Android OS, was developed with functions including a BSE date alarm, a reminder to encourage mother and daughter to practice BSE together, record keeping, and educational content with video clips. Females aged 19 and over were enrolled to evaluate the effectiveness of the application. Two series of questionnaires were carried out (before and after use of the application) by e-mail, telephone, and face-to-face interviews between July and September 2012. Results Forty-five subjects were enrolled in the study (age 29.5-5.9 years). Of the participants, only 28 (62.2%) had ever practiced BSE and only one of these (2.2%) was carried out at the appropriate time, based on the results of the baseline survey. After using the application, the number of participants practicing BSE increased from 28 to 32 (62.2% to 71.1%, p = 0.503). In subgroup analysis (age < 30 years), the number of participants using BSE increased from 8 to 18 (36.4% to 81.8%, p = 0.002), and the number of those using it at the appropriate time rose from 1 to 15 (2.2% to 33.3%, p < 0.001). Conclusions The use of the developed smartphone application increased BSE in females younger than 30 years. To confirm the long-term benefits of the mobile application, additional studies must be carried out.
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Affiliation(s)
- Jaesung Heo
- Department of Radiation Oncology, Ajou University School of Medicine, Suwon, Korea
| | - Mison Chun
- Department of Radiation Oncology, Ajou University School of Medicine, Suwon, Korea
| | - Ki Young Lee
- Department of Biomedical Informatics, Ajou University School of Medicine, Suwon, Korea
| | - Young-Taek Oh
- Department of Radiation Oncology, Ajou University School of Medicine, Suwon, Korea
| | - O Kyu Noh
- Department of Radiation Oncology, Ajou University School of Medicine, Suwon, Korea
| | - Rae Woong Park
- Department of Biomedical Informatics, Ajou University School of Medicine, Suwon, Korea. ; Center for Clinical Epidemiology and Biostatistics/Department of Biostatistics & Epidemiology, Perelman School of Medicine at the University of Pennsylvania, Philadelphia, PA, USA. ; Center for Pharmacoepidemiology Research and Training, Perelman School of Medicine at the University of Pennsylvania, Philadelphia, PA, USA
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Park H, Choi DH, Noh JM, Huh SJ, Park W, Nam SJ, Lee JE. Acute skin toxicity in Korean breast cancer patients carrying BRCA mutations. Int J Radiat Biol 2013; 90:90-4. [PMID: 23957571 DOI: 10.3109/09553002.2013.835504] [Citation(s) in RCA: 20] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022]
Abstract
PURPOSE In contrast to in vitro studies, most clinical trials testing the radiosensitivity of BRCA (Breast cancer susceptibility gene) mutations do not find a correlation between BRCA status and enhanced radiosensitivity. These trials include different ethnicities, and there is a lack of clinical data on BRCA1/2 mutation carriers and radiosensitivity in non-Caucasian patients. The goal of this study was to investigate acute skin toxicity, as a part of radiosensitivity, in breast cancer patients with BRCA1/2 mutations. MATERIAL AND METHODS BRCA mutation analysis was performed for 213 patients who underwent breast-conserving therapy using radiotherapy. Skin toxicity was scored according to the Radiation Therapy Oncology Group (RTOG) criteria during treatment and during one-month follow-up after radiation therapy. RESULTS Forty-six patients had BRCA1/2 mutations and 57 patients showed higher than grade 2 (RTOG) skin toxicity. In multivariate analysis, significant associations were found between mean breast volume and acute skin toxicity. BRCA mutation status, however, failed to show a significant correlation. CONCLUSIONS Our results indicate that carriers of BRCA1/2 mutations among non-Caucasian breast cancer patients showed no enhancement in radiation sensitivity. Multiple genetic markers may be correlated with normal tissue responses after radiotherapy. Further studies are needed to identify genetic predispositions to normal tissue responses after radiotherapy.
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Affiliation(s)
- Hyojung Park
- Department of Radiation Oncology, Samsung Medical Center, Sungkyunkwan University School of Medicine , Seoul , Korea
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Chung SY, Cha JH, Kim HH, Shin HJ, Kim HJ, Chae EY, Shin JE, Choi WJ, Hong MJ, Ahn SH, Lee JW, Jung KH. Magnetic Resonance Imaging of Breast Cancer Patients with BRCA Mutation. ACTA ACUST UNITED AC 2013. [DOI: 10.13104/jksmrm.2013.17.3.207] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/01/2022]
Affiliation(s)
- Sun Young Chung
- Department of Radiology and Research Institute of Radiology, Asan Medical Center, College of Medicine, University of Ulsan, Seoul, Korea
| | - Joo Hee Cha
- Department of Radiology and Research Institute of Radiology, Asan Medical Center, College of Medicine, University of Ulsan, Seoul, Korea
| | - Hak Hee Kim
- Department of Radiology and Research Institute of Radiology, Asan Medical Center, College of Medicine, University of Ulsan, Seoul, Korea
| | - Hee Jung Shin
- Department of Radiology and Research Institute of Radiology, Asan Medical Center, College of Medicine, University of Ulsan, Seoul, Korea
| | - Hyun Ji Kim
- Department of Radiology and Research Institute of Radiology, Asan Medical Center, College of Medicine, University of Ulsan, Seoul, Korea
| | - Eun Young Chae
- Department of Radiology and Research Institute of Radiology, Asan Medical Center, College of Medicine, University of Ulsan, Seoul, Korea
| | - Ji Eun Shin
- Department of Radiology and Research Institute of Radiology, Asan Medical Center, College of Medicine, University of Ulsan, Seoul, Korea
| | - Woo Jung Choi
- Department of Radiology and Research Institute of Radiology, Asan Medical Center, College of Medicine, University of Ulsan, Seoul, Korea
| | - Min Ji Hong
- Department of Radiology and Research Institute of Radiology, Asan Medical Center, College of Medicine, University of Ulsan, Seoul, Korea
| | - Sei Hyun Ahn
- Department of General Surgery, Asan Medical Center, College of Medicine, University of Ulsan, Seoul, Korea
| | - Jong Won Lee
- Department of General Surgery, Asan Medical Center, College of Medicine, University of Ulsan, Seoul, Korea
| | - Kyung Hae Jung
- Department of Internal Medicine, Asan Medical Center, College of Medicine, University of Ulsan, Seoul, Korea
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Noh JM, Choi DH, Baek H, Nam SJ, Lee JE, Kim JW, Ki CS, Park W, Huh SJ. Associations between BRCA Mutations in High-Risk Breast Cancer Patients and Familial Cancers Other than Breast or Ovary. J Breast Cancer 2012; 15:283-7. [PMID: 23091540 PMCID: PMC3468781 DOI: 10.4048/jbc.2012.15.3.283] [Citation(s) in RCA: 19] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/26/2012] [Accepted: 05/28/2012] [Indexed: 02/06/2023] Open
Abstract
PURPOSE We investigated the relationship between BRCA mutations and the distribution of familial cancers other than breast or ovary in high-risk breast cancer patients. METHODS PATIENTS WITH BREAST CANCER WHO HAD AT LEAST ONE OF THE FOLLOWING RISK FACTORS WERE ENROLLED: reported family history of breast or ovarian cancer; 40 years of age or younger age at diagnosis; bilateral breast cancer; or male gender. Genetic testing for BRCA mutation and questionnaires about personal and family histories of malignancies were performed. RESULTS Among the 238 eligible patients, 49 (20.6%) patients had BRCA1/2 mutations, which were more frequent in patients with multiple risk factors (p<0.0001). There were 271 members of 156 (65.5%) families who had histories of other primary cancer. The distribution of the families was 119 (63.0%) and 37 (75.5%) in the BRCA-negative and positive group, respectively (p=0.0996). Multiple familial cancers occurred in 70 families, which were significantly more frequent in BRCA-positive families (p=0.0034). By ordinal logistic regression, the occurrence of multiple familial cancers was associated with BRCA mutations (p=0.0045), not with other risk factors. The most common site of disease was the stomach, which is the most common in nationwide. And the proportional incidence of pancreatic cancer (6.8%) was significantly higher than that of nationwide cancer statistics (2.4%, p=0.0137). CONCLUSION BRCA mutations in high-risk breast cancer patients were associated with multiple risk factors and multiple family members with other primary cancers. Genetic counseling based on accurate information should be provided to families with BRCA mutation carriers.
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Affiliation(s)
- Jae Myoung Noh
- Department of Radiation Oncology, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Korea
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Shin KR, Park HJ, Kim M. Practice of breast self-examination and knowledge of breast cancer among female university students in Korea. Nurs Health Sci 2012; 14:292-7. [PMID: 22672532 DOI: 10.1111/j.1442-2018.2012.00696.x] [Citation(s) in RCA: 10] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/01/2022]
Abstract
This study examined the practice of breast self-examination and knowledge of breast cancer among female university students in Korea. This was a cross-sectional descriptive study. The participants were 2186 female university students in Korea. The Breast Cancer and Heredity Knowledge Scale was used. The collected data were analyzed through descriptive statistics, χ(2)-test, t-test, ANOVA, and logistic regression. Twenty-seven percent of students reported engaging in breast self-examination. The participants displayed a medium-level score (total score: 5.33 ± 2.70, range: 0-11) on knowledge about breast cancer. Predictors for breast self-examination were age (odds ratio = 1.15, P < 0.001), major (odds ratio = 1.80, P < 0.001), and knowledge of breast cancer (odds ratio = 1.16, P < 0.001). This study was the sole nationwide-scale research that examined the practice of breast self-examination, related factors, and knowledge of breast cancer among female university students, as a representative sample of young Korean women. The results are valuable in developing educational programs that can increase knowledge related to breast cancer, as well as the practice of breast self-examination, to support health promotion among young women.
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Affiliation(s)
- Kyung Rim Shin
- College of Health Sciences, Ewha Womans University, Seodaemoon-Ku, Seoul, Korea
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Kim IK, Park S, Hwang H, Lee JS, Ko SM, Kim SI, Park BW. Clinical Significance of Age at the Time of Diagnosis among Young Breast Cancer Patients. J Breast Cancer 2011; 14:314-21. [PMID: 22323919 PMCID: PMC3268929 DOI: 10.4048/jbc.2011.14.4.314] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/29/2011] [Accepted: 11/11/2011] [Indexed: 11/30/2022] Open
Abstract
PURPOSE The aims of this study were to investigate outcomes corresponding to age at diagnosis as categorized into 5-year intervals and to explore whether endocrine-responsive tumors display clinical benefits from endocrine therapy after chemotherapy among young breast cancer patients. METHODS A total of 1,171 patients who were under 40 years old at diagnosis between 1985 and 2007 were divided into 3 subgroups: ≤30 years (Group I, 13.3%), 31-35 years (Group II, 30.5%), and 36-40 years (Control group, 56.2%). Clinicopathological factors and outcomes were compared using a chi-square test, the Kaplan-Meier method, and Cox's hazards models. RESULTS There were no significant differences in the characteristics and treatment patterns between the 3 groups, except for the grade, hormone receptors expression, and use of endocrine therap. Group I showed the worst survival and subsequently Group II presented worse outcomes than the Control group, mainly among hormone receptors-positive patients. Groups I and II showed increased risks of recurrence and death in multivariate analyses. Among 529 hormone receptors-positive patients who received chemotherapy, favorable outcomes for patients who were treated with endocrine agents were demonstrated, mainly in patients aged 35 years or less. However, interaction tests between the use of endocrine therapy and age at diagnosis were not significant. CONCLUSION Age at diagnosis is an independent prognostic factor and the age of 35 years is a rational cut-off among young patients. Our subgroup analysis suggests that endocrine therapy may provide additional benefits even in young breast cancers. Therefore, further researches should be directed towards improving outcomes for this population.
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Affiliation(s)
- Im-Kyung Kim
- Department of Surgery, Yonsei University College of Medicine, Seoul, Korea
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Han SA, Park SK, Hyun Ahn S, Hyuk Lee M, Noh DY, Kim LS, Noh WC, Jung Y, Sang Kim K, Kim SW, Korean Breast Cancer Study Group. The Korean Hereditary Breast Cancer (KOHBRA) Study: Protocols and Interim Report. Clin Oncol (R Coll Radiol) 2011; 23:434-41. [DOI: 10.1016/j.clon.2010.11.007] [Citation(s) in RCA: 50] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/23/2009] [Revised: 10/28/2010] [Accepted: 11/01/2010] [Indexed: 10/18/2022]
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Affiliation(s)
- Sung-Won Kim
- Department of Surgery, Seoul National University College of Medicine, Korea.
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Kim KS, Kim S, Han SA, Kang E, Jeon YT, Ha TH, Heo CY, Jang M, Kim SM, Kim JH, Lee KE, Kim SW. Contralateral Prophylactic Mastectomy and Prophylactic Salphingo-Oophorectomy in a BRCA1-Positive Breast Cancer Patient: A Case Report. J Breast Cancer 2008. [DOI: 10.4048/jbc.2008.11.4.218] [Citation(s) in RCA: 9] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022] Open
Affiliation(s)
- Ku Sang Kim
- Department of Surgery, Ajou University School of Medicine, Suwon, Korea
| | - Sairhee Kim
- Department of Surgery, National University Bundang Hospital, Seongnam, Korea
| | - Sang Ah Han
- Department of Surgery, National University Bundang Hospital, Seongnam, Korea
| | - Eunyoung Kang
- Department of Surgery, National University Bundang Hospital, Seongnam, Korea
| | - Yong Tark Jeon
- Department of Gynecology, National University Bundang Hospital, Seongnam, Korea
| | - Tae-Hyeon Ha
- Department of Psychiatry, National University Bundang Hospital, Seongnam, Korea
| | - Chan-Yeong Heo
- Department of Plastic Surgery, National University Bundang Hospital, Seongnam, Korea
| | - Mijung Jang
- Department of Radiology, National University Bundang Hospital, Seongnam, Korea
| | - Sun Mi Kim
- Department of Radiology, National University Bundang Hospital, Seongnam, Korea
| | - Jee Hyun Kim
- Department of Internal Medicine, National University Bundang Hospital, Seongnam, Korea
| | - Kyu Eun Lee
- Department of Surgery, Seoul National University, College of Medicine, Seoul, Korea
| | - Sung-Won Kim
- Department of Surgery, National University Bundang Hospital, Seongnam, Korea
- Department of Surgery, Seoul National University, College of Medicine, Seoul, Korea
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