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Ahn SG, Nam SJ, Ahn SH, Jung Y, Park HK, Lee SJ, Kang SS, Han W, Park KH, Park YL, Lee J, Youn HJ, Kim JH, Yoo Y, Song JY, Ko BK, Gwak G, Chung MS, Kim SY, Cho SH, Kim D, Chang MC, Moon BI, Kim LS, Kim SJ, Park MH, Kim TH, Cho J, Lim CW, Bae YT, Gong G, Bae YK, Lee A, Jeong J. Clinical Outcomes Following Letrozole Treatment according to Estrogen Receptor Expression in Postmenopausal Women: LETTER Study (KBCSG-006). J Breast Cancer 2021; 24:164-174. [PMID: 33818022 PMCID: PMC8090806 DOI: 10.4048/jbc.2021.24.e17] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/24/2020] [Revised: 01/28/2021] [Accepted: 02/23/2021] [Indexed: 01/20/2023] Open
Abstract
Purpose In this trial, we investigated the efficacy and safety of adjuvant letrozole for hormone receptor (HR)-positive breast cancer. Here, we report the clinical outcome in postmenopausal women with HR-positive breast cancer treated with adjuvant letrozole according to estrogen receptor (ER) expression levels. Methods In this multi-institutional, open-label, observational study, postmenopausal patients with HR-positive breast cancer received adjuvant letrozole (2.5 mg/daily) for 5 years unless they experienced disease progression or unacceptable toxicity or withdrew their consent. The patients were stratified into the following 3 groups according to ER expression levels using a modified Allred score (AS): low, intermediate, and high (AS 3–4, 5–6, and 7–8, respectively). ER expression was centrally reviewed. The primary objective was the 5-year disease-free survival (DFS) rate. Results Between April 25, 2010, and February 5, 2014, 440 patients were enrolled. With a median follow-up of 62.0 months, the 5-year DFS rate in all patients was 94.2% (95% confidence interval [CI], 91.8–96.6). The 5-year DFS and recurrence-free survival (RFS) rates did not differ according to ER expression; the 5-year DFS rates were 94.3% and 94.1%in the low-to-intermediate and high expression groups, respectively (p = 0.6), and the corresponding 5-year RFS rates were 95.7% and 95.4%, respectively (p = 0.7). Furthermore, 25 patients discontinued letrozole because of drug toxicity. Conclusion Treatment with adjuvant letrozole showed very favorable treatment outcomes and good tolerability among Korean postmenopausal women with ER-positive breast cancer, independent of ER expression. Trial Registration ClinicalTrials.gov Identifier: NCT01069211
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Affiliation(s)
- Sung Gwe Ahn
- Department of Surgery, Gangnam Severance Hospital, Seoul, Korea
| | - Seok Jin Nam
- Department of Surgery, Samsung Medical Center, Seoul, Korea
| | - Sei Hyun Ahn
- Department of Surgery, Asan Medical Center, Seoul, Korea
| | - Yongsik Jung
- Department of Surgery, Ajou University School of Medicine, Suwon, Korea
| | - Heung Kyu Park
- Department of Surgery, Gachon University Gil Hospital, Incheon, Korea
| | - Soo Jung Lee
- Department of Surgery, Yeungnam University College of Medicine, Daegu, Korea
| | - Sung Soo Kang
- Department of Surgery, CHA University Ilsan Medical Center, Goyang, Korea
| | - Wonshik Han
- Department of Surgery, Seoul National University College of Medicine, Seoul, Korea
| | - Kyong Hwa Park
- Division of Oncology/Hematology, Department of Internal Medicine, Korea University College of Medicine, Seoul, Korea
| | - Yong Lai Park
- Department of Surgery, Kangbuk Samsung Hospital, Seoul, Korea
| | - Jihyoun Lee
- Department of Surgery, Soonchunhyang University Seoul Hospital, Seoul, Korea
| | - Hyun Jo Youn
- Department of Surgery, Jeonbuk National University Medical School, Jeonju, Korea
| | - Jun Hyun Kim
- Department of Surgery, Busan St. Mary's Hospital, Busan, Korea
| | - Youngbum Yoo
- Department of Surgery, Konkuk University Medical Center, Choongju, Korea
| | - Jeong Yoon Song
- Department of Surgery, Kyung Hee University Hospital, Seoul, Korea
| | - Byung Kyun Ko
- Department of Surgery, Ulsan University Hospital, Ulsan, Korea
| | - Geumhee Gwak
- Department of Surgery, Inje University Sanggye Paik Hospital, Seoul, Korea
| | - Min Sung Chung
- Department of Surgery, Hanyang University Hospital, Seoul, Korea
| | - Sung Yong Kim
- Department of Surgery, Soonchunhyang University Cheonan Hospital, Cheonan, Korea
| | - Seo Heon Cho
- Department of Surgery, Dong-A University Hospital, Busan, Korea
| | - Doyil Kim
- Department of Surgery, Kangseo MizMedi Hospital, Seoul, Korea
| | - Myung Chul Chang
- Department of Surgery, Dankook University Hospital, Cheonan, Korea
| | - Byung In Moon
- Department of Surgery, Ewha Woman's University Mokdong Hospital, Seoul, Korea
| | - Lee Su Kim
- Department of Surgery, Hallym University Sacred Heart Hospital, Anyang, Korea
| | - Sei Joong Kim
- Department of Surgery, Gangseo Mizmedi Hospital, Seoul, Korea
| | - Min Ho Park
- Department of Surgery, Chonnam National University Medical School, Gwangju, Korea
| | - Tae Hyun Kim
- Department of Surgery, Inje University Busan Paik Hospital, Busan, Korea
| | - Jihyoung Cho
- Department of Surgery, Keimyung University School of Medicine, Daegu, Korea
| | - Cheol Wan Lim
- Department of Surgery, Soonchunhyang University Bucheon Hospital, Bucheon, Korea
| | - Young Tae Bae
- Department of Surgery, Pusan National University Hospital, Busan, Korea
| | - Gyungyub Gong
- Department of Pathology, Asan Medical Center, Seoul, Korea
| | - Young Kyung Bae
- Department of Pathology, Yeungnam University College of Medicine, Daegu, Korea
| | - Ahwon Lee
- Department of Pathology, Seoul St. Mary's Hospital, The Catholic University of Korea, Seoul, Korea
| | - Joon Jeong
- Department of Surgery, Gangnam Severance Hospital, Seoul, Korea.
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Yun YH, Lim CI, Lee ES, Kim YT, Shin KH, Kim YW, Park KJ, Jeong SY, Ryu KW, Han W, Jung KH, Park SC, Kim MS, Kim S, Shim YM, Oh JH, Lee JM, Ryoo SB, Woo J, Noh DY, Park JW, In Moon B, Kim HJ, Nam SJ, Lee DH, Zo JI, Park SM, Kang E, Rhee Y, Jung JY, Sim JA, Lee J, Shin A. Efficacy of health coaching and a web-based program on physical activity, weight, and distress management among cancer survivors: A multi-centered randomised controlled trial. Psychooncology 2020; 29:1105-1114. [PMID: 32307828 DOI: 10.1002/pon.5394] [Citation(s) in RCA: 23] [Impact Index Per Article: 5.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/14/2019] [Revised: 04/04/2020] [Accepted: 04/06/2020] [Indexed: 11/09/2022]
Abstract
OBJECTIVES To investigate the efficacy of health coaching and a web-based program on survivor physical activity (PA), weight, and distress management among stomach, colon, lung and breast cancer patients. METHODS This randomised, controlled, 1-year trial conducted in five hospitals recruited cancer survivors within 2 months of completing primary cancer treatment who had not met ≥1 of these behavioural goals: (i) conducting moderate PA for at least 150 minutes/week or strenuous exercise for over 75 minutes per week or, in the case of lung cancer patients, low or moderate intensity exercise for over 12.5 MET per week, (ii) maintaining normal weight, and (iii) attaining a score >72 in the Post Traumatic Growth Inventory (PTGI). Participants were randomly assigned to one of three groups: the control group, a web-only group, or a health coaching + web group. The primary endpoint was based on a composite of PA, weight, and PTGI score at 12 months. RESULTS Patients in the health coaching + web group (difference = 6.6%, P = .010) and the web-only group (difference = 5.9%, P = .031) had greater overall improvements across the three-outcome composite than the control group. The health coaching + web group had greater overall improvement in PTGI (difference = 12.6%; P < .001) than the control group, but not in PA and weight. CONCLUSION The web-based program, with or without health coaching, may improve health behaviours including PA, weight, and distress management among cancer survivors within 2 months of completing primary cancer treatment. The web-based program with health coaching was mainly effective for reducing psychological distress.
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Affiliation(s)
- Young Ho Yun
- Department of Family Medicine, Seoul National University College of Medicine, Seoul, South Korea
| | - Cheol Il Lim
- Department of Education, Seoul National University College of Education, Seoul, South Korea
| | - Eun Sook Lee
- Research Institute and Hospital, National Cancer Center, Goyang, South Korea
| | - Young Tae Kim
- Department of Cardiovascular and Thoracic Surgery, Seoul National University College of Medicine, Seoul, South Korea
| | - Kyung Hwan Shin
- Department of Radiation Oncology, Seoul National University College of Medicine, Seoul, South Korea
| | - Young-Woo Kim
- Research Institute and Hospital, National Cancer Center, Goyang, South Korea
| | - Kyu Joo Park
- Department of Surgery, Seoul National University College of Medicine, Seoul, South Korea
| | - Seung-Yong Jeong
- Department of Surgery, Seoul National University College of Medicine, Seoul, South Korea
| | - Keun Won Ryu
- Research Institute and Hospital, National Cancer Center, Goyang, South Korea
| | - Wonshik Han
- Department of Surgery, Seoul National University College of Medicine, Seoul, South Korea
| | - Kyung Hae Jung
- Department of Oncology, University of Ulsan College of Medicine, Seoul, South Korea
| | - Sung Chan Park
- Research Institute and Hospital, National Cancer Center, Goyang, South Korea
| | - Moon Soo Kim
- Research Institute and Hospital, National Cancer Center, Goyang, South Korea
| | - Sung Kim
- Department of Surgery, Sungkyunkwan University School of Medicine, Seoul, South Korea
| | - Young Mog Shim
- Department of Cardiovascular and Thoracic Surgery, Sungkyunkwan University School of Medicine, Seoul, South Korea
| | - Jae Hwan Oh
- Research Institute and Hospital, National Cancer Center, Goyang, South Korea
| | - Jong Mog Lee
- Research Institute and Hospital, National Cancer Center, Goyang, South Korea
| | - Seung-Bum Ryoo
- Department of Surgery, Seoul National University College of Medicine, Seoul, South Korea
| | - Joohyun Woo
- Department of Oncology, Ewha Womans University College of Medicine, Seoul, South Korea
| | - Dong-Young Noh
- Department of Surgery, Seoul National University College of Medicine, Seoul, South Korea
| | - Ji Won Park
- Department of Surgery, Seoul National University College of Medicine, Seoul, South Korea
| | - Byung In Moon
- Department of Oncology, Ewha Womans University College of Medicine, Seoul, South Korea
| | - Hak Jae Kim
- Department of Radiation Oncology, Seoul National University College of Medicine, Seoul, South Korea
| | - Seok Jin Nam
- Department of Surgery, Sungkyunkwan University School of Medicine, Seoul, South Korea
| | - Dae Ho Lee
- Department of Oncology, University of Ulsan College of Medicine, Seoul, South Korea
| | - Jae Il Zo
- Department of Cardiovascular and Thoracic Surgery, Sungkyunkwan University School of Medicine, Seoul, South Korea
| | - Sang Min Park
- Department of Family Medicine, Seoul National University College of Medicine, Seoul, South Korea
| | - EunKyo Kang
- Department of Family Medicine, Seoul National University College of Medicine, Seoul, South Korea
| | - YeEun Rhee
- Department of Family Medicine, Seoul National University College of Medicine, Seoul, South Korea
| | - Ju Youn Jung
- Department of Family Medicine, Seoul National University College of Medicine, Seoul, South Korea
| | - Jin Ah Sim
- Department of Family Medicine, Seoul National University College of Medicine, Seoul, South Korea
| | - Joonki Lee
- Department of Preventive Medicine, Seoul National University College of Medicine, Seoul, South Korea
| | - Aesun Shin
- Department of Preventive Medicine, Seoul National University College of Medicine, Seoul, South Korea
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Lee A, Moon BI, Kim TH. BRCA1/ BRCA2 Pathogenic Variant Breast Cancer: Treatment and Prevention Strategies. Ann Lab Med 2020; 40:114-121. [PMID: 31650727 PMCID: PMC6822003 DOI: 10.3343/alm.2020.40.2.114] [Citation(s) in RCA: 57] [Impact Index Per Article: 14.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/14/2019] [Revised: 08/21/2019] [Accepted: 10/10/2019] [Indexed: 12/24/2022] Open
Abstract
Hereditary breast cancer is known for its strong tendency of inheritance. Most hereditary breast cancers are related to BRCA1/BRCA2 pathogenic variants. The lifelong risk of breast cancer in pathogenic BRCA1 and BRCA2 variant carriers is approximately 65% and 45%, respectively, whereas that of ovarian cancer is estimated to be 39% and 11%, respectively. Therefore, understanding these variants and clinical knowledge on their occurrence in breast cancers and carriers are important. BRCA1 pathogenic variant breast cancer shows more aggressive clinicopathological features than the BRCA2 pathogenic variant breast cancer. Compared with sporadic breast cancer, their prognosis is still debated. Treatments of BRCA1/BRCA2 pathogenic variant breast cancer are similar to those for BRCA-negative breast cancer, mainly including surgery, radiotherapy, and chemotherapy. Recently, various clinical trials have investigated poly (adenosine diphosphate [ADP]-ribose) polymerase (PARP) inhibitor treatment for advanced-stage BRCA1/BRCA2 pathogenic variant breast cancer. Among the various PARP inhibitors, olaparib and talazoparib, which reached phase III clinical trials, showed improvement of median progression-free survival around three months. Preventive and surveillance strategies for BRCA pathogenic variant breast cancer to reduce cancer recurrence and improve treatment outcomes have recently received increasing attention. In this review, we provide an information on the clinical features of BRCA1/BRCA2 pathogenic variant breast cancer and clinical recommendations for BRCA pathogenic variant carriers, with a focus on treatment and prevention strategies. With this knowledge, clinicians could manage the BRCA1/BRCA2 pathogenic variant breast cancer patients more effectively.
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Affiliation(s)
- Anbok Lee
- Department of Surgery, Busan Paik Hospital, Inje University College of Medicine, Busan, Korea.
| | - Byung In Moon
- Department of Surgery, Mokdong Hospital, Ewha Womans University College of Medicine, Seoul, Korea
| | - Tae Hyun Kim
- Department of Surgery, Busan Paik Hospital, Inje University College of Medicine, Busan, Korea
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Lee KM, Lee JE, Cha ES, Chung J, Kim JH, Moon BI. Dystrophic Calcifications in the Breast from Secondary Hyperparathyroidism. Breast Care (Basel) 2018; 13:44-46. [PMID: 29950967 DOI: 10.1159/000484198] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/19/2022] Open
Abstract
Background Soft tissue calcification is common in patients with secondary hyperparathyroidism who have received long-term treatment with hemodialysis. However, calcifications in the breast parenchyma are not common. We report a case of a woman with dystrophic breast calcifications from secondary hyperparathyroidism. Case Report A 65-year-old woman presented with a palpable mass in her right breast which she had discovered 1 month ago. She had a medical history of end-stage renal disease. Mammography and ultrasound revealed large dystrophic calcifications in both breasts. Core needle biopsy was performed for calcifications in the right breast, and the pathologic diagnosis was dystrophic calcification in the stroma from secondary hyperparathyroidism. Conclusion Reviewing our case will contribute to a fast and correct diagnosis in patients with dystrophic breast calcifications and lab results indicating secondary hyperparathyroidism, and will help discriminate these benign lesions from malignancies.
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Affiliation(s)
- Kyoung Min Lee
- Department of Radiology, Ewha Womans University, School of Medicine, Seoul, Republic of Korea
| | - Jee Eun Lee
- Department of Radiology, Ewha Womans University, School of Medicine, Seoul, Republic of Korea
| | - Eun Suk Cha
- Department of Radiology, Ewha Womans University, School of Medicine, Seoul, Republic of Korea
| | - Jin Chung
- Department of Radiology, Ewha Womans University, School of Medicine, Seoul, Republic of Korea
| | - Jeoung Hyun Kim
- Department of Radiology, Ewha Womans University, School of Medicine, Seoul, Republic of Korea
| | - Byung In Moon
- Department of Surgery, Ewha Womans University, School of Medicine, Seoul, Republic of Korea
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Jung Y, Lee SJ, Lee J, Noh WC, Nam SJ, Park BW, Bae YT, Kang SS, Park HK, Yoon JH, Kim JR, Cho SH, Kim LS, Moon BI, Jung SH, Lim CW, Kim SY, Park HY, Song J, Lee KM, Park SH, Jeong J, Park HL, Kim SW, Kwak BS, Kang SH, Cho YU, Gwak GH, Park YL, Kim SW, Han S. Assessment of Quality of Life and Safety in Postmenopausal Breast Cancer Patients Receiving Letrozole as an Early Adjuvant Treatment. J Breast Cancer 2018; 21:182-189. [PMID: 29963114 PMCID: PMC6015975 DOI: 10.4048/jbc.2018.21.2.182] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/23/2018] [Accepted: 06/04/2018] [Indexed: 11/30/2022] Open
Abstract
Purpose There are few reports from Asian countries about the long-term results of aromatase inhibitor adjuvant treatment for breast cancer. This observational study aimed to evaluate the long-term effects of letrozole in postmenopausal Korean women with operable breast cancer. Methods Self-reported quality of life (QoL) scores were serially assessed for 3 years during adjuvant letrozole treatment using the Korean version of the Functional Assessment of Cancer Therapy-Breast questionnaires (version 3). Changes in bone mineral density (BMD) and serum cholesterol levels were also examined. Results All 897 patients received the documented informed consent form and completed a baseline questionnaire before treatment. Adjuvant chemotherapy was administered to 684 (76.3%) subjects, and 410 (45.7%) and 396 (44.1%) patients had stage I and II breast cancer, respectively. Each patient completed questionnaires at 3, 6, 12, 18, 24, 30, and 36 months after enrollment. Of 897 patients, 749 (83.5%) completed the study. The dropout rate was 16.5%. The serial trial outcome index, the sum of the physical and functional well-being subscales, increased gradually and significantly from baseline during letrozole treatment (p<0.001). The mean serum cholesterol level increased significantly from 199 to 205 after 36 months (p=0.042). The mean BMD significantly decreased from −0.39 at baseline to −0.87 after 36 months (p<0.001). Conclusion QoL gradually improved during letrozole treatment. BMD and serum cholesterol level changes were similar to those in Western countries, indicating that adjuvant letrozole treatment is well tolerated in Korean women, with minimal ethnic variation.
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Affiliation(s)
- Yongsik Jung
- Department of Surgery, Ajou University School of Medicine, Suwon, Korea
| | - Soo Jung Lee
- Department of Surgery, Yeungnam University Hospital, Daegu, Korea
| | - Juneyoung Lee
- Department of Biostatistics, Korea University College of Medicine, Seoul, Korea
| | - Woo Chul Noh
- Department of Surgery, Korea Institute of Radiological and Medical Science, Seoul, Korea
| | - Seok Jin Nam
- Department of Surgery, Samsung Medical Center, Seoul, Korea
| | - Byeong-Woo Park
- Department of Surgery, Yonsei University College of Medicine, Seoul, Korea
| | - Young Tae Bae
- Department of Surgery, Pusan National University School of Medicine, Busan, Korea
| | - Sung-Soo Kang
- Department of Surgery, Cheil General Hospital & Women's Healthcare Center, Dankook University College of Medicine, Seoul, Korea
| | - Heung Kyu Park
- Department of Surgery, Gachon University Gil Hospital, Incheon, Korea
| | - Jung-Han Yoon
- Department of Surgery, Chonnam National University Hwasun Hospital, Hwasun, Korea
| | - Je Ryong Kim
- Department of Surgery, Chungnam National University Hospital, Daejeon, Korea
| | - Se Hun Cho
- Department of Surgery, Dong-A University Hospital, Busan, Korea
| | - Lee Su Kim
- Department of Surgery, Hallym University College of Medicine, Anyang, Korea
| | - Byung In Moon
- Breast Cancer Center, Ewha Womans University Hospital, Seoul, Korea
| | - Sung Hoo Jung
- Department of Surgery, Chonbuk National University Medical School, Jeonju, Korea
| | - Chol Wan Lim
- Department of Surgery, Soonchunhyang University Bucheon Hospital, Bucheon, Korea
| | - Sung Yong Kim
- Department of Surgery, Soonchunhyang University Cheonan Hospital, Cheonan, Korea
| | - Ho Yong Park
- Department of Surgery, Kyungpook National University Medical Center, Daegu, Korea
| | - Jeongyoon Song
- Department of Surgery, Kyung Hee University Hospital at Gangdong, Seoul, Korea
| | - Kwang Man Lee
- Department of Surgery, Wonkwang University Hospital, Iksan, Korea
| | - Sung Hwan Park
- Department of Surgery, Daegu Catholic University Hospital, Daegu, Korea
| | - Joon Jeong
- Department of Surgery, Yonsei University Gangnam Severance Hospital, Seoul, Korea
| | - Hae Lin Park
- Department of Surgery, CHA Gangnam Medical Center, Seoul, Korea
| | - Sung Won Kim
- Department of Surgery, Daerim St. Mary's Hospital, Seoul, Korea
| | - Beom Seok Kwak
- Department of Surgery, Dongguk University Ilsan Hospital, Goyang, Korea
| | - Sun Hee Kang
- Department of Surgery, Keimyung University School of Medicine, Daegu, Korea
| | - Young Up Cho
- Department of Surgery, Yonsei University College of Medicine, Seoul, Korea
| | - Geum Hee Gwak
- Department of Surgery, Inje University Sanggye Paik Hospital, Seoul, Korea
| | - Yong Lae Park
- Department of Surgery, Kangbuk Samsung Hospital, Seoul, Korea
| | - Sang Wook Kim
- Department of Surgery, Bundang Jesaeng Hospital, Seongnam, Korea
| | - Sehwan Han
- Department of Surgery, Ajou University School of Medicine, Suwon, Korea
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Jung H, Kim B, Moon BI, Oh ES. Cytokeratin 18 is necessary for initiation of TGF-β1-induced epithelial-mesenchymal transition in breast epithelial cells. Mol Cell Biochem 2016; 423:21-28. [PMID: 27734227 DOI: 10.1007/s11010-016-2818-7] [Citation(s) in RCA: 18] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/28/2016] [Accepted: 09/08/2016] [Indexed: 01/10/2023]
Abstract
During epithelial-mesenchymal transition (EMT), epithelial cells lose key phenotypic markers (e.g., E-cadherin and cytokeratin 18) and acquire mesenchymal markers (e.g., N-cadherin and vimentin). Although the loss of cytokeratin 18 is a hallmark of EMT, the regulatory role of cytokeratin 18 in EMT is not yet fully understood. Here, we report that cytokeratin 18 is involved in the regulation of transforming growth factor-beta1 (TGF-β1)-induced EMT in breast epithelial cells. When MCF10A cells were treated with TGF-β1 for 24 h, considerable morphological changes, indicative of the early stages of EMT (e.g., loss of cell-cell contact), were observed and cytokeratin 18 was downregulated. However, E-cadherin levels were not altered until a later time point. This suggests that cytokeratin 18 may play an active role during the earlier stages of EMT. Consistent with this notion, siRNA-mediated knockdown of cytokeratin 18 delayed TGF-β1-mediated EMT, and the associated downregulation of E-cadherin reduced the phosphorylation/nuclear localization of smad 2/3 and decreased the expression levels of snail and slug (which inhibit E-cadherin expression in epithelial cells as an early response to TGF-β1). Taken together, these results suggest that cytokeratin 18 critically contributes to initiating TGF-β1-induced EMT via the smad 2/3-mediated regulation of snail and slug expression in breast epithelial cells.
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Affiliation(s)
- Hyejung Jung
- Department of Life Sciences, the Research Center for Cellular Homeostasis, Ewha Womans University, 52, Ewhayeodae-gil, Seodaemoon-Gu, Seoul, 120-750, Korea
| | - Bomin Kim
- Department of Life Sciences, the Research Center for Cellular Homeostasis, Ewha Womans University, 52, Ewhayeodae-gil, Seodaemoon-Gu, Seoul, 120-750, Korea
| | - Byung In Moon
- Department of Surgery, College of Medicine, Ewha Womans University, 911-1 Mok-Dong Yangcheon-Ku, Seoul, 158-710, Korea.
| | - Eok-Soo Oh
- Department of Life Sciences, the Research Center for Cellular Homeostasis, Ewha Womans University, 52, Ewhayeodae-gil, Seodaemoon-Gu, Seoul, 120-750, Korea.
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Lim ST, Yu JH, Park HK, Moon BI, Ko BK, Suh YJ. A comparison of the clinical outcomes of patients with invasive lobular carcinoma and invasive ductal carcinoma of the breast according to molecular subtype in a Korean population. World J Surg Oncol 2014; 12:56. [PMID: 24621330 PMCID: PMC3995623 DOI: 10.1186/1477-7819-12-56] [Citation(s) in RCA: 17] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/08/2013] [Accepted: 02/19/2014] [Indexed: 11/23/2022] Open
Abstract
Background To investigate the clinicopathological characteristics and the survival outcomes of invasive lobular carcinoma (ILC) patients compared to invasive ductal carcinoma (IDC) patients according to their molecular subtype. Methods We compared the clinicopathological characteristics, breast cancer-specific survival (BCSS) and overall survival (OS) between patients with IDC (n = 14,547) and ILC (n = 528). Results The ILC presented with a larger tumor size, more advanced cancer stage, increased rate of hormonal receptor positivity, human epidermal growth factor 2 (HER2) negativity and mastectomy than the IDC. The ILC patients more frequently presented with the luminal A subtype, whereas the IDC patients more frequently presented with the luminal B, HER2-overexpression, or triple negative subtype. The BCSS and OS were not significantly different between the IDC and ILC for each molecular subtype. Conclusions Similar to IDC patients, molecular subtype should be considered when determining the prognosis and treatment regimen for ILC patients.
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Affiliation(s)
| | | | | | | | | | - Young Jin Suh
- Department of Surgery, St, Vincent's Hospital, The Catholic University of Korea, 93, Joongboo-Daero Suwon, Paldal-gu, Kyunggi-do 442-723, Korea.
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Ha B, Suh HS, Lee J, Lee KJ, Lee R, Moon BI. Long-term results of forward intensity-modulated radiation therapy for patients with early-stage breast cancer. Radiat Oncol J 2013; 31:191-8. [PMID: 24501706 PMCID: PMC3912232 DOI: 10.3857/roj.2013.31.4.191] [Citation(s) in RCA: 14] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/13/2013] [Revised: 10/10/2013] [Accepted: 10/16/2013] [Indexed: 11/08/2022] Open
Abstract
Purpose To observe long-term clinical outcomes for patients with early-stage breast cancer treated with forward intensity-modulated radiation therapy (IMRT), including local control and clinical toxicities. Materials and Methods We retrospectively analyzed a total of 214 patients with stage I-II breast cancer who were treated with breast conserving surgery followed by adjuvant breast radiation therapy between 2001 and 2008. All patients were treated using forward IMRT. The whole breast was irradiated to a dose of 50 to 50.4 Gy followed by an 8 to 12 Gy electron boost to the surgical bed. Results The median age was 46 years (range, 21 to 82 years) and the medial follow-up time was 7.3 years (range, 2.4 to 11.7 years). Stage T1 was 139 (65%) and T2 was 75 (35%), respectively. Ipsilateral breast recurrence was observed in 3 patients. The 5- and 10-year local control rates were 99.1% and 97.8%, respectively. The cosmetic outcome was evaluated according to the Harvard scale and 89.4% of patients were scored as excellent or good. Conclusion The whole breast radiation therapy as an adjuvant treatment using a forward IMRT technique showed excellent long-term local control as well as favorable outcomes of toxicity and cosmesis.
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Affiliation(s)
- Boram Ha
- Department of Radiation Oncology, Ewha Womans University College of Medicine, Seoul, Korea
| | - Hyun Suk Suh
- Department of Radiation Oncology, Ewha Womans University College of Medicine, Seoul, Korea
| | - Jihae Lee
- Department of Radiation Oncology, Ewha Womans University College of Medicine, Seoul, Korea
| | - Kyung-Ja Lee
- Department of Radiation Oncology, Ewha Womans University College of Medicine, Seoul, Korea
| | - Rena Lee
- Department of Radiation Oncology, Ewha Womans University College of Medicine, Seoul, Korea
| | - Byung In Moon
- Department of General Surgery, Ewha Womans University College of Medicine, Seoul, Korea
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Yom CK, Lee KM, Han W, Kim SW, Kim HS, Moon BI, Jeong KY, Im SA, Noh DY. Leptin as a potential target for estrogen receptor-positive breast cancer. J Breast Cancer 2013; 16:138-45. [PMID: 23843844 PMCID: PMC3706857 DOI: 10.4048/jbc.2013.16.2.138] [Citation(s) in RCA: 19] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/08/2013] [Accepted: 04/02/2013] [Indexed: 11/30/2022] Open
Abstract
Purpose Leptin is a potent adipokine that plays a significant role in tumor development and the progression of breast cancer. The aim of this study was to evaluate whether leptin affects the response to tamoxifen treatment in estrogen receptor (ER)-positive breast cancer cells. Methods Leptin, leptin receptor (Ob-R), and activation of signaling pathways were studied by Western immunoblotting. The effects of leptin on tamoxifen-dependent growth inhibition were studied in MCF-7 and T-47D cells. Results Leptin was expressed in MCF-7 and T-47D and had a proliferative effect on MCF-7 cells. Leptin significantly inhibited the antiestrogenic effect of tamoxifen in both cells only under β-estradiol (E2) (20 nM) conditions. In MCF-7, the inhibitory effect against tamoxifen was a result from the activation of the ERK1/2 and STAT3 signal transduction pathway. Conclusion Leptin interferes with the effects of tamoxifen under E2 stimulated conditions in ER-positive breast cancer cells. These results imply that inhibition of leptin is expected to enhance the response to tamoxifen in ER-positive breast cancer cells, and, therefore, could be a promising way to overcome endocrine resistance.
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Affiliation(s)
- Cha Kyong Yom
- Department of Surgery, Seoul National University Bundang Hospital, Seoul National University College of Medicine, Seongnam, Korea
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Kim BS, Moon BI, Cha ES. A comparative study of breast-specific gamma imaging with the conventional imaging modality in breast cancer patients with dense breasts. Ann Nucl Med 2012; 26:823-9. [DOI: 10.1007/s12149-012-0649-5] [Citation(s) in RCA: 16] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/07/2012] [Accepted: 08/07/2012] [Indexed: 11/30/2022]
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Noh KT, Oh B, Sung SH, Lee RA, Chung SS, Moon BI, Kim KH. Metastasis to the breast from colonic adenocarcinoma. J Korean Surg Soc 2011; 81 Suppl 1:S43-6. [PMID: 22319737 PMCID: PMC3267064 DOI: 10.4174/jkss.2011.81.suppl1.s43] [Citation(s) in RCA: 15] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 05/06/2011] [Revised: 07/28/2011] [Accepted: 08/09/2011] [Indexed: 01/19/2023]
Abstract
A 63-year-old woman was referred to a breast surgeon with a breast mass discovered incidentally during follow-up study after colon cancer surgery. Invasive adenocarcinoma was revealed on core needle biopsy. Wide excision of the breast including the tumor was performed. On standard histological examination the tumor showed features of moderately differentiated adenocarcinoma. The immunohistochemistry study revealed positive results for cytokeratin (CK)20 and CDX2, but negative for CK7. These are typical characteristics for colon cancer. Considering her history of subtotal colectomy for sigmoid colon cancer, it is presumable that the mass in the breast was of colonic origin, and it was an extremely rare case of metastasis to the breast from primary colorectal neoplasm. Although the instance is rare, clinicians should keep the possibility of breast metastasis from colorectal cancer in mind for early and correct diagnosis.
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Affiliation(s)
- Kyoung Tae Noh
- Department of Surgery, Ewha Womans University School of Medicine, Seoul, Korea
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Kang H, Cheong H, Cho MS, Koo H, Han WS, Lee KE, Moon BI, Sung SH. Significance of Foxp3 Positive Regulatory T Cell and Tumor Infiltrating T Lymphocyte in Triple Negative Breast Cancer. Korean J Pathol 2011. [DOI: 10.4132/koreanjpathol.2011.45.1.53] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
Affiliation(s)
- Hanna Kang
- Department of Pathology, Ewha Medical Research Institute, Ewha Womans University School of Medicine, Seoul, Korea
| | - Harin Cheong
- Department of Pathology, Ewha Medical Research Institute, Ewha Womans University School of Medicine, Seoul, Korea
| | - Min Sun Cho
- Department of Pathology, Ewha Medical Research Institute, Ewha Womans University School of Medicine, Seoul, Korea
| | - Heasoo Koo
- Department of Pathology, Ewha Medical Research Institute, Ewha Womans University School of Medicine, Seoul, Korea
| | - Woon Sup Han
- Department of Pathology, Ewha Medical Research Institute, Ewha Womans University School of Medicine, Seoul, Korea
| | - Kyung Eun Lee
- Department of Internal Medicine, Ewha Medical Research Institute, Ewha Womans University School of Medicine, Seoul, Korea
| | - Byung In Moon
- Department of Surgery, Ewha Medical Research Institute, Ewha Womans University School of Medicine, Seoul, Korea
| | - Sun Hee Sung
- Department of Pathology, Ewha Medical Research Institute, Ewha Womans University School of Medicine, Seoul, Korea
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Affiliation(s)
- Sun Ah Lee
- Department of Pathology, Ewha Medical Research Institute, Ewha Womans University School of Medicine, Seoul, Korea
| | - Kyung Eun Lee
- Department of Internal Medicine, Ewha Medical Research Institute, Ewha Womans University School of Medicine, Seoul, Korea
| | - Byung In Moon
- Department of Surgery, Ewha Medical Research Institute, Ewha Womans University School of Medicine, Seoul, Korea
| | - Woon Sup Han
- Department of Pathology, Ewha Medical Research Institute, Ewha Womans University School of Medicine, Seoul, Korea
| | - Sun Hee Sung
- Department of Pathology, Ewha Medical Research Institute, Ewha Womans University School of Medicine, Seoul, Korea
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Jin JW, Yom CK, Koo MY, Moon BI, Choi KJ, Choi HY. The Role and Significance of Preoperative Breast MRI in the Setting of Breast Cancer. J Breast Cancer 2008. [DOI: 10.4048/jbc.2008.11.3.146] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022] Open
Affiliation(s)
- Jun Woo Jin
- Department of General Surgery, School of Medicine, Ewha Womans University, Seoul, Korea
| | - Cha Kyong Yom
- Department of General Surgery, Kangbuk Samsung Hospital, Seoul, Korea
| | - Min Young Koo
- Department of General Surgery, School of Medicine, Ewha Womans University, Seoul, Korea
| | - Byung In Moon
- Department of General Surgery, School of Medicine, Ewha Womans University, Seoul, Korea
| | - Kook Jin Choi
- Department of General Surgery, School of Medicine, Ewha Womans University, Seoul, Korea
| | - Hye Young Choi
- Department of Radiolology, School of Medicine, Ewha Womans University, Seoul, Korea
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Moon BI. Endoscopic Thyroidectomy. J Korean Med Assoc 2007. [DOI: 10.5124/jkma.2007.50.8.736] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/06/2022] Open
Affiliation(s)
- Byung In Moon
- Department of Surgery, Ewha Womans University College of Medicine, Korea.
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Abstract
Secretory carcinoma of the breast is a rare but histologically distinct variant of invasive ductal carcinoma that has an indolent growth pattern and a more favorable prognosis than that of typical ductal carcinoma. We present the imaging and histopathologic findings of a case of this tumor that initially manifested as a palpable mass in the left breast of a 31-year-old woman. It appeared sonographically as a round, well-circumscribed but microlobulated hypoechoic solid mass. Secretory carcinoma of the breast may resemble other well-circumscribed breast carcinomas as well as some benign masses, including fibroadenomas. Breast imagers should be aware of this rare tumor's nonspecific imaging features and clinical implications when making a differential diagnosis of solid breast masses.
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Affiliation(s)
- Mi Hye Paeng
- Department of Radiology, Mok-dong Hospital, Ewha Womans University, 911-1 Mok-dong, Yangcheon-Ku, Seoul 158-710, South Korea
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