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Kang MJ, Hong HK, Eo PS, Lee JS, Lee JW, Lee J, Park HY, Yang JD. Surgical Strategies for Partial Breast Reconstruction in Medial-Located Breast Cancer: A 12-Year Experience. J Breast Cancer 2023; 26:35-45. [PMID: 36852966 PMCID: PMC9981984 DOI: 10.4048/jbc.2023.26.e8] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/08/2022] [Revised: 11/01/2022] [Accepted: 01/08/2023] [Indexed: 02/18/2023] Open
Abstract
PURPOSE Partial breast reconstruction is challenging in medially located breast cancer, particularly in terms of achieving satisfactory aesthetic coverage. Thus, we aimed to investigate surgical strategies for filling medial defects resulting from breast-conserving surgery to improve patient satisfaction and aesthetic outcomes. METHODS We retrospectively evaluated 113 patients (114 cases) with medially located breast cancer between 2007 and 2018. We analysed the patient data, such as breast size, specimen weight, complications, and aesthetic results obtained using a questionnaire. RESULTS The mean body mass index and specimen weight were 23.43 kg/m² (range, 18.5-26.8) and 83.29 g (range, 15-290 g), respectively. The tennis racket and round-block techniques were chosen for small defects (< 10%-15%) in small- and medium-sized breasts. The rotational and perforator flap techniques were used for medium-sized defects. The latissimus dorsi (LD) flap technique was used for large defects (> 30%). Hematoma was found in 1 case (0.96%), linear skin necrosis was found in 1 case (0.96%), seroma in the LD flaps was found in 8 cases (7.69%); fat necrosis in the rotational flaps was found in 2 cases (1.92%); and fat necrosis in an anterior intercostal artery perforator flap was found in 1 case (0.96%). 91 patients (87.5%) were satisfied with the aesthetic results. CONCLUSION The techniques used in this study for medially located breast cancer can produce fine aesthetic outcomes with regard to breast size and resection volume, with few complications.
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Affiliation(s)
- Myeong Jae Kang
- Department of Plastic and Reconstructive Surgery, Kyungpook National University School of Medicine, Daegu, Korea
| | - Hyun Ki Hong
- Department of Plastic and Reconstructive Surgery, Kyungpook National University School of Medicine, Daegu, Korea
| | - Pil Seon Eo
- Department of Plastic and Reconstructive Surgery, Kyungpook National University School of Medicine, Daegu, Korea
| | - Joon Seok Lee
- Department of Plastic and Reconstructive Surgery, Kyungpook National University School of Medicine, Daegu, Korea
| | - Jeong Woo Lee
- Department of Plastic and Reconstructive Surgery, Kyungpook National University School of Medicine, Daegu, Korea
| | - Jeeyeon Lee
- Department of Surgery, Kyungpook National University School of Medicine, Daegu, Korea
| | - Ho Yong Park
- Department of Surgery, Kyungpook National University School of Medicine, Daegu, Korea
| | - Jung Dug Yang
- Department of Plastic and Reconstructive Surgery, Kyungpook National University School of Medicine, Daegu, Korea.
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Kim NI, Park MH, Lee JS. Associations of B7-H3 and B7-H4 Expression in Ductal Carcinoma In Situ of the Breast With Clinicopathologic Features and T-Cell Infiltration. Appl Immunohistochem Mol Morphol 2021; 28:767-775. [PMID: 31714284 DOI: 10.1097/pai.0000000000000817] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
Abstract
B7-H3 and B7-H4 play an inhibitory role in T-cell function by limiting proliferation and cytokine production. Information about B7-H3 and B7-H4 expression in ductal carcinoma in situ (DCIS) remains uncertain. The objective of this study was to evaluate the expression levels of B7-H3 and B7-H4 in DCIS and their associations with clinicopathologic features and T-cell infiltration. B7-H3 and B7-H4 mRNA and protein expression levels in 8 pairs of DCIS tissues and matched normal adjacent tissues were examined by RNAscope in situ hybridization and immunohistochemistry analysis. Immunohistochemical staining of B7-H3, B7-H4, CD3, and CD8 was performed for 79 DCIS samples using tissue microarray. RNAscope in situ hybridization and immunohistochemistry analysis revealed that expression levels of B7-H3 and B7-H4 in DCIS tissues were higher than those in corresponding normal tissues. B7-H3 and B7-H4 mRNA and protein appeared to be mainly expressed in DCIS carcinoma cells. High B7-H3 and B7-H4 expression was observed in 58 (73.4%) and 62 (78.5%) cases with DCIS, respectively. High B7-H3 expression was significantly associated with high-nuclear grade and presence of comedo-type necrosis (both P<0.05). B7-H3 expression in HR/HER2 subtype was higher than that in HR/HER2 subtype (P<0.05). B7-H3 and B7-H4 expression levels were negatively related to the density of CD3 and CD8 T-cell infiltrates. B7-H3 and B7-H4 may play an important role in immune surveillance mechanisms of DCIS. They might be useful targets to develop immune-based therapy to alter or prevent DCIS progression.
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Affiliation(s)
| | - Min Ho Park
- Surgery, Chonnam National University Medical School, Gwangju, South Korea
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Rayzah M, Ryu JM, Lee JH, Nam SJ, Kim SW, Lee SK, Yu J, Lee KT, Bang SI, Mun GH, Pyon JK, Jeon BJ, Lee JE. Changes in Korean National Healthcare Insurance Policy and Breast Cancer Surgery Trend in Korea. J Korean Med Sci 2021; 36:e194. [PMID: 34313035 PMCID: PMC8313396 DOI: 10.3346/jkms.2021.36.e194] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/25/2021] [Accepted: 06/20/2021] [Indexed: 12/24/2022] Open
Abstract
BACKGROUND Since April 2015, the Korean National Health Insurance (NHI) has reimbursed breast cancer patients, approximately 50% of the cost of the breast reconstruction (BR) procedure. We aimed to investigate NHI reimbursement policy influence on the rate of immediate BR (IBR) following total mastectomy (TM). METHODS We retrospectively analyzed breast cancer data between April 2011 and June 2016. We divided patients who underwent IBR following TM for primary breast cancer into "uninsured" and "insured" groups using their NHI statuses at the time of surgery. Univariate analyses determined the insurance influence on the decision to undergo IBR. RESULTS Of 2,897 breast cancer patients, fewer uninsured patients (n = 625) underwent IBR compared with those insured (n = 325) (30.0% vs. 39.8%, P < 0.001). Uninsured patients were younger than those insured (median age [range], 43 [38-48] vs. 45 [40-50] years; P < 0.001). Pathologic breast cancer stage did not differ between the groups (P = 0.383). More insured patients underwent neoadjuvant chemotherapy (P = 0.011), adjuvant radiotherapy (P < 0.001), and IBR with tissue expander insertion (P = 0.005) compared with those uninsured. CONCLUSION IBR rate in patients undergoing TM increased after NHI reimbursement.
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Affiliation(s)
- Musaed Rayzah
- Division of Breast and Endocrine Surgery, Department of Surgery, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Korea
- Department of Surgery, College of Medicine, Majmaah University, Ministry of Education, Riyadh, Saudi Arabia
| | - Jai Min Ryu
- Division of Breast and Endocrine Surgery, Department of Surgery, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Korea
| | - Jun Hee Lee
- Division of Breast and Endocrine Surgery, Department of Surgery, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Korea
| | - Seok Jin Nam
- Division of Breast and Endocrine Surgery, Department of Surgery, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Korea
| | - Seok Won Kim
- Division of Breast and Endocrine Surgery, Department of Surgery, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Korea
| | - Se Kyung Lee
- Division of Breast and Endocrine Surgery, Department of Surgery, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Korea
| | - Jonghan Yu
- Division of Breast and Endocrine Surgery, Department of Surgery, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Korea
| | - Kyeong Tae Lee
- Department of Plastic Surgery, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Korea
| | - Sa Ik Bang
- Department of Plastic Surgery, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Korea
| | - Goo Hyun Mun
- Department of Plastic Surgery, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Korea
| | - Jai Kyong Pyon
- Department of Plastic Surgery, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Korea
| | - Byung Joon Jeon
- Department of Plastic Surgery, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Korea
| | - Jeong Eon Lee
- Division of Breast and Endocrine Surgery, Department of Surgery, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Korea.
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Abstract
BACKGOUND Even a minor iodine deficiency can result in adverse thyroidal health consequences while excess iodine intake can also result in thyroid function disorders. One source of iodine is seaweed which as a foodstuff is enjoying an increasing profile in Western countries. Apart from its potential involvement in thyroidal health, gaseous iodine released from seaweeds plays a significant role in influencing coastal climate through cloud formation. SUMMARY Sources of dietary iodine, its assessment, recommended dietary intake, and consequences of iodine excess are outlined. The benefits and possible dangers of dietary intake of iodine-rich seaweed are described. Studies linking seaweed intake to breast cancer prevalence are discussed as is the role of gaseous iodine released from seaweeds influencing weather patterns and contributing to iodine intake in coastal populations. KEY MESSAGES Universal salt iodization remains the optimum method of achieving optimum iodine status. Promoting increased dietary iodine intake is recommended in young women, in early pregnancy, and in vegan and vegetarian diets. Even where iodine intake is enhanced, regular assessment of iodine status is necessary. Caution against consumption of brown seaweeds (kelps) is required as even small amounts can have antithyroid actions while product labelling may be insufficient. Gaseous iodine produced from seaweeds can have a significant effect on cloud formation and associated global warming/cooling. Increased overall iodine deposition through rainfall and apparent uptake in populations dwelling in seaweed-rich coastal regions may provide a partial natural remedy to global iodine deficits.
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Affiliation(s)
- Peter P.A. Smyth
- *Peter P.A. Smyth, 8 Fairlawns Saval Park Road Dalkey, Co Dublin A96FX09 (Ireland),
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Jankowska-Polańska B, Świątoniowska-Lonc N, Ośmiałowska E, Gałka A, Chabowski M. The Association Between Illness Acceptance and Quality of Life in Women with Breast Cancer. Cancer Manag Res 2020; 12:8451-8464. [PMID: 32982439 PMCID: PMC7500846 DOI: 10.2147/cmar.s261624] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/12/2020] [Accepted: 07/30/2020] [Indexed: 11/23/2022] Open
Abstract
Introduction Breast cancer is the most common cause of cancer death in women. Aim The aim of the study was to investigate the association between illness acceptance and quality of life (QoL) in patients with breast cancer. Patients and Methods The study included 150 patients who had undergone surgery for breast cancer. The following standardized questionnaires were used: the Acceptance of Illness Scale (AIS), the EORT QLQ-C30 (The European Organisation for Research and Treatment of Cancer Quality of Life Questionnaire Core 30), and the EORT QL-BR 23 (Quality of Life Questionnaire for Breast Cancer) for QoL evaluation. Socio-clinical data were obtained from the patients' medical records. Results In the study group, the overall QoL score was 62.67±17.11 in the BCT group, 63±14.3 in the MTX group, and the highest: 65.5±20.2 in the reconstruction group. Comparative analysis showed that patients in the BCT group reported significantly more fatigue (p=0.007) and appetite loss (p=0.032) than those in the MTX+R group. Patients in the MTX group were significantly less satisfied with their body image (p=0.001) and experienced more financial troubles (p=0.013) than the remaining patients. Patients in the MTX+R group reported significantly better sexual function and more sexual enjoyment than the remaining patients (p<0.001). All patients scored high for illness acceptance, though patients in the MTX group had lower scores (28.17±7.2) than the others: 31.84±6.51 in the BCT group and 32.78±7.97 in the MTX+R group. The comparative analysis of QoL according to the level of AIS showed the significantly better QoL and less intense symptoms within all the domains except for the insomnia and hair loss domains in the group of high AIS in comparison with medium and lack of AIS. Acceptance of illness significantly correlated with 4 domains of the QLQ-C30 (p<0.05). The correlation between illness acceptance and overall QoL was positive (r=0.243; p=0.003) - the higher the acceptance, the better the QoL. Correlations with pain, diarrhoea, and financial difficulties were negative. Illness acceptance was positively correlated with QoL in 3 domains of the EORTC-BR23: body image (p<0.001), sexual function (p=0.015), and sexual enjoyment (p=0.047), and negatively with the "treatment side effects" (p=0.011). Conclusion The level of illness acceptance varies depending on the treatment method, and is the lowest in the group of women having undergone a mastectomy, and the highest in patients after a mastectomy with immediate breast reconstruction. Acceptance of illness improves the QoL of women treated for breast cancer, regardless of the specific treatment method.
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Affiliation(s)
- Beata Jankowska-Polańska
- Division of Nervous System Diseases, Department of Clinical Nursing, Faculty of Health Science, Wroclaw Medical University, Wroclaw 51-618, Poland
| | - Natalia Świątoniowska-Lonc
- Division of Nervous System Diseases, Department of Clinical Nursing, Faculty of Health Science, Wroclaw Medical University, Wroclaw 51-618, Poland
| | - Edyta Ośmiałowska
- Division of Nervous System Diseases, Department of Clinical Nursing, Faculty of Health Science, Wroclaw Medical University, Wroclaw 51-618, Poland
| | - Aneta Gałka
- Division of Nervous System Diseases, Department of Clinical Nursing, Faculty of Health Science, Wroclaw Medical University, Wroclaw 51-618, Poland
| | - Mariusz Chabowski
- Division of Oncology and Palliative Care, Department of Clinical Nursing, Faculty of Health Science, Wroclaw Medical University, Wroclaw 51-618, Poland.,Department of Surgery, 4th Military Teaching Hospital, Wroclaw 50-981, Poland
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Machine learning-based lifetime breast cancer risk reclassification compared with the BOADICEA model: impact on screening recommendations. Br J Cancer 2020; 123:860-867. [PMID: 32565540 PMCID: PMC7463251 DOI: 10.1038/s41416-020-0937-0] [Citation(s) in RCA: 16] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/02/2019] [Revised: 05/13/2020] [Accepted: 05/29/2020] [Indexed: 12/17/2022] Open
Abstract
Background The clinical utility of machine-learning (ML) algorithms for breast cancer risk prediction and screening practices is unknown. We compared classification of lifetime breast cancer risk based on ML and the BOADICEA model. We explored the differences in risk classification and their clinical impact on screening practices. Methods We used three different ML algorithms and the BOADICEA model to estimate lifetime breast cancer risk in a sample of 112,587 individuals from 2481 families from the Oncogenetic Unit, Geneva University Hospitals. Performance of algorithms was evaluated using the area under the receiver operating characteristic (AU-ROC) curve. Risk reclassification was compared for 36,146 breast cancer-free women of ages 20–80. The impact on recommendations for mammography surveillance was based on the Swiss Surveillance Protocol. Results The predictive accuracy of ML-based algorithms (0.843 ≤ AU-ROC ≤ 0.889) was superior to BOADICEA (AU-ROC = 0.639) and reclassified 35.3% of women in different risk categories. The largest reclassification (20.8%) was observed in women characterised as ‘near population’ risk by BOADICEA. Reclassification had the largest impact on screening practices of women younger than 50. Conclusion ML-based reclassification of lifetime breast cancer risk occurred in approximately one in three women. Reclassification is important for younger women because it impacts clinical decision- making for the initiation of screening.
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Lee M, Piao J, Jeon MJ. Risk Factors Associated with Endometrial Pathology in Premenopausal Breast Cancer Patients Treated with Tamoxifen. Yonsei Med J 2020; 61:317-322. [PMID: 32233174 PMCID: PMC7105402 DOI: 10.3349/ymj.2020.61.4.317] [Citation(s) in RCA: 20] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/03/2019] [Revised: 02/11/2020] [Accepted: 02/27/2020] [Indexed: 11/27/2022] Open
Abstract
PURPOSE To evaluate factors associated with endometrial pathology during tamoxifen use in premenopausal breast cancer (BC) patients. MATERIALS AND METHODS We reviewed the medical records of premenopausal BC patients treated with tamoxifen who underwent endometrial biopsy with or without hysteroscopy. Clinical characteristics were compared between women with endometrial pathology (endometrial hyperplasia or cancer) and those with normal histology or endometrial polyps. RESULTS Among 284 endometrial biopsies, endometrial hyperplasia was diagnosed in 7 patients (2.5%), endometrial cancer was diagnosed in 5 patients (1.8%), normal histology was noted in 146 patients (51.4%), and endometrial polyp was present in 114 patients (40.1%). When comparing women with endometrial cancer (n=5) to women with normal histology, abnormal uterine bleeding was more common (p=0.007), and endometrial thickness was greater (p=0.007) in women with endometrial cancer. Chemotherapy for BC was also more common in patients with endometrial cancer (p=0.037). When comparing women with endometrial polyps and those with endometrial hyperplasia or cancer, the presence of abnormal uterine bleeding was more common in patients with endometrial hyperplasia or cancer (p<0.001); however, tamoxifen duration and endometrial thickness did not differ significantly between the two groups. CONCLUSION In premenopausal BC patients treated with tamoxifen, abnormal uterine bleeding, increased endometrial thickness, and chemotherapy for BC were associated with the occurrence of endometrial cancer. These findings may provide useful information for gynecologic surveillance and counseling during tamoxifen treatment in premenopausal BC patients.
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Affiliation(s)
- Maria Lee
- Department of Obstetrics and Gynecology, Seoul National University College of Medicine, Seoul, Korea
- Department of Obstetrics and Gynecology, Seoul National University Hospital, Seoul, Korea
| | - Jinlan Piao
- Department of Obstetrics and Gynecology, Seoul National University College of Medicine, Seoul, Korea
| | - Myung Jae Jeon
- Department of Obstetrics and Gynecology, Seoul National University College of Medicine, Seoul, Korea
- Department of Obstetrics and Gynecology, Seoul National University Hospital, Seoul, Korea.
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Coping Strategies Used by Breast, Prostate, and Colorectal Cancer Survivors: A Literature Review. Cancer Nurs 2019; 41:E23-E39. [PMID: 28723724 DOI: 10.1097/ncc.0000000000000528] [Citation(s) in RCA: 38] [Impact Index Per Article: 7.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
Abstract
BACKGROUND Individual coping strategies are a fundamental element underpinning psychosocial distress. OBJECTIVE The aim of this study was to describe coping strategies and their measurement used by survivors of breast, prostate, and/or colorectal cancer after treatment. METHODS A search of electronic databases (PubMed, CINAHL, and PsycINFO) was conducted from January 1980 to March 2015. Data were extracted using standardized forms and included studies that explored the coping mechanisms of survivorship of breast, prostate, or colorectal cancer. RESULTS Two thousand one hundred forty-seven studies were retrieved for potential inclusion; 19 publications met the inclusion criteria and were included in the review. CONCLUSIONS Breast, prostate, and colorectal cancer survivors seem to use different coping strategies that varied throughout the survivorship trajectory. Breast cancer survivors highlighted the importance of accepting their diagnosis and engaging in physical activities that provided social and emotional support. Personality seemed to have a significant effect on coping for prostate cancer survivors. Colorectal cancer survivors emphasized the importance of seeking information to master self-management and return to social activities. IMPLICATIONS FOR PRACTICE Understanding coping strategies, during the survivorship trajectories, is essential to planning contemporary care after cancer treatment. Nurses and other healthcare professionals may use this knowledge to improve quality of life and decrease distress after diagnosis.
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The Korea Cancer Big Data Platform (K-CBP) for Cancer Research. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2019; 16:ijerph16132290. [PMID: 31261630 PMCID: PMC6651426 DOI: 10.3390/ijerph16132290] [Citation(s) in RCA: 13] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 04/08/2019] [Revised: 05/31/2019] [Accepted: 06/24/2019] [Indexed: 12/23/2022]
Abstract
Data warehousing is the most important technology to address recent advances in precision medicine. However, a generic clinical data warehouse does not address unstructured and insufficient data. In precision medicine, it is essential to develop a platform that can collect and utilize data. Data were collected from electronic medical records, genomic sequences, tumor biopsy specimens, and national cancer control initiative databases in the National Cancer Center (NCC), Korea. Data were de-identified and stored in a safe and independent space. Unstructured clinical data were standardized and incorporated into cancer registries and linked to cancer genome sequences and tumor biopsy specimens. Finally, national cancer control initiative data from the public domain were independently organized and linked to cancer registries. We constructed a system for integrating and providing various cancer data called the Korea Cancer Big Data Platform (K-CBP). Although the K-CBP could be used for cancer research, the legal and regulatory aspects of data distribution and usage need to be addressed first. Nonetheless, the system will continue collecting data from cancer-related resources that will hopefully facilitate precision-based research.
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Lee HM, Kim BW, Park S, Park S, Lee JE, Choi YJ, Kim SY, Woo SU, Youn HJ, Lee I. Childbirth in young Korean women with previously treated breast cancer: The SMARTSHIP study. Breast Cancer Res Treat 2019; 176:419-427. [DOI: 10.1007/s10549-019-05244-6] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/08/2018] [Accepted: 04/15/2019] [Indexed: 12/13/2022]
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Jung J, Suh YJ, Ko BK, Lee ES, Kim E, Paik NS, Byun KD, Hwang K. Clinical implication of subcategorizing T2 category into T2a and T2b in TNM staging of breast cancer. Cancer Med 2018; 7:5514-5524. [PMID: 30311421 PMCID: PMC6246943 DOI: 10.1002/cam4.1831] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/19/2018] [Revised: 08/27/2018] [Accepted: 09/24/2018] [Indexed: 12/29/2022] Open
Abstract
Regarding TNM staging in breast cancer, T2 category is currently not divided into subcategories even though it covers a wider range of tumor sizes than T1 category. Using Korean Breast Cancer Registry database, data of 41 071 women diagnosed as non-metastatic T2 breast cancer between 2001 and 2014 were analyzed. Cutoff value for optimal tumor size was approximated by receiver operating characteristic (ROC) curve to subcategorize T2 tumors. Overall survival (OS) was compared between two subcategories. Median follow-up period was 65 months. Of 41 071 patients, 4504 (11.0%) died. Based on ROC curve analysis, 3.0 cm was selected as the cutoff value. Five-year OS rate was 91% in patients with breast tumors ≤3.0 cm (T2a) and 86% in patients with breast tumors >3.0 cm (T2b) (log-rank P < 0.001). T2b subcategory showed worse OS than T2a subcategory regardless of node status (log-rank P < 0.001 for all node categories). Within every subgroup defined by primary OS analysis covariates, T2b subcategory consistently showed worse outcome compared to T2a subcategory. By multivariate analysis, T2b subcategory was a significant independent prognostic factor of OS (hazard ratio: 1.26, 95% CI = 1.18-1.34). T2 category of breast cancer could be subcategorized into T2a and T2b with a cutoff value of 3 cm. These subcategories definitely showed different OSs even after adjusted for known prognostic factors. Subcategorization of T2 category might be useful for predicting prognosis more accurately and tailoring adjuvant therapy.
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Affiliation(s)
- Jiwoong Jung
- Department of SurgerySeoul Medical CenterSeoulKorea
| | - Young Jin Suh
- Department of SurgerySt. Vincent's HospitalCollege of MedicineThe Catholic University of KoreaSuwonKorea
| | - Byung Kyun Ko
- Department of SurgeryUlsan University HospitalUniversity of Ulsan College of MedicineUlsanKorea
| | - Eun Sook Lee
- Center for Breast CancerResearch Institute and HospitalNational Cancer CenterGoyangKorea
| | - Eun‐Kyu Kim
- Department of SurgerySeoul National University Bundang HospitalSeoul National University College of MedicineSeongnamKorea
| | - Nam Sun Paik
- Department of SurgeryEwha Womans University Mokdong HospitalEwha Womans University College of MedicineSeoulKorea
| | - Kyung Do Byun
- Department of SurgeryDong‐A University Medical CenterDong‐A University College of MedicineBusanKorea
| | - Ki‐Tae Hwang
- Department of SurgerySeoul National University Boramae Medical CenterSeoulKorea
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Jang CE, Jung MS, Sohn EH, Kim M, Yoo HS, Bae K, Kim JR, Lee JS. The evaluation of changes in peripheral neuropathy and quality-of-life using low-frequency electrostimulation in patients treated with chemotherapy for breast cancer: a study protocol. Trials 2018; 19:526. [PMID: 30268158 PMCID: PMC6162932 DOI: 10.1186/s13063-018-2874-2] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/08/2018] [Accepted: 08/23/2018] [Indexed: 12/13/2022] Open
Abstract
BACKGROUND Chemotherapy-induced peripheral neuropathy (CIPN) is a progressive, enduring, and sometimes irreversible neurotoxic symptom that occurs in 30-40% of chemotherapy-treated cancer patients. CIPN negatively affects both the patient's abilities to perform daily activities and their health-related quality of life (HRQOL) after chemotherapy treatment. Although this neuropathy has been treated with duloxetine and/or gabapentin, limited therapeutic benefits have been reported, thereby necessitating the development of an integrated approach that combines pharmacological management and complementary methods such as acupuncture and electric nerve stimulation. Therefore, this study is designed to examine the effect of a portable, low-frequency electrostimulation (ES) device on CIPN symptoms and HRQOL of female patients diagnosed with CIPN immediately after chemotherapy for breast cancer. METHODS This study is a single-center, randomized, placebo-controlled trial with two parallel groups and a 2-week follow-up. We will enroll 80 breast cancer patients who are newly diagnosed with CIPN after chemotherapy. Duloxetine or pregabalin will be prescribed to all participants from the initial assessment. Half of the patients will be assigned into the experimental group and the other half to the control group. The CarebandR (Piomed Inc., Seoul, Korea), a wearable wristband that generates low-frequency electrostimulation, will be administered only to the experimental group. Electrostimulation will be administered on the unilateral PC6 acupoint. A numerical rating scale will be used to assess the overall intensity of CIPN symptoms. The key secondary outcome variables include patient-reported CIPN symptom distress tested by a self-rated questionnaire, physician-rated symptom severity assessed by the Total Neuropathy Score, and HRQOL. DISCUSSION It is expected that the combination of a low-frequency electrostimulation device and pharmacological intervention (duloxetine or pregabalin) will produce synergistic effects in breast cancer patients with CIPN after treatment. To our knowledge, this is the first study to investigate the beneficial effect of a new integrated approach for CIPN management after breast cancer treatment. The study findings can expand our knowledge and understanding of the occurrence of CIPN and the efficacy of integrated intervention efforts to ameliorate CIPN symptoms. TRIAL REGISTRATION Clinical Research Information Service (CRIS), Republic of Korea, ID: KCT0002357 . Registered retrospectively on 13 June 2017.
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Affiliation(s)
- Chang eun Jang
- Department of Surgery, Yonsei University College of Medicine, Seoul, Korea
| | - Mi Sook Jung
- College of Nursing, Chungnam National University, Daejeon, Korea
| | - Eun Hee Sohn
- Department of Neurology, Chungnam National University Hospital, Daejeon, Korea
| | - Mijung Kim
- College of Nursing, Chungnam National University, Daejeon, Korea
| | - Hwa-Seung Yoo
- East-West Cancer Center, Dunsan Korean Medicine Hospital of Daejeon University, Daejeon, Korea
| | - Kyeore Bae
- East-West Cancer Center, Dunsan Korean Medicine Hospital of Daejeon University, Daejeon, Korea
| | - Je Ryong Kim
- Departmetn of Surgery and Research Institute for Medicinal Sciences, College of Medicine, Chungnam National University, 33 Munwha-ro, Jung-gu, Daejeon, Korea
| | - Jin Sun Lee
- Departmetn of Surgery and Research Institute for Medicinal Sciences, College of Medicine, Chungnam National University, 33 Munwha-ro, Jung-gu, Daejeon, Korea
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Chronologically changing patterns in the survival of korean patients with breast cancer and related clinical factors: a nationwide registry-based study. Breast Cancer Res Treat 2018; 172:273-282. [PMID: 30088179 DOI: 10.1007/s10549-018-4892-x] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/10/2018] [Accepted: 07/13/2018] [Indexed: 10/28/2022]
Abstract
PURPOSE Advances in breast cancer treatment have contributed to marked improvements in patient outcomes over the past three decades. This study aims to chronologically evaluate the survival of patients with breast cancer and investigate the observed changes over time. METHODS Statistics from the Korean National Cancer Registry, based on all 60,571 patients with invasive breast cancer during the 21 year period, were analyzed. We divided the study interval into four periods (P1: 1988-1992, P2: 1993-1997, P3: 1998-2002, P4: 2003-2008). RESULTS The patients treated during P4 showed significantly better 5-year overall survival (OS) than did those treated during P1 (5Y OS; P1 = 79.0 vs. P4 = 92.2, p < 0.001). In the multivariate analyses, younger age, mastectomy, high stage, high tumor grade, lymphovascular invasion, and hormone receptor negativity were poor prognostic factors. The multivariate analysis demonstrated that diagnosis periods significantly and independently associated with OS in the overall group of patients. In our analysis of age-period-interaction models, the hazard ratio (HR) for death for patients who were under 35 years of age, compared to those who were older, tended to decrease over time (HR of age < 35 vs. 35 ~ 50; P1 = 0.739, p = 0.007; P2 = 0.744, p < 0.001; P3 = 0.886, p = 0.041; P4 = 0.983, p = 0.813). The survival rate of patients who underwent breast conserving surgery (BCS) has recently gotten better than that of mastectomy (HR of mastectomy vs. BCS; P1 = 0.957, p = 0.790; P2 = 0.542, p < 0.001; P3 = 0.543, p < 0.001; P4 = 0.425, p < 0.001). CONCLUSIONS The clinical factors related to the changes in breast cancer survival have improved and increased patient OS over the past 20 years in Korea. In addition, we provided new insights into the effects of age and surgery methods on prognosis in each period.
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Trends in breast reconstruction: Implications for the National Health Insurance Service. Arch Plast Surg 2018; 45:239-245. [PMID: 29788687 PMCID: PMC5968321 DOI: 10.5999/aps.2017.01417] [Citation(s) in RCA: 20] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/31/2017] [Revised: 03/02/2017] [Accepted: 03/15/2017] [Indexed: 01/02/2023] Open
Abstract
Background Breast reconstruction has become more common as mastectomy has become more frequent. In Korea, the National Health Insurance Service (NHIS) began covering breast reconstruction in April 2015. This study aimed to investigate trends in mastectomy and breast reconstruction over the past 10 years and to evaluate the impact of NHIS coverage on breast reconstruction. Methods Nationwide data regarding mastectomy and breast reconstruction were collected from the Korean Breast Cancer Society registry database. Multiple variables were analyzed in the records of patients who underwent breast reconstruction from January 2005 to March 2017 at a single institution. Results At Seoul National University Hospital, the total number of reconstruction cases increased 13-fold from 2005 to 2016. The proportion of immediate breast reconstruction (IBR) cases out of all cases of total mastectomy increased from 4% in 2005 to 52.0% in 2016. The proportion of delayed breast reconstruction (DBR) cases out of all cases of breast reconstruction and the overall number of DBR cases increased from 8.8% (20 cases) in 2012 to 18.3% (76 cases) in 2016. After NHIS coverage was initiated, the proportions of IBR and DBR showed statistically significant increases (P<0.05). Among the IBR cases, the percentage of prosthesis-based reconstructions increased significantly (P<0.05), but this trend was not found with DBR. Total mastectomy became significantly more common after the expansion of NHIS coverage (P<0.05). Conclusions Over the last decade, there has been an increase in mastectomy and breast reconstruction, and the pace of increase accelerated after the expansion of NHIS coverage. It is expected that breast reconstruction will be a routine option for patients with breast cancer under the NHIS.
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Abstract
OBJECTIVE To summarise the evidence on determinants of health-related quality of life (HRQL) in Asian patients with breast cancer. DESIGN Systematic review conducted according to the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) recommendations and registered with PROSPERO (CRD42015032468). METHODS According to the PRISMA guidelines, databases of MEDLINE (PubMed), Embase and PsycINFO were systematically searched using the following terms and synonyms: breast cancer, quality of life and Asia. Articles reporting on HRQL using EORTC-QLQ-C30, EORTC-QLQ-BR23, FACT-G and FACT-B questionnaires in Asian patients with breast cancer were eligible for inclusion. The methodological quality of each article was assessed using the quality assessment scale for cross-sectional studies or the Newcastle-Ottawa Quality Assessment Scale for cohort studies. RESULTS Fifty-seven articles were selected for this qualitative synthesis, of which 43 (75%) were cross-sectional and 14 (25%) were longitudinal studies. Over 75 different determinants of HRQL were studied with either the EORTC or FACT questionnaires. Patients with comorbidities, treated with chemotherapy, with less social support and with more unmet needs have poorer HRQL. HRQL improves over time. Discordant results in studies were found in the association of age, marital status, household income, type of surgery, radiotherapy and hormone therapy and unmet sexuality needs with poor global health status or overall well-being. CONCLUSIONS In Asia, patients with breast cancer, in particular those with other comorbidities and those treated with chemotherapy, with less social support and with more unmet needs, have poorer HRQL. Appropriate social support and meeting the needs of patients may improve patients' HRQL.
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Affiliation(s)
- Peh Joo Ho
- Saw Swee Hock School of Public Health, National University of Singapore, Singapore
| | - Sofie A M Gernaat
- Julius Center for Health Sciences and Primary Care, University Medical Center Utrecht, Utrecht University, Utrecht, The Netherlands
| | - Mikael Hartman
- Saw Swee Hock School of Public Health, National University of Singapore, Singapore
- Department of Surgery, National University of Singapore, Singapore
| | - Helena M Verkooijen
- Julius Center for Health Sciences and Primary Care, University Medical Center Utrecht, Utrecht University, Utrecht, The Netherlands
- Imaging Division, University Medical Center Utrecht, Utrecht University, Utrecht, The Netherlands
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Kang SY, Kim YS, Kim Z, Kim HY, Lee SK, Jung KW, Youn HJ. Basic Findings Regarding Breast Cancer in Korea in 2015: Data from a Breast Cancer Registry. J Breast Cancer 2018; 21:1-10. [PMID: 29628978 PMCID: PMC5880959 DOI: 10.4048/jbc.2018.21.1.1] [Citation(s) in RCA: 50] [Impact Index Per Article: 8.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/27/2018] [Accepted: 03/09/2018] [Indexed: 12/19/2022] Open
Abstract
The Korean Breast Cancer Society (KBCS) has established a nationwide breast cancer database using an online registration program in 1996. The present study aimed to analyze the basic findings and trends of breast cancer in Korea in 2015 using the data provided by the Korea Central Cancer Registry and the KBCS. In 2015, a total of 22,550 patients were newly diagnosed with breast cancer, of which 3,331 were carcinoma in situ cases and 19,219 were invasive cancer cases. The incidence rate of breast cancer in Korea has steadily increased since the nationwide database was established, and the crude rate and age-standardized rate including that of carcinoma in situ, were 88.1 and 66.0 cases per 100,000 women, respectively. In terms of age, the incidence of breast cancer was the highest in the 40–49-year-old age group (7,889 patients, 35.0%). With regard to surgical procedure, breast-conserving surgery was frequently performed (62.3%). However, the rate of mastectomy has been gradually increasing since 2012, that is, from 32.3% in 2014 to 36.1% in 2015. The rate of early breast cancer has continued to increase, and that of stages III and IV breast cancer was only 9.1% at the time of diagnosis. However, the 5-year survival rate of patients with carcinoma in situ from 2011 to 2015 was 92.3%, which was 14.4% higher than that from 1993 to 1995 (77.9%). Analysis of data from the nationwide registry of breast cancer will not only help to understand the characteristics of breast cancer in individuals in Korea, but will also significantly contribute to the treatment and research of breast cancer. Therefore, a high quality database for breast cancer in Korea must be established by further initiating registration project and establishing an objective legal basis.
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Affiliation(s)
- Sang Yull Kang
- Department of Surgery, Research Institute of Clinical Medicine, Chonbuk National University Hospital, Chonbuk National University and Biomedical Research Institute, Jeonju, Korea
| | - Yoo Seok Kim
- Department of Surgery, Chosun University Hospital, Chosun University College of Medicine, Gwangju, Korea
| | - Zisun Kim
- Department of Surgery, Soonchunhyang University Bucheon Hospital, Soonchunhyang University College of Medicine, Bucheon, Korea
| | - Hyun-Yul Kim
- Department of Surgery, Pusan National University Yangsan Hospital, Pusan National University School of Medicine, Busan, Korea
| | - Se Kyung Lee
- Division of Breast and Endocrine Surgery, Department of Surgery, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Korea
| | - Kyu-Won Jung
- The Korea Central Cancer Registry, Division of Cancer Registration and Surveillance, National Cancer Center, Goyang, Korea
| | - Hyun Jo Youn
- Department of Surgery, Research Institute of Clinical Medicine, Chonbuk National University Hospital, Chonbuk National University and Biomedical Research Institute, Jeonju, Korea
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Rizzolo P, Navazio AS, Silvestri V, Valentini V, Zelli V, Zanna I, Masala G, Bianchi S, Scarnò M, Tommasi S, Palli D, Ottini L. Somatic alterations of targetable oncogenes are frequently observed in BRCA1/2 mutation negative male breast cancers. Oncotarget 2018; 7:74097-74106. [PMID: 27765917 PMCID: PMC5342038 DOI: 10.18632/oncotarget.12272] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/02/2016] [Accepted: 09/16/2016] [Indexed: 12/14/2022] Open
Abstract
Male breast cancer (MBC) is a rare disease. Due to its rarity, MBC research and clinical approach are mostly based upon data derived from its largely known female counterpart. We aimed at investigating whether MBC cases harbor somatic alterations of genes known as prognostic biomarkers and molecular therapeutic targets in female breast cancer. We examined 103 MBC cases, all characterized for germ-line BRCA1/2 mutations, for somatic alterations in PIK3CA, EGFR, ESR1 and CCND1 genes. Pathogenic mutations of PIK3CA were detected in 2% of MBCs. No pathogenic mutations were identified in ESR1 and EGFR. Gene copy number variations (CNVs) analysis showed amplification of PIK3CA in 8.1%, EGFR in 6.8% and CCND1 in 16% of MBCs, whereas deletion of ESR1 was detected in 15% of MBCs. Somatic mutations and gene amplification were found only in BRCA1/2 mutation negative MBCs. Significant associations emerged between EGFR amplification and large tumor size (T4), ER-negative and HER2-positive status, between CCND1 amplification and HER2-positive and MIB1-positive status, and between ESR1 deletion and ER-negative status. Our results show that amplification of targetable oncogenes is frequent in BRCA1/2 mutation negative MBCs and may identify MBC subsets characterized by aggressive phenotype that may benefit from potential targeted therapeutic approaches.
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Affiliation(s)
- Piera Rizzolo
- Department of Molecular Medicine, Sapienza University of Rome, Rome, Italy
| | - Anna Sara Navazio
- Department of Molecular Medicine, Sapienza University of Rome, Rome, Italy
| | | | - Virginia Valentini
- Department of Molecular Medicine, Sapienza University of Rome, Rome, Italy
| | - Veronica Zelli
- Department of Molecular Medicine, Sapienza University of Rome, Rome, Italy
| | - Ines Zanna
- Molecular and Nutritional Epidemiology Unit, Cancer Research and Prevention Institute (ISPO), Florence, Italy
| | - Giovanna Masala
- Molecular and Nutritional Epidemiology Unit, Cancer Research and Prevention Institute (ISPO), Florence, Italy
| | - Simonetta Bianchi
- Division of Pathological Anatomy, Department of Medical and Surgical Critical Care, University of Florence, Florence, Italy
| | - Marco Scarnò
- CINECA (Inter University Consortium for Super Computing), Rome, Italy
| | - Stefania Tommasi
- Molecular Genetics Laboratory, Istituto Tumori "Giovanni Paolo II", Bari, Italy
| | - Domenico Palli
- Molecular and Nutritional Epidemiology Unit, Cancer Research and Prevention Institute (ISPO), Florence, Italy
| | - Laura Ottini
- Department of Molecular Medicine, Sapienza University of Rome, Rome, Italy
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Reduced RKIP Expression is Associated With Breast Neoplastic Progression and is Correlated With Poor Outcomes and Aberrant Methylation in Breast Carcinoma. Appl Immunohistochem Mol Morphol 2018; 25:467-474. [PMID: 26894644 DOI: 10.1097/pai.0000000000000323] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/26/2022]
Abstract
Raf kinase inhibitor protein's (RKIP) downregulation can predict poor outcome in patients with various types of malignancy. In this study, we aimed to assess the potential involvement of RKIP in breast carcinogenesis and to evaluate its association with outcome variables and aberrant promoter methylation in breast carcinoma (BC). Tissue microarray sections were immunostained for RKIP in 26 normal breasts, 25 usual ductal hyperplasia, 76 ductal carcinoma in situ, and 198 BC specimens. The methylation status of RKIP was also determined in BC. In addition, the mRNA and protein level of RKIP was analyzed in 8 pairs of BC tissues and surrounding normal tissues by quantitative real-time polymerase chain reaction and Western blot analysis, respectively. RKIP mRNA and protein expression was significantly downregulated in BC tissues compared with the surrounding normal tissues (P<0.05 and P<0.01, respectively). Reduced RKIP expression seemed to increase progressively from normal breast to BC (P<0.001). Reduced RKIP expression was significantly associated with metastatic relapse (P<0.001) and was identified as an independent adverse prognostic indicator for disease-free survival (P=0.003). Reduced RKIP expression in BC was significantly correlated with its aberrant promoter methylation (P<0.05). In conclusion, downregulation of RKIP plays an important role in the breast neoplastic progression and correlates with poor prognosis in patients with BC. Aberrant RKIP methylation is one of the mechanisms that lead to downregulation of RKIP in BC.
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Kim HS, Kang SH. Utility of Regular Radiological Follow-up on Early Detection of Contralateral Malignancy and Long-term Outcomes in Metachronous Bilateral Breast Cancer Patients. KOSIN MEDICAL JOURNAL 2017. [DOI: 10.7180/kmj.2017.32.1.72] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/11/2022] Open
Abstract
Objectives We investigated the utility of regular radiological follow-up on the early detection of contralateral breast cancer(CBC) and prognosis in patients with metachronous bilateral breast cancer. Methods Between 1983 and 2010, 49(2.1%) metachronous bilateral breast cancer patients were identified among a total of 2,343 cases of invasive or in situ breast carcinomas. We reviewed the patients' medical records including age, stage, duration between the first and second breast cancer diagnosis, operation method, recurrence, and breast cancer-specific survival. Results The mean ages at the first and second breast cancer diagnosis were 43.8 and 49.2 years, respectively. The mean duration between the first and second breast cancer diagnosis was 68.9 months (range, 7–266 months). Regular radiological follow-up with annual mammography(MMG) with or without ultrasonography was conducted in 28 patients (63.6%, Group 1), and no regular follow-up was performed in 12 patients (27.3%, Group 2). The median follow-up duration was 150 months. In a comparative analysis, Group 1 patients exhibited more stage 0 and stage 1 malignancies (82.1% vs. 25%, P =0.006) as second cancer and the same or an improved stage (71.4% vs. 33.3%, P =0.042) of second cancer compared to Group 2 patients. Breast cancer-specific survival rates between the two groups after the first cancer occurrence were higher in Group 1 patients compared to Group 2 patients, although this did not reach statistical significance. Conclusion Screening for CBC with regular radiological follow-up could result in early detection of CBC, less invasive surgical procedures, and enhanced breast cancer-specific survival outcomes.
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20
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Daniel OK, Lim SM, Kim JH, Park HS, Park S, Kim SI. Preoperative prediction of the size of pure ductal carcinoma in situ using three imaging modalities as compared to histopathological size: does magnetic resonance imaging add value? Breast Cancer Res Treat 2017; 164:437-444. [PMID: 28439735 DOI: 10.1007/s10549-017-4252-2] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/18/2016] [Accepted: 04/17/2017] [Indexed: 11/26/2022]
Abstract
PURPOSE The purpose of this study was to evaluate whether magnetic resonance imaging (MRI) and ultrasonography add value to traditional mammography in an Asian population with ductal carcinoma in situ (DCIS). METHODS Data of 244 patients with pure DCIS treated at Severance Hospital between 2013 and 2015 were analyzed retrospectively. Data extracted included age, preoperative diagnosis, tumor size on preoperative imaging studies, and final histopathological tumor type and size, including hormone receptor status. The extent of correlation between imaging and histopathological tumor sizes was evaluated using a variety of methods, including Bland-Altman analysis. RESULTS The mean patient age was 52.39 years (SD = 10.31). The mean measurements of the tumor on preoperative ultrasonography, mammography, MRI, and histopathology were 1.80 (SD = 1.23) cm, 2.97 (SD = 1.92) cm, 2.53(SD = 1.84) cm, and 1.88 (SD = 1.36) cm, respectively. The mean differences in tumor size between ultrasonography, mammography, and MRI compared with histopathology were -0.09 (SD = 1.39), 1.09 (SD = 1.89), and 0.65 (SD = 1.78), respectively. The correlation between the sizes was significant with r values for ultrasonography, mammography, and MRI of 0.447 (SE = 0.061), 0.375 (SE = 0.042), and 0.409 (SE = 0.043), respectively. Mammography and MRI estimated tumor size significantly better for patients older than 50 years (p = 0.045 and <0.001, respectively). Mammography also provided good estimation for patients with a body mass index under 25 (p = 0.041). CONCLUSION MRI is better at estimation of histopathological DCIS size compared with mammography. However, ultrasonography had better estimation compared with MRI and mammography, probably owing to the high breast density in this population.
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Affiliation(s)
| | - Sung Mook Lim
- Department of Surgery, Yonsei University College of Medicine, 50 Yonsei-ro, Seodaemun-gu, Seoul, 120-752, Republic of Korea
| | - Joo Heung Kim
- Department of Surgery, Yonsei University College of Medicine, 50 Yonsei-ro, Seodaemun-gu, Seoul, 120-752, Republic of Korea
| | - Hyung Seok Park
- Department of Surgery, Yonsei University College of Medicine, 50 Yonsei-ro, Seodaemun-gu, Seoul, 120-752, Republic of Korea
| | - Seho Park
- Department of Surgery, Yonsei University College of Medicine, 50 Yonsei-ro, Seodaemun-gu, Seoul, 120-752, Republic of Korea.
- Frontier Research Institute of Convergence Sports Science, Yonsei University, Seoul, Republic of Korea.
| | - Seung Il Kim
- Department of Surgery, Yonsei University College of Medicine, 50 Yonsei-ro, Seodaemun-gu, Seoul, 120-752, Republic of Korea
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Park EH, Min SY, Kim Z, Yoon CS, Jung KW, Nam SJ, Oh SJ, Lee S, Park BW, Lim W, Hur MH. Basic Facts of Breast Cancer in Korea in 2014: The 10-Year Overall Survival Progress. J Breast Cancer 2017; 20:1-11. [PMID: 28382089 PMCID: PMC5378568 DOI: 10.4048/jbc.2017.20.1.1] [Citation(s) in RCA: 86] [Impact Index Per Article: 12.3] [Reference Citation Analysis] [Abstract] [Key Words] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/12/2017] [Accepted: 03/01/2017] [Indexed: 12/15/2022] Open
Abstract
We, the Korean Breast Cancer Society (KBCS), present the facts and the trends of breast cancer in Korea in 2014. Data on the total number of newly diagnosed patients was obtained from the Korea Central Cancer Registry database, other data were collected from the KBCS online registry database, and the overall survival data of patients were updated from Statistics Korea. A total of 21,484 female patients were newly diagnosed with breast cancer in 2014. The crude incidence rate and the age-standardized incidence rate (ASR) of breast cancer in female patients, including carcinoma in situ, were 83.4 cases and 63.9 cases per 100,000 women, respectively. The ASR showed an annual increase of 6.1% from 1999 to 2014; however, although the increase of the ASR had slowed since 2008, the incidence rate itself continuously increased. The proportion of early breast cancer increased consistently, and the pathological features changed accordingly. While breast-conserving surgery was mainly performed, the proportion of total mastectomy was slightly increased. The total number of breast reconstruction surgeries increased rapidly. The 5-year and 10-year overall survival rates for all stages of breast cancer patients were 91.2% and 84.8%, respectively. The overall survival rate of Korean patients with breast cancer was extremely high, compared with other developed countries. Thus, we consider that the clinical characteristics of breast cancer have changed over the past decade. A nationwide registry data will contribute to a better understanding of the characteristics of breast cancer in Korea.
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Affiliation(s)
- Eun Hwa Park
- Department of Surgery, Gangneung Asan Hospital, University of Ulsan College of Medicine, Gangneung, Korea
| | - Sun Young Min
- Department of Surgery, Kyung Hee University Medical Center, Kyung Hee University School of Medicine, Seoul, Korea
| | - Zisun Kim
- Department of Surgery, Soonchunhyang University Bucheon Hospital, Soonchunhyang University College of Medicine, Bucheon, Korea
| | - Chan Seok Yoon
- Department of Surgery, Cheil General Hospital and Women's Healthcare Center, Dankook University College of Medicine, Seoul, Korea
| | - Kyu-Won Jung
- The Korea Central Cancer Registry, Division of Cancer Registration and Surveillance, National Cancer Center, Goyang, Korea
| | - Seok Jin Nam
- Department of Surgery, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Korea
| | - Se Jeong Oh
- Department of Surgery, Incheon St. Mary's Hospital, The Catholic University of Korea College of Medicine, Incheon, Korea
| | - Seeyoun Lee
- Center for Breast Cancer, National Cancer Center, Goyang, Korea
| | - Byeong-Woo Park
- Department of Surgery, Yonsei University College of Medicine, Seoul, Korea
| | - Woosung Lim
- Department of Surgery, Ewha Womans University Mokdong Hospital, Seoul, Korea
| | - Min Hee Hur
- Department of Surgery, Inha University Hospital, Inha University School of Medicine, Incheon, Korea
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Endometrial polyp surveillance in premenopausal breast cancer patients using tamoxifen. Obstet Gynecol Sci 2017; 60:26-31. [PMID: 28217668 PMCID: PMC5313360 DOI: 10.5468/ogs.2017.60.1.26] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/16/2016] [Revised: 07/11/2016] [Accepted: 08/03/2016] [Indexed: 11/10/2022] Open
Abstract
Objective To describe the endometrial pathologic lesions in premenopausal breast cancer patients with a history of tamoxifen (TMX) use. Methods We retrospectively reviewed the medical records of 120 premenopausal breast cancer patients with a history of TMX use that had undergone a gynecological examination. Results Among 120 patients, 44.2% (n=53) were asymptomatic with an endometrial thickness ≥5 mm, as assessed by transvaginal ultrasonography. Of the patients that reported abnormal uterine bleeding, 5% (n=6) had an endometrial thickness <5 mm and 20% (n=24) had an endometrial thickness ≥5 mm by transvaginal ultrasonography. The final group of patients were asymptomatic, but showed an abnormal endometrial lesion, such as an endometrial polyp, by transvaginal ultrasonography (30.8%, n=37). Of the 56 benign lesions that were histologically reviewed, 50 (41.7%) were endometrial polyps, 3 (2.5%) were submucosal myomas, 2 (1.7%) were endometrial hyperplasias, and 1 (0.8%) was chronic endometritis. There were 64 (53.3%) other non-pathologic conditions, including secreting, proliferative, and atrophic endometrium, or in some cases, there was insufficient material for diagnosis. In our data, only one case was reported as a complex hyperplasia without atypia arising from an endometrial polyp, and one patient was diagnosed with endometrioid adenocarcinoma. Conclusion For premenopausal breast cancer patients with a history of TMX use, the majority of the patients were asymptomatic, and endometrial polyps were the most common endometrial pathology observed. Therefore, we believe that endometrial assessment before starting TMX treatment, and regular endometrial screening throughout TMX treatment, are reasonable suggestions for premenopausal breast cancer patients.
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Alramadhan M, Ryu JM, Rayzah M, Nam SJ, Kim SW, Yu J, Lee SK, Bae SY, Park S, Paik HJ, Lee JE. Goserelin plus tamoxifen compared to chemotherapy followed by tamoxifen in premenopausal patients with early stage-, lymph node-negative breast cancer of luminal A subtype. Breast 2016; 30:111-117. [PMID: 27697675 DOI: 10.1016/j.breast.2016.08.011] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/22/2016] [Revised: 08/02/2016] [Accepted: 08/18/2016] [Indexed: 01/11/2023] Open
Abstract
OBJECTIVES To study the outcomes of adjuvant goserelin combined with tamoxifen (GosTam) compared to chemotherapy followed by tamoxifen (ChemTam) in premenopausal patients with early stage, luminal A breast cancer. METHODS From 2008 until 2013, data were retrospectively collected for premenopausal patients who underwent surgery for invasive tumors that were ≤2.0 cm, node-negative, strongly positive for estrogen and progesterone receptors, HER-2-negative, and Ki-67 < 25%. The patients were divided into two groups according to adjuvant regimen, either GosTam or ChemTam. All patients who underwent different adjuvant regimens were excluded. RESULTS In total, 235 patients underwent GosTam and 171 patients underwent ChemTam. There were significantly more patients younger than 40 years in the GosTam group (32% GosTam vs. 22% ChemTam, p = 0.031). Mean tumor size was significantly smaller (1.19 cm vs. 1.48 cm, p < 0.001), Ki-67 significantly lower (p = 0.049), and nuclear grade was low in a significant number of patients in the GosTam group (2% vs. 13%, p < 0.001). After a median follow-up of 51.3 months, there was no mortality in either group. There was no significant difference in 5-year disease-free survival (DFS) between the two groups even after univariate analysis considering age, tumor size, nuclear grade, and P53% (GosTam = 98.9% vs. ChemTam = 95.7%, HR = 0.404, 95% CI = [0.073, 2.222], p = 0.248). CONCLUSION There was no difference between treatment groups, and neither chemotherapy nor ovarian suppression seemed to improve the outcome. Thus, tamoxifen alone might be a sufficient option for this low-risk patient population.
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Affiliation(s)
- Mansoor Alramadhan
- Division of Breast and Endocrine Surgery, Department of Surgery, Samsung Medical Center, Sungkyunkwan University School of Medicine, 81 Irwon-ro, Gangnam-gu, Seoul, Republic of Korea
| | - Jai Min Ryu
- Division of Breast and Endocrine Surgery, Department of Surgery, Samsung Medical Center, Sungkyunkwan University School of Medicine, 81 Irwon-ro, Gangnam-gu, Seoul, Republic of Korea
| | - Musaed Rayzah
- Division of Breast and Endocrine Surgery, Department of Surgery, Samsung Medical Center, Sungkyunkwan University School of Medicine, 81 Irwon-ro, Gangnam-gu, Seoul, Republic of Korea
| | - Seok Jin Nam
- Division of Breast and Endocrine Surgery, Department of Surgery, Samsung Medical Center, Sungkyunkwan University School of Medicine, 81 Irwon-ro, Gangnam-gu, Seoul, Republic of Korea
| | - Seok Won Kim
- Division of Breast and Endocrine Surgery, Department of Surgery, Samsung Medical Center, Sungkyunkwan University School of Medicine, 81 Irwon-ro, Gangnam-gu, Seoul, Republic of Korea
| | - Jonghan Yu
- Division of Breast and Endocrine Surgery, Department of Surgery, Samsung Medical Center, Sungkyunkwan University School of Medicine, 81 Irwon-ro, Gangnam-gu, Seoul, Republic of Korea
| | - Se Kyung Lee
- Division of Breast and Endocrine Surgery, Department of Surgery, Samsung Medical Center, Sungkyunkwan University School of Medicine, 81 Irwon-ro, Gangnam-gu, Seoul, Republic of Korea
| | - Soo Youn Bae
- Division of Breast and Endocrine Surgery, Department of Surgery, Samsung Medical Center, Sungkyunkwan University School of Medicine, 81 Irwon-ro, Gangnam-gu, Seoul, Republic of Korea
| | - Sungmin Park
- Division of Breast and Endocrine Surgery, Department of Surgery, Samsung Medical Center, Sungkyunkwan University School of Medicine, 81 Irwon-ro, Gangnam-gu, Seoul, Republic of Korea
| | - Hyun-June Paik
- Division of Breast and Endocrine Surgery, Department of Surgery, Samsung Medical Center, Sungkyunkwan University School of Medicine, 81 Irwon-ro, Gangnam-gu, Seoul, Republic of Korea
| | - Jeong Eon Lee
- Division of Breast and Endocrine Surgery, Department of Surgery, Samsung Medical Center, Sungkyunkwan University School of Medicine, 81 Irwon-ro, Gangnam-gu, Seoul, Republic of Korea.
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Beom SH, Oh J, Kim TY, Lee KH, Yang Y, Suh KJ, Moon HG, Han SW, Oh DY, Han W, Kim TY, Noh DY, Im SA. Efficacy of Letrozole as First-Line Treatment of Postmenopausal Women with Hormone Receptor-Positive Metastatic Breast Cancer in Korea. Cancer Res Treat 2016; 49:454-463. [PMID: 27554482 PMCID: PMC5398408 DOI: 10.4143/crt.2016.259] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/23/2016] [Accepted: 07/27/2016] [Indexed: 11/24/2022] Open
Abstract
Purpose Letrozole showed efficacy and generally favorable toxicities, along with the convenience of oral administration in postmenopausal patients with hormone receptor (HR)–positive metastatic breast cancer (MBC). To the best of our knowledge, there have been no reports of the clinical outcomes in Korean patients, although letrozole is widely used in practice. Therefore, this studywas conducted to affirm the efficacy and toxicities of letrozole in Korean patients. Materials and Methods This study retrospectively analyzed 84 HR-positive MBC patients who had been treated with letrozole from January 2001 to December 2012. Clinicopathological characteristics and treatment history were extracted from medicalrecords. All patients received 2.5 mg letrozole once a day until there were disease progressions or unacceptable toxicity. Progression-free survival (PFS) was the primary endpoint, and secondary endpoints were overall survival (OS), objective response rate (ORR), and toxicity. Results The median age of the subjects was 59.3 years. Letrozole treatment resulted in a median PFS of 16.8 months (95% confidence interval [CI], 9.8 to 23.8) and a median OS of 56.4 months (95% CI, 38.1 to 74.7). The ORR was 36.9% for the 84 patients with measurable lesions. Multivariate analysis revealed symptomatic visceral disease (hazard ratio, 3.437; 95% CI, 1.576 to 7.495; p=0.002) and a disease-free interval ≤ 2 years (hazard ratio, 2.697; 95% CI, 1.262 to 5.762; p=0.010) were independently associated with shorter PFS. However, sensitivity to adjuvant hormone treatment was not related to PFS. Letrozole was generally well tolerated. Conclusion Letrozole showed considerable efficacy and tolerability as a first-line treatment in postmenopausal patients with HR-positive MBC.
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Affiliation(s)
- Seung Hoon Beom
- Department of Internal Medicine, Yonsei University College of Medicine, Seoul, Korea
| | - Jisu Oh
- Department of Internal Medicine, CHA Bundang Medical Center, CHA University, Seongnam, Korea
| | - Tae-Yong Kim
- Department of Internal Medicine, Seoul National University Hospital, Seoul, Korea.,Cancer Research Institute, Seoul National University College of Medicine, Seoul, Korea
| | - Kyung-Hun Lee
- Department of Internal Medicine, Seoul National University Hospital, Seoul, Korea.,Cancer Research Institute, Seoul National University College of Medicine, Seoul, Korea
| | - Yaewon Yang
- Department of Internal Medicine, Seoul National University Hospital, Seoul, Korea.,Cancer Research Institute, Seoul National University College of Medicine, Seoul, Korea
| | - Koung Jin Suh
- Department of Internal Medicine, Seoul National University Hospital, Seoul, Korea
| | - Hyeong-Gon Moon
- Department of Internal Medicine, Seoul National University Hospital, Seoul, Korea.,Department of Surgery, Seoul National University Hospital, Seoul, Korea
| | - Sae-Won Han
- Department of Internal Medicine, Seoul National University Hospital, Seoul, Korea.,Cancer Research Institute, Seoul National University College of Medicine, Seoul, Korea
| | - Do-Youn Oh
- Department of Internal Medicine, Seoul National University Hospital, Seoul, Korea.,Cancer Research Institute, Seoul National University College of Medicine, Seoul, Korea
| | - Wonshik Han
- Department of Internal Medicine, Seoul National University Hospital, Seoul, Korea.,Department of Surgery, Seoul National University Hospital, Seoul, Korea
| | - Tae-You Kim
- Department of Internal Medicine, Seoul National University Hospital, Seoul, Korea.,Cancer Research Institute, Seoul National University College of Medicine, Seoul, Korea
| | - Dong-Young Noh
- Department of Internal Medicine, Seoul National University Hospital, Seoul, Korea.,Department of Surgery, Seoul National University Hospital, Seoul, Korea
| | - Seock-Ah Im
- Department of Internal Medicine, Seoul National University Hospital, Seoul, Korea.,Cancer Research Institute, Seoul National University College of Medicine, Seoul, Korea
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Jeon M, You D, Bae SY, Kim SW, Nam SJ, Kim HH, Kim S, Lee JE. Dimerization of EGFR and HER2 induces breast cancer cell motility through STAT1-dependent ACTA2 induction. Oncotarget 2016; 8:50570-50581. [PMID: 28881584 PMCID: PMC5584169 DOI: 10.18632/oncotarget.10843] [Citation(s) in RCA: 28] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/14/2016] [Accepted: 07/10/2016] [Indexed: 11/25/2022] Open
Abstract
The dimerization of EGFR and HER2 is associated with poor prognosis such as induction of tumor growth and cell invasion compared to when EGFR remains as a homodimer. However, the mechanism for events after dimerization in breast cancer models is not clear. We found that expressions of alpha-smooth muscle actin (ACTA2) and signal transducer and activator of transcription 1 (STAT1) significantly increased with transient or stable overexpression of HER2 in EGFR-positive breast cancer cells. ACTA2 and STAT1 expression was also increased in HER2-positive breast cancer patients. In contrast, ACTA2 expression was decreased by HER2 siRNA. Next, we investigated the co-relation between STAT1 and ACTA2 expression. Basal ACTA2 expression was significantly decreased by treatment with the STAT1 inhibitor fludarabine or the JAK2 inhibitor AG490. In contrast, ACTA2 expression was increased by STAT1 overexpression. Levels of ACTA2, STAT1, and HER2 were increased and relapse free survival was decreased in high-risk breast cancer patients. We also investigated the effect of ACTA2 on cell motility, which was suppressed by ACTA2 shRNA overexpression in MDA-MB231 HER2 and 4T1 mammary carcinoma cells. The number of lung metastatic nodules was significantly decreased in ACTA2 knockdown mice. Taken together, these results demonstrated that induction of ACTA2 by EGFR and HER2 dimerization was regulated through a JAK2/STAT1 signaling pathway, and aberrant ACTA2 expression accelerated the invasiveness and metastasis of breast cancer cells.
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Affiliation(s)
- Myeongjin Jeon
- Department of Surgery, Samsung Medical Center, Gangnam-gu, Seoul 06351, Korea.,Department of Health Sciences and Technology, SAIHST, Sungkyunkwan University, Gangnam-gu, Seoul 06351, Korea
| | - Daeun You
- Department of Surgery, Samsung Medical Center, Gangnam-gu, Seoul 06351, Korea.,Department of Health Sciences and Technology, SAIHST, Sungkyunkwan University, Gangnam-gu, Seoul 06351, Korea
| | - Soo Youn Bae
- Department of Surgery, Samsung Medical Center, Gangnam-gu, Seoul 06351, Korea
| | - Seok Won Kim
- Department of Surgery, Samsung Medical Center, Gangnam-gu, Seoul 06351, Korea
| | - Seok Jin Nam
- Department of Surgery, Samsung Medical Center, Gangnam-gu, Seoul 06351, Korea
| | - Hyeon Ho Kim
- Department of Health Sciences and Technology, SAIHST, Sungkyunkwan University, Gangnam-gu, Seoul 06351, Korea
| | - Sangmin Kim
- Department of Surgery, Samsung Medical Center, Gangnam-gu, Seoul 06351, Korea
| | - Jeong Eon Lee
- Department of Surgery, Samsung Medical Center, Gangnam-gu, Seoul 06351, Korea.,Department of Health Sciences and Technology, SAIHST, Sungkyunkwan University, Gangnam-gu, Seoul 06351, Korea
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26
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Min SY, Kim Z, Hur MH, Yoon CS, Park EH, Jung KW. The Basic Facts of Korean Breast Cancer in 2013: Results of a Nationwide Survey and Breast Cancer Registry Database. J Breast Cancer 2016; 19:1-7. [PMID: 27066090 PMCID: PMC4822102 DOI: 10.4048/jbc.2016.19.1.1] [Citation(s) in RCA: 53] [Impact Index Per Article: 6.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/22/2016] [Accepted: 03/09/2016] [Indexed: 01/17/2023] Open
Abstract
The Korean Breast Cancer Society (KBCS) has reported a nationwide breast cancer data since 1996. We present a comprehensive report on the facts and trends of breast cancer in Korea in 2013. Data on the newly diagnosed patients in the year 2013 were collected from 99 hospitals by using nationwide questionnaire survey. Clinical characteristics such as stage of cancer, histologic types, biological markers, and surgical management were obtained from the online registry database. A total of 19,316 patients were newly diagnosed with breast cancer in 2013. The crude incidence rate of female breast cancer including carcinoma in situ was 76.2 cases per 100,000 women. The median age at diagnosis was 50 years, and the proportions of postmenopausal women with breast cancer accounted for more than half of total patients. The proportion of early breast cancer increased consistently, and the pathologic features have changed accordingly. Breast-conserving surgery was performed in more cases than total mastectomy in the year. The total number of breast reconstruction surgeries markedly increased approaching 3-fold in last 11 years. According to annual percentile change of invasive cancer incidence, the incidence increased rapidly until 2010. And thereafter the increase of it became steadier. For ductal carcinoma in situ, the incidence consistently increased during the same period without any joinpoint. Analysis of nationwide registry data will contribute to defining of the trends and characteristics of breast cancer in Korea.
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Affiliation(s)
- Sun Young Min
- Department of Surgery, Kyung Hee University Medical Center, Kyung Hee University School of Medicine, Seoul, Korea
| | - Zisun Kim
- Department of Surgery, Soonchunhyang University Bucheon Hospital, Soonchunhyang University College of Medicine, Bucheon, Korea
| | - Min Hee Hur
- Department of Surgery, Cheil General Hospital and Women's Healthcare Center, Dankook University College of Medicine, Seoul, Korea
| | - Chan Seok Yoon
- Department of Surgery, Cheil General Hospital and Women's Healthcare Center, Dankook University College of Medicine, Seoul, Korea
| | - Eun-Hwa Park
- Department of Surgery, Gangneung Asan Hospital, University of Ulsan College of Medicine, Gangneung, Korea
| | - Kyu-Won Jung
- The Korea Central Cancer Registry, Division of Cancer Registration and Surveillance, National Cancer Center, Goyang, Korea
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27
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Park SH, Han W, Yoo TK, Lee HB, Jin US, Chang H, Minn KW, Noh DY. Oncologic Safety of Immediate Breast Reconstruction for Invasive Breast Cancer Patients: A Matched Case Control Study. J Breast Cancer 2016; 19:68-75. [PMID: 27064557 PMCID: PMC4822109 DOI: 10.4048/jbc.2016.19.1.68] [Citation(s) in RCA: 28] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/03/2015] [Accepted: 12/26/2015] [Indexed: 01/13/2023] Open
Abstract
Purpose The purpose of this study was to compare locoregional recurrence-free survival (LRFS) and disease-free survival (DFS) between patients undergoing mastectomy and immediate breast reconstruction (IBR) and those undergoing mastectomy alone. Methods A retrospective review of patients who underwent mastectomy and immediate breast reconstruction for resectable invasive breast cancer between 2002 and 2010 at a single center was conducted. These cases were matched to patients who underwent mastectomy alone in the same time period, performed by 1:2 matching. Matching control variables included age, tumor size, axillary lymph node metastasis, and estrogen receptor status. Overall, 189 patients were identified in the IBR group, and 362 patients were matched to this group. Results In the IBR group, 75 patients (39.7%) underwent conventional total mastectomy, 78 (41.3%) underwent skin-sparing mastectomy (SSM), and 36 (19.0%) underwent nipple-sparing mastectomy (NSM). The IBR group was significantly younger than the control group (41.9 and 45.1 years, respectively) (p=0.032), in spite of matching between three age groups. The DFS rates were similar between the IBR group and mastectomy alone group, at 92.0% and 89.9%, respectively, at 5-year follow-up (log-rank test, p=0.496). The 5-year LRFS was 96.2% in the IBR group and 96.4% in the mastectomy alone group (log-rank test, p=0.704), similar to data from previous reports. Subgroup analyses for SSM or NSM patients showed no differences in LRFS and DFS between the two groups. Additionally, in stage III patients, IBR did not cause an increase in recurrence. Conclusion IBR after mastectomy, including both SSM and NSM, had no negative impact on recurrence or patient survival, even in patients with advanced disease.
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Affiliation(s)
- Shin-Hoo Park
- Department of Surgery, Seoul National University College of Medicine, Seoul, Korea
| | - Wonshik Han
- Department of Surgery, Seoul National University College of Medicine, Seoul, Korea.; Cancer Research Institute, Seoul National University College of Medicine, Seoul, Korea
| | - Tae-Kyung Yoo
- Department of Surgery, Seoul National University College of Medicine, Seoul, Korea
| | - Han-Byoel Lee
- Department of Surgery, Seoul National University College of Medicine, Seoul, Korea
| | - Ung Sik Jin
- Department of Plastic and Reconstructive Surgery, Seoul National University College of Medicine, Seoul, Korea
| | - Hak Chang
- Department of Plastic and Reconstructive Surgery, Seoul National University College of Medicine, Seoul, Korea
| | - Kyung Won Minn
- Department of Plastic and Reconstructive Surgery, Seoul National University College of Medicine, Seoul, Korea
| | - Dong-Young Noh
- Department of Surgery, Seoul National University College of Medicine, Seoul, Korea.; Cancer Research Institute, Seoul National University College of Medicine, Seoul, Korea
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28
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Impact of young age on local control after partial breast irradiation in Japanese patients with early stage breast cancer. Breast Cancer 2016; 24:79-85. [PMID: 26832859 DOI: 10.1007/s12282-016-0669-4] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/13/2015] [Accepted: 01/18/2016] [Indexed: 12/19/2022]
Abstract
BACKGROUND Partial breast irradiation (PBI) is an alternative to whole breast irradiation (WBI) for breast-conserving therapy (BCT). A randomised phase 3 trial demonstrated that PBI using multicatheter brachytherapy had an equivalent rate of local recurrence, disease-free survival, and overall survival as compared to WBI. However, limited data are available on PBI efficacy for young patients with breast cancer. METHODS We evaluated consecutive patients with Tis-2 (≤ 3 cm) N0-1 breast cancer who underwent BCT. For PBI, patients received radiotherapy using multicatheter brachytherapy in an accelerated manner with a dose of 32 Gy in eight fractions over 5-6 days. For WBI, patients received an external beam radiation therapy that was applied to the entire breast with a total dose of 50 Gy in fractions of 2 Gy for 5 weeks. Two hundred seventy-four patients with 278 lesions received PBI; 190 patients with 193 lesions received WBI. RESULTS Patients aged <50 years including 98 women with 99 lesions receiving PBI and 85 women with 85 lesions receiving WBI were selected. Ipsilateral breast tumor recurrence rate was 3.0 and 2.4 % by PBI and WBI, respectively (P = 0.99). There was no significant difference in 4-year probability of disease-free survival (97.6 and 91.4 % for PBI and WBI, respectively; P = 0.87). CONCLUSIONS This is the first report of PBI efficacy in young patients in Asia. Although it is a nonrandomized retrospective chart review of a small cohort of patients with a relatively short follow-up period, PBI may be a better option than WBI following BCS in some young patients with breast cancer.
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29
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Fan L, Goss PE, Strasser-Weippl K. Current Status and Future Projections of Breast Cancer in Asia. Breast Care (Basel) 2015; 10:372-8. [PMID: 26989355 PMCID: PMC4789872 DOI: 10.1159/000441818] [Citation(s) in RCA: 70] [Impact Index Per Article: 7.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/30/2022] Open
Abstract
Asia is the world's largest continent comprising about 3/5 of the human population. Breast cancer is the most common type of cancer and the second leading cause of cancer-related deaths among women in Asia, accounting for 39% of all breast cancers diagnosed worldwide. The incidence of breast cancer in Asia varies widely across the continent and is still lower than in Western countries, but the proportional contribution of Asia to the global breast cancer rates is increasing rapidly in parallel to the socioeconomic development. However, the mortality-to-incidence ratios are much higher for Asia than for Western countries. Most Asian countries are low- and middle-income countries (LMICs) where breast cancer presents at a younger age and a later stage, and where patients are more likely to die from the disease than those in Western countries. Moreover, diagnostic workup, treatment and palliative services are inadequate in most Asian LMICs. In this review, we present an overview of the breast cancer risk factors and epidemiology, control measures, and cancer care among Asian countries.
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Affiliation(s)
- Lei Fan
- Breast Cancer Institute, Cancer Hospital, Department of Oncology, Shanghai Medical College, Institutes of Biomedical Science, Fudan University, Shanghai, China
| | - Paul E. Goss
- Global Cancer Institute, Boston, MA, USA
- Massachusetts General Hospital, Harvard Medical School, Boston, MA, USA
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30
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Lee HJ, Yang YL, Chu SH. Current Domestic Research Trends for Exercise Intervention for Patients with Breast Cancer Undergoing Chemotherapy or Radiotherapy. ASIAN ONCOLOGY NURSING 2015. [DOI: 10.5388/aon.2015.15.4.185] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022]
Affiliation(s)
- Hyun Joo Lee
- College of Nursing, Graduate School, Yonsei University, Seoul, Korea
| | - You Lee Yang
- College of Nursing, Graduate School, Yonsei University, Seoul, Korea
| | - Sang Hui Chu
- Mo-Im Kim Nursing Research Institute, Yonsei University College of Nursing, Seoul, Korea
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31
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Bae JM. Two different views of interpreting the related evidences on the reply to reader's letter. JOURNAL OF THE KOREAN MEDICAL ASSOCIATION 2015. [DOI: 10.5124/jkma.2015.58.12.1196] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/06/2022] Open
Affiliation(s)
- Jong-Myon Bae
- Department of Preventive Medicine, Jeju National University School of Medicine, Jeju, Korea
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