1
|
Jeong S, Song BJ, Rhu J, Kim C, Im S, Park GY. A Risk Factor Analysis of Axillary Web Syndrome in Patients After Breast Cancer Surgery: A Single Center Study in Korea. Ann Rehabil Med 2021; 45:401-409. [PMID: 34743483 PMCID: PMC8572992 DOI: 10.5535/arm.21092] [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: 04/29/2021] [Accepted: 07/12/2021] [Indexed: 01/21/2023] Open
Abstract
OBJECTIVE To investigate the prevalence and risk factors of axillary web syndrome (AWS) in Korean patients. METHODS This retrospective study included a total of 189 women who underwent breast cancer surgery and received physical therapy between September 2019 and August 2020. We analyzed AWS and the correlation between the patients' demographics, underlying disease, type of surgery and chemotherapy or radiation therapy, and lymphedema. RESULTS The prevalence of AWS was found to be 30.6%. In the univariable analysis, age, chemotherapy, and hypertension were related to AWS. Finally, the multivariable logistic regression revealed that chemotherapy (odds ratio [OR]=2.84; 95% confidence interval [CI], 1.46-5.53) and HTN (OR=2.72; 95% CI, 1.18-6.30) were the strongest risk factors of AWS. CONCLUSION To the best of our knowledge, this was the first study that explored the risk factors of AWS in a Korean population after breast cancer surgery. As almost one-third of patients suffer from AWS after breast cancer surgery, it is essential to closely monitor the development of AWS in patients with hypertension or undergoing chemotherapy.
Collapse
Affiliation(s)
- Sangah Jeong
- Department of Rehabilitation Medicine, Bucheon St. Mary's Hospital, College of Medicine, The Catholic University of Korea, Bucheon, Korea
| | - Byung Joo Song
- Department of Surgery, Uijeongbu Eulji Medical Center, Eulji University, Uijeongbu, Korea
| | - Jiyoung Rhu
- Department of Surgery, Bucheon St. Mary's Hospital, College of Medicine, The Catholic University of Korea, Bucheon, Korea
| | - Cheolki Kim
- Department of Rehabilitation Medicine, Bucheon St. Mary's Hospital, College of Medicine, The Catholic University of Korea, Bucheon, Korea
| | - Sun Im
- Department of Rehabilitation Medicine, Bucheon St. Mary's Hospital, College of Medicine, The Catholic University of Korea, Bucheon, Korea
| | - Geun-Young Park
- Department of Rehabilitation Medicine, Bucheon St. Mary's Hospital, College of Medicine, The Catholic University of Korea, Bucheon, Korea
| |
Collapse
|
2
|
Yoo TK, Kang BJ, Kim SH, Song BJ, Ahn J, Park WC, Chae BJ. Axillary lymph node dissection is not obligatory in breast cancer patients with biopsy-proven axillary lymph node metastasis. Breast Cancer Res Treat 2020; 181:403-409. [PMID: 32328848 DOI: 10.1007/s10549-020-05636-z] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/14/2020] [Accepted: 04/08/2020] [Indexed: 01/08/2023]
Abstract
PURPOSE The ACOSOG Z0011 trial demonstrated that axillary lymph node dissection (ALND) is unnecessary in select patients with cT1-2N0 tumors undergoing breast-conserving therapy with 1-2 positive sentinel lymph nodes (SLNs). However, patients with preoperatively confirmed ALN metastasis were not included and may be subjected to unnecessary ALND. The aim of this study is to identify patients who can be considered for ALND omission when the preoperative ALN biopsy results are positive. METHODS Breast cancer patients who underwent preoperative ALN biopsy and primary surgery were retrospectively reviewed. Among patients with positive ALN biopsy results, clinicopathological and imaging characteristics were compared according to LN disease burden (1-2 positive LNs vs. ≥ 3 positive LNs). RESULTS A total of 542 patients were included in the analysis. Among them, 225 (41.5%) patients had a preoperative positive ALN biopsy. More than 40% of the patients (n = 99, 44.0%) with a positive biopsy had only 1-2 positive ALNs. The association between nodal burden and imaging factors was strongest when ≥ 2 suspicious LNs were identified on PET/CT images (HR 8.795, 95% CI 4.756 to 13.262). More than one imaging modality showing ≥ 2 suspicious LNs was also strongly correlated with ≥ 3 positive ALNs (HR 5.148, 95% CI 2.881 to 9.200). CONCLUSIONS Nearly half of patients with a preoperative biopsy-proven ALN metastasis had only 1-2 positive LNs on ALND. Patients meeting ACOSOG Z0011 criteria with only one suspicious LN on PET/CT or those presenting with few abnormal ALNs on only one imaging modality appear appropriate for SLNB and consideration of ALND omission.
Collapse
MESH Headings
- Axilla
- Breast Neoplasms/diagnostic imaging
- Breast Neoplasms/pathology
- Breast Neoplasms/surgery
- Carcinoma, Ductal, Breast/diagnostic imaging
- Carcinoma, Ductal, Breast/secondary
- Carcinoma, Ductal, Breast/surgery
- Carcinoma, Lobular/diagnostic imaging
- Carcinoma, Lobular/secondary
- Carcinoma, Lobular/surgery
- Female
- Follow-Up Studies
- Humans
- Lymph Node Excision
- Lymph Nodes/pathology
- Lymph Nodes/surgery
- Lymphatic Metastasis
- Mastectomy, Segmental/methods
- Middle Aged
- Positron Emission Tomography Computed Tomography
- Prognosis
- Receptor, ErbB-2/metabolism
- Receptors, Estrogen/metabolism
- Receptors, Progesterone/metabolism
- Retrospective Studies
- Sentinel Lymph Node Biopsy/methods
Collapse
Affiliation(s)
- Tae-Kyung Yoo
- Department of Surgery, Seoul St. Mary's Hospital, College of Medicine, The Catholic University of Korea, 222 Banpo-daero, Seocho-gu, Seoul, 06591, Republic of Korea
- Cancer Research Institute, College of Medicine, The Catholic University of Korea, 222 Banpo-daero, Seocho-gu, Seoul, 06591, Republic of Korea
| | - Bong Joo Kang
- Department of Radiology, Seoul St. Mary's Hospital, College of Medicine, The Catholic University of Korea, 222 Banpo-daero, Seocho-gu, Seoul, 06591, Republic of Korea
| | - Sung Hun Kim
- Department of Radiology, Seoul St. Mary's Hospital, College of Medicine, The Catholic University of Korea, 222 Banpo-daero, Seocho-gu, Seoul, 06591, Republic of Korea
| | - Byung Joo Song
- Division of Breast-Thyroid Surgery, Department of Surgery, Bucheon St. Mary's Hospital, College of Medicine, The Catholic University of Korea, 327 Sosa-ro, Wonmi-gu, Gyeonggi-do, 14647, Republic of Korea
| | - Juneyoung Ahn
- Department of Surgery, Seoul St. Mary's Hospital, College of Medicine, The Catholic University of Korea, 222 Banpo-daero, Seocho-gu, Seoul, 06591, Republic of Korea
| | - Woo-Chan Park
- Department of Surgery, Seoul St. Mary's Hospital, College of Medicine, The Catholic University of Korea, 222 Banpo-daero, Seocho-gu, Seoul, 06591, Republic of Korea
| | - Byung Joo Chae
- Department of Surgery, Samsung Medical Center, Sungkyunkwan University, 81 Irwon-Ro, Gangnam-Gu, Seoul, 06351, Republic of Korea.
| |
Collapse
|
3
|
Rhu J, Jun KW, Song BJ, Sung K, Cho J. Cephalic vein approach for the implantable central venous access: A retrospective review of the single institution's experiences; Cohort Study. Medicine (Baltimore) 2019; 98:e18007. [PMID: 31725671 PMCID: PMC6867776 DOI: 10.1097/md.0000000000018007] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/26/2022] Open
Abstract
Long-term venous access is usually required in patients receiving chemotherapy. We hypothesized that, out of the various central line approach techniques, the cephalic vein cut-down technique can be a safe and simple alternative in terms of surgical safety, feasibility, cost-effectiveness, and functional outcomes.We retrospectively reviewed the medical records of 569 patients who underwent implantable central venous access between January 2012 and December 2014 at our hospital.We classified our cohort according to access routes, as follows: 230 patients underwent subclavian vein access, 134 patients underwent internal jugular vein access, 25 patients underwent external jugular vein access, and 119 patients underwent cephalic vein access. The cephalic vein group had a significantly longer operation time than the subclavian group (P < .01); however, there was no difference in operation time between the internal jugular vein and cephalic vein groups (P = .59). The procedure-related complications and functional outcomes of the implanted venous port during chemotherapy were comparable between the cephalic group and other groups. Additionally, body mass index, operation time, and age did not correlate with catheter dysfunction in the multivariate logistic regression analysis (P = .53; P = .66; P = .19, respectively).We suggest that a cut-down central venous catheter insertion through the cephalic vein can be performed easily and safely with no differences in surgical and clinical outcomes compared to those of conventional percutaneous approaches. Moreover, the cephalic vein approach requires no specialized equipment, including percutaneous vascular kits, tunneling instruments, and intraoperative ultrasonography. Therefore, this technique might incur less medical expenses than conventional approaches and would be helpful for both patients and surgeons.
Collapse
|
4
|
Yoo TK, Chae BJ, Ahn JY, Ryu J, Eom YH, Park WC, Song BJ. Abstract P3-03-28: Withdrawn. Cancer Res 2019. [DOI: 10.1158/1538-7445.sabcs18-p3-03-28] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
Abstract
This abstract was withdrawn by the authors.
Citation Format: Yoo T-K, Chae BJ, Ahn JY, Ryu J, Eom YH, Park WC, Song BJ. Withdrawn [abstract]. In: Proceedings of the 2018 San Antonio Breast Cancer Symposium; 2018 Dec 4-8; San Antonio, TX. Philadelphia (PA): AACR; Cancer Res 2019;79(4 Suppl):Abstract nr P3-03-28.
Collapse
Affiliation(s)
- T-K Yoo
- Seoul St. Mary's Hospital, Catholic University of Korea, Seoul, Republic of Korea; Incheon St. Mary's Hospital, Catholic University of Korea, Incheon, Republic of Korea; Bucheon St. Mary's Hospital, Catholic University of Korea, Bucheon, Republic of Korea
| | - BJ Chae
- Seoul St. Mary's Hospital, Catholic University of Korea, Seoul, Republic of Korea; Incheon St. Mary's Hospital, Catholic University of Korea, Incheon, Republic of Korea; Bucheon St. Mary's Hospital, Catholic University of Korea, Bucheon, Republic of Korea
| | - JY Ahn
- Seoul St. Mary's Hospital, Catholic University of Korea, Seoul, Republic of Korea; Incheon St. Mary's Hospital, Catholic University of Korea, Incheon, Republic of Korea; Bucheon St. Mary's Hospital, Catholic University of Korea, Bucheon, Republic of Korea
| | - J Ryu
- Seoul St. Mary's Hospital, Catholic University of Korea, Seoul, Republic of Korea; Incheon St. Mary's Hospital, Catholic University of Korea, Incheon, Republic of Korea; Bucheon St. Mary's Hospital, Catholic University of Korea, Bucheon, Republic of Korea
| | - YH Eom
- Seoul St. Mary's Hospital, Catholic University of Korea, Seoul, Republic of Korea; Incheon St. Mary's Hospital, Catholic University of Korea, Incheon, Republic of Korea; Bucheon St. Mary's Hospital, Catholic University of Korea, Bucheon, Republic of Korea
| | - WC Park
- Seoul St. Mary's Hospital, Catholic University of Korea, Seoul, Republic of Korea; Incheon St. Mary's Hospital, Catholic University of Korea, Incheon, Republic of Korea; Bucheon St. Mary's Hospital, Catholic University of Korea, Bucheon, Republic of Korea
| | - BJ Song
- Seoul St. Mary's Hospital, Catholic University of Korea, Seoul, Republic of Korea; Incheon St. Mary's Hospital, Catholic University of Korea, Incheon, Republic of Korea; Bucheon St. Mary's Hospital, Catholic University of Korea, Bucheon, Republic of Korea
| |
Collapse
|
5
|
Im S, Chae BJ, Kim SH, Kang BJ, Song BJ, Lee A. Primary angiosarcoma of the breast: a case report. Int J Clin Exp Pathol 2019; 12:664-668. [PMID: 31933872 PMCID: PMC6945096] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Subscribe] [Scholar Register] [Received: 09/06/2018] [Accepted: 09/27/2018] [Indexed: 06/10/2023]
Abstract
BACKGROUND Primary angiosarcoma of the breast is extremely rare, accounting for less than 0.05% of all primary malignancies of the breast. Here, we report here a case of primary angiosarcoma with full description of radiology and histology, including electron microscopic findings. CASE PRESENTATION A 39-year-old woman complained of a diffuse hard mass in her right breast. She did not have any history of radiation exposure. Ultrasonography revealed a 7 cm sized mass with an irregular anechoic cystic portion replacing the entire right breast. Modified radical mastectomy was performed. The diagnosis of intermediate grade angiosarcoma was made by microscopic examination, immunohistochemical staining, and electron microscopic examination. The patient underwent four cycles of adriamycin-ifosfamide chemotherapy and received radiation therapy. Multiple bone metastases occurred 9 months after surgery and palliative treatment was given. Follow up was lost at post-operative 22 months. CONCLUSIONS We report a rare case of intermediate grade primary angiosarcoma with detailed radiological and histological findings. Despite postoperative chemoradiation therapy, multiple metastases suggest that intermediate grade may have a more aggressive behavior.
Collapse
Affiliation(s)
- Soyoung Im
- Department of Pathology, St. Vincent’s Hospital, The Catholic University of Korea, College of MedicineSuwon, Republic of Korea
| | - Byung Joo Chae
- Department of Surgery, Seoul St. Mary’s Hospital, The Catholic University of Korea, College of MedicineSeoul, Republic of Korea
| | - Sung Hun Kim
- Department of Radiology, Seoul St. Mary’s Hospital, The Catholic University of Korea, College of MedicineSeoul, Republic of Korea
| | - Bong-Joo Kang
- Department of Radiology, Seoul St. Mary’s Hospital, The Catholic University of Korea, College of MedicineSeoul, Republic of Korea
| | - Byung Joo Song
- Department of Surgery, Bucheon St. Mary’s Hospital, The Catholic University of Korea, College of MedicineBucheon, Republic of Korea
| | - Ahwon Lee
- Department of Hospital Pathology, Seoul St. Mary’s Hospital, The Catholic University of Korea, College of MedicineSeoul, Republic of Korea
| |
Collapse
|
6
|
Lee HL, Bae SH, Jang B, Hwang S, Yang H, Nam HC, Sung PS, Lee SW, Jang JW, Choi JY, Han NI, Song BJ, Lee JW, Yoon SK. Reactivation of Hepatitis C Virus and Its Clinical Outcomes in Patients Treated with Systemic Chemotherapy or Immunosuppressive Therapy. Gut Liver 2018; 11:870-877. [PMID: 28750484 PMCID: PMC5669604 DOI: 10.5009/gnl16434] [Citation(s) in RCA: 21] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/01/2016] [Revised: 01/14/2017] [Accepted: 02/26/2017] [Indexed: 12/11/2022] Open
Abstract
Background/Aims According to the results of several studies, the outcome of hepatitis C virus (HCV) reactivation is not as severe as the outcome of hepatitis B virus reactivation. The aim of this study was to evaluate the effect of pharmacological immunosuppression on HCV reactivation. Methods The medical records of patients who underwent systemic chemotherapy, corticosteroid therapy, or other immunosuppressive therapies between January 2008 and March 2015 were reviewed. Subsequently, 202 patients who were seropositive for the anti-HCV antibody were enrolled. Exclusion criteria were: unavailability of data on HCV RNA levels, a history of treatment for chronic hepatitis C, and the presence of liver diseases other than a chronic HCV infection. Results Among the 120 patients enrolled in this study, hepatitis was present in 46 patients (38%). None of the patients were diagnosed with severe hepatitis. Enhanced replication of HCV was noted in nine (27%) of the 33 patients who had data available on both basal and follow-up HCV RNA loads. Reappearance of the HCV RNA from an undetectable state did not occur after treatment. The cumulative rate of enhanced HCV replication was 23% at 1 year and 30% at 2 years. Conclusions Although enhanced HCV replication is relatively common in HCV-infected patients treated with chemotherapy or immunosuppressive therapy, it does not lead to serious sequelae.
Collapse
Affiliation(s)
- Hae Lim Lee
- Division of Hepatology, Department of Internal Medicine, Bucheon St. Mary's Hospital, The Catholic University of Korea College of Medicine, Bucheon, Korea
| | - Si Hyun Bae
- Division of Hepatology, Seoul St. Mary's Hospital, The Catholic University of Korea College of Medicine, Seoul, Korea
| | - Bohyun Jang
- Department of Internal Medicine, Seoul St. Mary's Hospital, The Catholic University of Korea College of Medicine, Seoul, Korea
| | - Seawon Hwang
- Division of Hepatology, Seoul St. Mary's Hospital, The Catholic University of Korea College of Medicine, Seoul, Korea
| | - Hyun Yang
- Department of Internal Medicine, Seoul St. Mary's Hospital, The Catholic University of Korea College of Medicine, Seoul, Korea
| | - Hee Chul Nam
- Department of Internal Medicine, Seoul St. Mary's Hospital, The Catholic University of Korea College of Medicine, Seoul, Korea
| | - Pil Soo Sung
- Division of Hepatology, Seoul St. Mary's Hospital, The Catholic University of Korea College of Medicine, Seoul, Korea
| | - Sung Won Lee
- Division of Hepatology, Department of Internal Medicine, Bucheon St. Mary's Hospital, The Catholic University of Korea College of Medicine, Bucheon, Korea
| | - Jeong Won Jang
- Division of Hepatology, Seoul St. Mary's Hospital, The Catholic University of Korea College of Medicine, Seoul, Korea
| | - Jong Young Choi
- Division of Hepatology, Seoul St. Mary's Hospital, The Catholic University of Korea College of Medicine, Seoul, Korea
| | - Nam Ik Han
- Division of Hepatology, Department of Internal Medicine, Bucheon St. Mary's Hospital, The Catholic University of Korea College of Medicine, Bucheon, Korea
| | - Byung Joo Song
- Department of Surgery, Seoul St. Mary's Hospital, The Catholic University of Korea College of Medicine, Seoul, Korea
| | - Jong Wook Lee
- Division of Hematology, Department of Internal Medicine, Seoul St. Mary's Hospital, The Catholic University of Korea College of Medicine, Seoul, Korea
| | - Seung Kew Yoon
- Division of Hepatology, Seoul St. Mary's Hospital, The Catholic University of Korea College of Medicine, Seoul, Korea
| |
Collapse
|
7
|
Kim Y, Kim SH, Song BJ, Kang BJ, Yim KI, Lee A, Nam Y. Early Prediction of Response to Neoadjuvant Chemotherapy Using Dynamic Contrast-Enhanced MRI and Ultrasound in Breast Cancer. Korean J Radiol 2018; 19:682-691. [PMID: 29962874 PMCID: PMC6005946 DOI: 10.3348/kjr.2018.19.4.682] [Citation(s) in RCA: 39] [Impact Index Per Article: 6.5] [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: 09/29/2017] [Accepted: 01/15/2018] [Indexed: 01/25/2023] Open
Abstract
Objective To determine the diagnostic performance of dynamic contrast-enhanced magnetic resonance imaging (DCE-MRI) and DCE ultrasound (DCE-US) for predicting response to neoadjuvant chemotherapy (NAC) in breast cancer patients. Materials and Methods This Institutional Review Board-approved prospective study was performed between 2014 and 2016. Thirty-nine women with breast cancer underwent DCE-US and DCE-MRI before the NAC, follow-up DCE-US after the first cycle of NAC, and follow-up DCE-MRI after the second cycle of NAC. DCE-MRI parameters (transfer constant [Ktrans], reverse constant [kep], and leakage space [Ve]) were assessed with histograms. From DCE-US, peak-enhancement, the area under the curve, wash-in rate, wash-out rate, time to peak, and rise time (RT) were obtained. After surgery, all the imaging parameters and their changes were compared with histopathologic response using the Miller-Payne Grading (MPG) system. Data from minor and good responders were compared using Wilcoxon rank sum test, chi-square test, or Fisher's exact test. Receiver operating characteristic curve analysis was used for assessing diagnostic performance to predict good response. Results Twelve patients (30.8%) showed a good response (MPG 4 or 5) and 27 (69.2%) showed a minor response (MPG 1–3). The mean, 25th, 50th, and 75th percentiles of Ktrans and Kep of post-NAC DCE-MRI differed between the two groups. These parameters showed fair to good diagnostic performance for the prediction of response to NAC (AUC 0.76–0.81, p ≤ 0.007). Among DCE-US parameters, the percentage change in RT showed fair prediction (AUC 0.71, p = 0.023). Conclusion Quantitative analysis of DCE-MRI and DCE-US was helpful for early prediction of response to NAC.
Collapse
Affiliation(s)
- Yunju Kim
- Department of Radiology, National Cancer Center, Goyang 10408, Korea
| | - Sung Hun Kim
- Department of Radiology, College of Medicine, Seoul St. Mary's Hospital, The Catholic University of Korea, Seoul 06591, Korea
| | - Byung Joo Song
- Department of Surgery, College of Medicine, Bucheon St. Mary's Hospital, The Catholic University of Korea, Bucheon 14647, Korea
| | - Bong Joo Kang
- Department of Radiology, College of Medicine, Seoul St. Mary's Hospital, The Catholic University of Korea, Seoul 06591, Korea
| | - Kwang-Il Yim
- Department of Pathology, College of Medicine, Seoul St. Mary's Hospital, The Catholic University of Korea, Seoul 06591, Korea
| | - Ahwon Lee
- Department of Pathology, College of Medicine, Seoul St. Mary's Hospital, The Catholic University of Korea, Seoul 06591, Korea
| | - Yoonho Nam
- Department of Radiology, College of Medicine, Seoul St. Mary's Hospital, The Catholic University of Korea, Seoul 06591, Korea
| |
Collapse
|
8
|
Kim Y, Kim SH, Lee HW, Song BJ, Kang BJ, Lee A, Nam Y. Intravoxel incoherent motion diffusion-weighted MRI for predicting response to neoadjuvant chemotherapy in breast cancer. Magn Reson Imaging 2018; 48:27-33. [DOI: 10.1016/j.mri.2017.12.018] [Citation(s) in RCA: 31] [Impact Index Per Article: 5.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/06/2017] [Revised: 12/14/2017] [Accepted: 12/21/2017] [Indexed: 01/16/2023]
|
9
|
Seo HS, Eom YH, Kim MK, Kim YM, Song BJ, Song KY. A one-day surgical-skill training course for medical students' improved surgical skills and increased interest in surgery as a career. BMC Med Educ 2017; 17:265. [PMID: 29282043 PMCID: PMC5745757 DOI: 10.1186/s12909-017-1106-x] [Citation(s) in RCA: 27] [Impact Index Per Article: 3.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 01/31/2017] [Accepted: 12/14/2017] [Indexed: 05/02/2023]
Abstract
BACKGROUND Despite many high-quality programs in basic surgical-skill education, the surgical skill of junior doctors varies widely. This, together with the waning interest in surgery as a career among medical students, is a serious issue confronted by hospitals and healthcare systems worldwide. We, therefore, developed and implemented an intensive one-day surgical-skill training course for two purposes; it would improve surgical skills and increase interest in surgery among medical students. METHODS The surgical-skill training program is named Surgical Skill Weekend (SSW) and it includes hands-on training sessions for surgical-suturing techniques and advanced surgical procedures (i.e. laparoscopic and robot-assisted surgery), hybrid simulation sessions, and an operating-room session where aforementioned sessions are all put together. By the end of the program, students' improvements in surgical-suturing skills were assessed by experts in a form of checklist, and changes in the interest in a surgical career, if there were any, were answered by the students who participated in the program. RESULTS A total of ninety-one (91) medical students participated in the 2015 and 2016 SSW courses. Their overall satisfaction level with the course was very high (Very satisfied: 78%, Quite satisfied: 22%). All of the participant's surgical-suturing skills significantly improved (median score range: 14-20, P < 0.05) and their interest in a surgical career increased significantly (from 56% to 81%, P < 0.05) by completing the program. CONCLUSIONS An intensive and comprehensive surgical-skill training program for medical students can not only improve surgical-suturing skills but also increase interest in surgery as a career.
Collapse
Affiliation(s)
- Ho Seok Seo
- Department of Surgery, Seoul St. Mary’s Hospital, College of Medicine, The Catholic University of Korea, 222 Banpo-daero, Seocho-gu, Seoul, South Korea
| | - Yong Hwa Eom
- Department of Surgery, Seoul St. Mary’s Hospital, College of Medicine, The Catholic University of Korea, 222 Banpo-daero, Seocho-gu, Seoul, South Korea
| | - Min Ki Kim
- Department of Surgery, Seoul St. Mary’s Hospital, College of Medicine, The Catholic University of Korea, 222 Banpo-daero, Seocho-gu, Seoul, South Korea
| | - Young-Min Kim
- Department of Emergency Medicine, College of Medicine, Seoul St. Mary’s Hospital, The Catholic University of Korea, 222 Banpo-daero, Seocho-gu, Seoul, South Korea
- START Center for Medical Simulation, College of Medicine, The Catholic University of Korea, Songeui-building, 222 Banpo-daero, Seocho-gu, Seoul, South Korea
| | - Byung Joo Song
- Department of Surgery, Seoul St. Mary’s Hospital, College of Medicine, The Catholic University of Korea, 222 Banpo-daero, Seocho-gu, Seoul, South Korea
| | - Kyo Young Song
- Department of Surgery, Seoul St. Mary’s Hospital, College of Medicine, The Catholic University of Korea, 222 Banpo-daero, Seocho-gu, Seoul, South Korea
| |
Collapse
|
10
|
Kim HS, Shin MS, Kim CJ, Yoo SH, Yoo TK, Eom YH, Chae BJ, Song BJ. Improved Model for Predicting Axillary Response to Neoadjuvant Chemotherapy in Patients with Clinically Node-Positive Breast Cancer. J Breast Cancer 2017; 20:378-385. [PMID: 29285043 PMCID: PMC5743998 DOI: 10.4048/jbc.2017.20.4.378] [Citation(s) in RCA: 16] [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] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/07/2017] [Accepted: 10/02/2017] [Indexed: 02/06/2023] Open
Abstract
Purpose Pathological complete response (pCR) of axillary lymph node (LN) is frequently achieved in patients with clinically node-positive breast cancer after neoadjuvant chemotherapy (NAC). Treatment of the axilla after NAC is not well established and the value of sentinel LN biopsy following NAC remains unclear. This study investigated the predictive value of axillary response following NAC and evaluated the predictive value of a model based on axillary response. Methods Data prospectively collected on 201 patients with clinically node-positive breast cancer who were treated with NAC and underwent axillary LN dissection (ALND) were retrieved. A model predictive of axillary pCR was developed based on clinicopathologic variables. The overall predictive ability between models was compared by receiver operating characteristic (ROC) curve analysis. Results Of 201 patients who underwent ALND after NAC, 68 (33.8%) achieved axillary pCR. Multivariate analysis using axillary LN pCR after NAC as the dependent variable showed that higher histologic grade (p=0.031; odds ratio [OR], 2.537; 95% confidence interval [CI], 1.087–5.925) and tumor response rate ≥47.1% (p=0.001; OR, 3.212; 95% CI, 1.584–6.515) were significantly associated with an increased probability of achieving axillary pCR. The area under the ROC curve for estimating axillary pCR was significantly higher in the model that included tumor response rate than in the model that excluded this rate (0.732 vs. 0.649, p=0.022). Conclusion Tumor response rate was the most significant independent predictor of axillary pCR in response to NAC. The model that included tumor response rate was a significantly better predictor of axillary pCR than the model that excluded tumor response rate.
Collapse
Affiliation(s)
- Hyung Suk Kim
- Division of Breast Surgery, Department of Surgery, Seoul St. Mary's Hospital, College of Medicine, The Catholic University of Korea, Seoul, Korea
| | - Man Sik Shin
- Division of Breast Surgery, Department of Surgery, Seoul St. Mary's Hospital, College of Medicine, The Catholic University of Korea, Seoul, Korea
| | - Chang Jong Kim
- Division of Breast Surgery, Department of Surgery, Seoul St. Mary's Hospital, College of Medicine, The Catholic University of Korea, Seoul, Korea
| | - Sun Hyung Yoo
- Division of Breast Surgery, Department of Surgery, Seoul St. Mary's Hospital, College of Medicine, The Catholic University of Korea, Seoul, Korea
| | - Tae Kyung Yoo
- Division of Breast Surgery, Department of Surgery, Seoul St. Mary's Hospital, College of Medicine, The Catholic University of Korea, Seoul, Korea
| | - Yong Hwa Eom
- Division of Breast Surgery, Department of Surgery, Seoul St. Mary's Hospital, College of Medicine, The Catholic University of Korea, Seoul, Korea
| | - Byung Joo Chae
- Division of Breast Surgery, Department of Surgery, Seoul St. Mary's Hospital, College of Medicine, The Catholic University of Korea, Seoul, Korea
| | - Byung Joo Song
- Division of Breast Surgery, Department of Surgery, Bucheon St. Mary's Hospital, College of Medicine, The Catholic University of Korea, Bucheon, Korea
| |
Collapse
|
11
|
Cho N, Han W, Han BK, Bae MS, Ko ES, Nam SJ, Chae EY, Lee JW, Kim SH, Kang BJ, Song BJ, Kim EK, Moon HJ, Kim SI, Kim SM, Kang E, Choi Y, Kim HH, Moon WK. Breast Cancer Screening With Mammography Plus Ultrasonography or Magnetic Resonance Imaging in Women 50 Years or Younger at Diagnosis and Treated With Breast Conservation Therapy. JAMA Oncol 2017; 3:1495-1502. [PMID: 28655029 DOI: 10.1001/jamaoncol.2017.1256] [Citation(s) in RCA: 87] [Impact Index Per Article: 12.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/31/2023]
Abstract
Importance Younger women (aged ≤50 years) who underwent breast conservation therapy may benefit from breast magnetic resonance imaging (MRI) screening as an adjunct to mammography. Objective To prospectively determine the cancer yield and tumor characteristics of combined mammography with MRI or ultrasonography screening in women who underwent breast conservation therapy for breast cancers and who were 50 years or younger at initial diagnosis. Design, Setting, and Participants This multicenter, prospective, nonrandomized study was conducted from December 1, 2010, to January 31, 2016, at 6 academic institutions. Seven hundred fifty-four women who were 50 years or younger at initial diagnosis and who had undergone breast conservation therapy for breast cancer were recruited to participate in the study. Reference standard was defined as a combination of pathology and 12-month follow-up. Interventions Participants underwent 3 annual MRI screenings of the conserved and contralateral breasts in addition to mammography and ultrasonography, with independent readings. Main Outcomes and Measures Cancer detection rate, sensitivity, specificity, interval cancer rate, and characteristics of detected cancers. Results A total of 754 women underwent 2065 mammograms, ultrasonography, and MRI screenings. Seventeen cancers were diagnosed, and most of the detected cancers (13 of 17 [76%]) were stage 0 or stage 1. Overall cancer detection rate (8.2 vs 4.4 per 1000; P = .003) or sensitivity (100% vs 53%; P = .01) of mammography with MRI was higher than that of mammography alone. After the addition of ultrasonography, the cancer detection rate was higher than that by mammography alone (6.8 vs 4.4 per 1000; P = .03). The specificity of mammography with MRI or ultrasonography was lower than that by mammography alone (87% or 88% vs 96%; P < .001). No interval cancer was found. Conclusions and Relevance After breast conservation therapy in women 50 years or younger, the addition of MRI to annual mammography screening improves detection of early-stage but biologically aggressive breast cancers at acceptable specificity. Results from this study can inform patient decision making on screening methods after breast conservation therapy.
Collapse
Affiliation(s)
- Nariya Cho
- Department of Radiology, Seoul National University Hospital, Seoul National University College of Medicine, Seoul, Republic of Korea
| | - Wonshik Han
- Department of Surgery, Seoul National University Hospital, Seoul National University College of Medicine, Seoul, Republic of Korea
| | - Boo-Kyung Han
- Department of Radiology, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Republic of Korea
| | - Min Sun Bae
- Department of Radiology, Seoul National University Hospital, Seoul National University College of Medicine, Seoul, Republic of Korea
| | - Eun Sook Ko
- Department of Radiology, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Republic of Korea
| | - Seok Jin Nam
- Department of Surgery, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Republic of Korea
| | - Eun Young Chae
- Research Institute of Radiology, Department of Radiology, Asan Medical Center, University of Ulsan College of Medicine, Seoul, Republic of Korea
| | - Jong Won Lee
- Division of Breast and Endocrine Surgery, Department of Surgery, Asan Medical Center, University of Ulsan College of Medicine, Seoul, Republic of Korea
| | - Sung Hun Kim
- Department of Radiology, College of Medicine, Seoul St Mary's Hospital, The Catholic University of Korea, Seoul, Republic of Korea
| | - Bong Joo Kang
- Department of Radiology, College of Medicine, Seoul St Mary's Hospital, The Catholic University of Korea, Seoul, Republic of Korea
| | - Byung Joo Song
- Department of General Surgery, College of Medicine, Seoul St Mary's Hospital, The Catholic University of Korea, Seoul, Republic of Korea
| | - Eun-Kyung Kim
- Department of Radiology, Severance Hospital, Yonsei University College of Medicine, Seoul, Republic of Korea
| | - Hee Jung Moon
- Department of Radiology, Severance Hospital, Yonsei University College of Medicine, Seoul, Republic of Korea
| | - Seung Il Kim
- Department of Surgery, Severance Hospital, Yonsei University College of Medicine, Seoul, Republic of Korea
| | - Sun Mi Kim
- Department of Radiology, Seoul National University Bundang Hospital, Seoul National University College of Medicine, Bundang, Republic of Korea
| | - Eunyoung Kang
- Department of Surgery, Seoul National University Bundang Hospital, Bundang, Republic of Korea
| | - Yunhee Choi
- Medical Research Collaborating Center, Seoul National University Hospital, Seoul, Republic of Korea
| | - Hak Hee Kim
- Research Institute of Radiology, Department of Radiology, Asan Medical Center, University of Ulsan College of Medicine, Seoul, Republic of Korea
| | - Woo Kyung Moon
- Department of Radiology, Seoul National University Hospital, Seoul National University College of Medicine, Seoul, Republic of Korea
| |
Collapse
|
12
|
Henderson LE, Abdelmegeed MA, Yoo SH, Rhee SG, Zhu X, Smith MA, Nguyen RQ, Perry G, Song BJ. Enhanced Phosphorylation of Bax and Its Translocation into Mitochondria in the Brains of Individuals Affiliated with Alzheimer's Disease. Open Neurol J 2017; 11:48-58. [PMID: 29290835 PMCID: PMC5738752 DOI: 10.2174/1874205x01711010048] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.4] [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: 07/11/2017] [Revised: 09/05/2017] [Accepted: 10/10/2017] [Indexed: 12/22/2022] Open
Abstract
Background: Despite increased neuronal death, senile plaques, and neurofibrillary tangles observed in patients suffering from Alzheimer’s disease (AD), the detailed mechanism of cell death in AD is still poorly understood. Method: We hypothesized that p38 kinase activates and then phosphorylates Bax, leading to its translocation to mitochondria in AD brains compared to controls. The aim of this study was to investigate the role of p38 kinase in phosphorylation and sub-cellular localization of pro-apoptotic Bax in the frontal cortex of the brains from AD and control subjects. Increased oxidative stress in AD individuals compared to control was evaluated by measuring the levels of carbonylated proteins and oxidized peroxiredoxin, an antioxidant enzyme. The relative amounts of p38 kinase and phospho-Bax in mitochondria in AD brains and controls were determined by immunoblot analysis using the respective antibody against each protein following immunoprecipitation. Results: Our results showed that the levels of oxidized peroxiredoxin-SO3 and carbonylated proteins are significantly elevated in AD brains compared to controls, demonstrating the increased oxidative stress. Conclusion: The amount of phospho-p38 kinase is increased in AD brains and the activated p38 kinase appears to phosphorylate Thr residue(s) of Bax, which leads to its mitochondrial translocation, contributing to apoptosis and ultimately, neurodegeneration.
Collapse
Affiliation(s)
- L E Henderson
- Laboratory of Membrane Biochemistry and Biophysics, National Institute on Alcohol Abuse and Alcoholism, Bethesda, Maryland 20892-9410, USA
| | - M A Abdelmegeed
- Laboratory of Membrane Biochemistry and Biophysics, National Institute on Alcohol Abuse and Alcoholism, Bethesda, Maryland 20892-9410, USA
| | - S H Yoo
- Laboratory of Membrane Biochemistry and Biophysics, National Institute on Alcohol Abuse and Alcoholism, Bethesda, Maryland 20892-9410, USA
| | - S G Rhee
- Division of Life and Pharmaceutical Sciences, Ewha Womans University, Seoul, Korea
| | - X Zhu
- Department of Pathology, Case Western Reserve University, Cleveland, Ohio 44106, USA
| | - M A Smith
- Department of Pathology, Case Western Reserve University, Cleveland, Ohio 44106, USA
| | - R Q Nguyen
- Department of Biology, College of Sciences, University of Texas at San Antonio, San Antonio, TX, USA
| | - G Perry
- Department of Biology, College of Sciences, University of Texas at San Antonio, San Antonio, TX, USA
| | - B J Song
- Laboratory of Membrane Biochemistry and Biophysics, National Institute on Alcohol Abuse and Alcoholism, Bethesda, Maryland 20892-9410, USA
| |
Collapse
|
13
|
Kim HS, Shin MS, Kim CJ, You SH, Eom YH, Yoo TK, Lee A, Song BJ, Chae BJ. Sparganosis of the Unilateral Breast: A Case Report. Korean J Parasitol 2017; 55:421-424. [PMID: 28877574 PMCID: PMC5594728 DOI: 10.3347/kjp.2017.55.4.421] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [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: 12/24/2016] [Revised: 06/06/2017] [Accepted: 06/15/2017] [Indexed: 11/23/2022]
Abstract
Sparganosis is a parasitic infection caused by the sparganum, the plercercoid of the genus Spirometra. The preoperative diagnosis of breast sparganosis is difficult in most cases because it is a rare parasitic infection less than 2% of all cases. We report a 62-year-old woman case of breast sparganosis that were confirmed by surgical removal of worms from the right breast. The radiologic images of the patient also revealed characteristic features of breast sparganosis. The patient described the migrating palpable breast mass, which strongly suggested the possibility of breast sparganosis. The treatment of choice and confirmative diagnosis for sparganosis are complete surgical extraction of the sparganum irrespective of infected site. Inspection of the mass site with detailed medical history and radiological examinations are important for preoperative diagnosis of sparganosis patients.
Collapse
Affiliation(s)
- Hyung Suk Kim
- Department of Surgery, Seoul St. Mary's Hospital, Catholic University of Korea College of Medicine, Seoul 06591, Korea
| | - Man Sik Shin
- Department of Surgery, Seoul St. Mary's Hospital, Catholic University of Korea College of Medicine, Seoul 06591, Korea
| | - Chang Jong Kim
- Department of Surgery, Seoul St. Mary's Hospital, Catholic University of Korea College of Medicine, Seoul 06591, Korea
| | - Sun Hyung You
- Department of Surgery, Seoul St. Mary's Hospital, Catholic University of Korea College of Medicine, Seoul 06591, Korea
| | - Yong Hwa Eom
- Department of Surgery, Seoul St. Mary's Hospital, Catholic University of Korea College of Medicine, Seoul 06591, Korea
| | - Tae Kyung Yoo
- Department of Surgery, Seoul St. Mary's Hospital, Catholic University of Korea College of Medicine, Seoul 06591, Korea
| | - Ahwon Lee
- Department of Hospital Pathology, Seoul St. Mary's Hospital, Catholic University of Korea College of Medicine, Seoul 06591, Korea
| | - Byung Joo Song
- Department of Surgery, Seoul St. Mary's Hospital, Catholic University of Korea College of Medicine, Seoul 06591, Korea
| | - Byung Joo Chae
- Department of Surgery, Seoul St. Mary's Hospital, Catholic University of Korea College of Medicine, Seoul 06591, Korea
| |
Collapse
|
14
|
Hwang KT, Kim J, Kim EK, Jung SH, Sohn G, Kim SI, Jeong J, Lee HJ, Park JH, Oh S, Ahn SH, Noh DY, Nam SJ, Lee ES, Park BW, Noh WC, Yoon JH, Lee SJ, Lee EK, Jeong J, Han S, Park HY, Paik NS, Bae YT, Lee HJ, Park HK, Ko SS, Song BJ, Suh YJ, Jung SH, Cho SH, Kim SJ, Oh SJ, Ko BK, Kim KS, Park C, Baek JM, Hwang KT, Chang IS, Bae JW, Kim JS, Kang SH, Gwak G, Lee JH, Kim TH, Chang M, Kim SY, Lee JS, Song JY, Park HL, Min SY, Yang JH, Park SH, Park WC, Kim LS, Ryu DW, Kim KC, Chung MS, Park HB, Lim CW, Choi UJ, Kwak BS, Park YS, Shin HJ, Choi YJ, Kim D, Han A, Koh JH, Choi S, Yoon D, Choi SY, Chul SH, Kim JI, Choi JH, Ryu JW, Ko CD, Lee IK, Lee DS, Choi S, Min YK, Jeon YS, Park EH. Poor Prognosis of Lower Inner Quadrant in Lymph Node–negative Breast Cancer Patients Who Received No Chemotherapy: A Study Based on Nationwide Korean Breast Cancer Registry Database. Clin Breast Cancer 2017; 17:e169-e184. [DOI: 10.1016/j.clbc.2016.12.011] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/22/2016] [Accepted: 12/26/2016] [Indexed: 11/29/2022]
|
15
|
Hong YR, Lee SH, Lim DJ, Kim MH, Jung CK, Chae BJ, Song BJ, Bae JS. The stratification of patient risk depending on the size and ratio of metastatic lymph nodes in papillary thyroid carcinoma. World J Surg Oncol 2017; 15:74. [PMID: 28376807 PMCID: PMC5379650 DOI: 10.1186/s12957-017-1141-4] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.9] [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: 01/15/2017] [Accepted: 03/22/2017] [Indexed: 11/16/2022] Open
Abstract
Background The aims of this study were to identify the clinical significances of the size of metastatic lymph node (mLN) and LN ratio (LNR) and to attempt to create a risk stratification for papillary thyroid carcinoma (PTC) patients. Methods We investigated the 435 PTC patients who underwent radioactive iodine (RAI) ablation treatment following thyroid surgery. The patients were classified into two groups (micrometastasis (pN1mic) ≤ 0.2 cm and macrometastasis (pN1mac) > 0.2 cm) and were stratified into the following three risk groups: group I (pN1mic, LNR ≤ 0.5); group II (pN1mic, LNR > 0.5 or pN1mac, LNR ≤ 0.5); and group III (pN1mac with LNR > 0.5). And then we investigated the association of the classified groups and variable clinicopathologic factors. Results The clinical characteristics such as large tumor size, extrathyroidal extension, higher T stage, and greater number of mLN or LNR were significantly associated with pN1mac. The mean stimulated thyroglobulin levels were increased with the patient risk groups (p = 0.02). The recurrence-free survivals were significantly different between the stratified groups (p = 0.001). Conclusions The patient groups I, II, and III may be referred to as low-, intermediate-, and high-risk groups. Clinicians should consider the possibility of recurrence, and the decisions about the application of RAI ablation based on the size of mLN and the patient’s risk groups.
Collapse
Affiliation(s)
- Young Ran Hong
- Department of Surgery, CHA Bundang Medical Center, CHA University, Gyeonggi-do, Korea
| | - So Hee Lee
- Department of Surgery, Seoul St. Mary's Hospital, College of Medicine, The Catholic University of Korea, Seoul, Republic of Korea
| | - Dong Jun Lim
- Department of Internal Medicine, Seoul St. Mary's Hospital, College of Medicine, The Catholic University of Korea, Seoul, Republic of Korea
| | - Min Hee Kim
- Department of Internal Medicine, Seoul St. Mary's Hospital, College of Medicine, The Catholic University of Korea, Seoul, Republic of Korea
| | - Chan Kwon Jung
- Department of Hospital Pathology, Seoul St. Mary's Hospital, College of Medicine, The Catholic University of Korea, Seoul, Republic of Korea
| | - Byung Joo Chae
- Department of Surgery, Seoul St. Mary's Hospital, College of Medicine, The Catholic University of Korea, Seoul, Republic of Korea
| | - Byung Joo Song
- Department of Surgery, Seoul St. Mary's Hospital, College of Medicine, The Catholic University of Korea, Seoul, Republic of Korea
| | - Ja Seong Bae
- Department of Surgery, Seoul St. Mary's Hospital, College of Medicine, The Catholic University of Korea, Seoul, Republic of Korea.
| |
Collapse
|
16
|
Kim DH, Chae H, Jo I, Yoo J, Lee H, Jang W, Park J, Lee GD, Jeon DS, Lee KH, Hur SY, Chae BJ, Song BJ, Kim M, Kim Y. Identification of large genomic rearrangement of BRCA1/2 in high risk patients in Korea. BMC Med Genet 2017; 18:38. [PMID: 28351343 PMCID: PMC5371242 DOI: 10.1186/s12881-017-0398-3] [Citation(s) in RCA: 9] [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] [Subscribe] [Scholar Register] [Received: 05/21/2016] [Accepted: 03/14/2017] [Indexed: 12/21/2022]
Abstract
Background While the majority of germline inactivating mutations in BRCA1/2 are small-scale mutations, large genomic rearrangements (LGRs) are also detected in a variable proportion of patients. However, routine genetic methods are incapable of detecting LGRs, and comprehensive genetic testing algorithm is necessary. Methods We performed multiplex ligation-dependent probe amplification assay for small-scale mutation negative patients at high-risk for LGR, based on previously published LGR risk criteria. The inclusion criteria for the high-risk subgroup were personal history of 1) early-onset breast cancer (diagnosed at ≤36 years); 2) two breast primaries; 3) breast cancer diagnosed at any age, with ≥1 close blood relatives (includes first-, second-, or third-degree) with breast and/or epithelial ovarian cancer; 4) both breast and epithelial ovarian cancer diagnosed at any age; and 5) epithelial ovarian cancer with ≥1 close blood relatives with breast and/or epithelial ovarian cancer. Results Two LGRs were identified. One was a heterozygous deletion of exon 19 and the other was a heterozygous duplication of exon 4–6. The prevalence of LGRs was 7% among Sanger-negative, high-risk patients, and accounted for 13% of all BRCA1 mutations and 2% of all patients. Moreover, LGRs reported in Korean patients, including our 2 newly identified cases, were found exclusively in families with at least one high-risk feature. Conclusions Our result suggests that selective LGR screening for Sanger-negative, high-risk patients is necessary for Korean patients.
Collapse
Affiliation(s)
- Do-Hoon Kim
- Department of Laboratory Medicine, Seoul St. Mary's Hospital, College of Medicine, The Catholic University of Korea, 222, Banpo-daero, Seocho-gu, Seoul, 06591, Republic of Korea.,Department of Laboratory Medicine, Keimyung University School of Medicine, Daegu, South Korea
| | - Hyojin Chae
- Department of Laboratory Medicine, Seoul St. Mary's Hospital, College of Medicine, The Catholic University of Korea, 222, Banpo-daero, Seocho-gu, Seoul, 06591, Republic of Korea. .,Catholic Genetic Laboratory Center, Seoul St. Mary's Hospital, College of Medicine, The Catholic University of Korea, Seoul, Republic of Korea.
| | - Irene Jo
- Department of Laboratory Medicine, Seoul St. Mary's Hospital, College of Medicine, The Catholic University of Korea, 222, Banpo-daero, Seocho-gu, Seoul, 06591, Republic of Korea.,Catholic Genetic Laboratory Center, Seoul St. Mary's Hospital, College of Medicine, The Catholic University of Korea, Seoul, Republic of Korea
| | - Jaeeun Yoo
- Department of Laboratory Medicine, Seoul St. Mary's Hospital, College of Medicine, The Catholic University of Korea, 222, Banpo-daero, Seocho-gu, Seoul, 06591, Republic of Korea.,Catholic Genetic Laboratory Center, Seoul St. Mary's Hospital, College of Medicine, The Catholic University of Korea, Seoul, Republic of Korea
| | - Hyeyoung Lee
- Catholic Genetic Laboratory Center, Seoul St. Mary's Hospital, College of Medicine, The Catholic University of Korea, Seoul, Republic of Korea
| | - Woori Jang
- Department of Laboratory Medicine, Seoul St. Mary's Hospital, College of Medicine, The Catholic University of Korea, 222, Banpo-daero, Seocho-gu, Seoul, 06591, Republic of Korea.,Catholic Genetic Laboratory Center, Seoul St. Mary's Hospital, College of Medicine, The Catholic University of Korea, Seoul, Republic of Korea
| | - Joonhong Park
- Department of Laboratory Medicine, Seoul St. Mary's Hospital, College of Medicine, The Catholic University of Korea, 222, Banpo-daero, Seocho-gu, Seoul, 06591, Republic of Korea.,Catholic Genetic Laboratory Center, Seoul St. Mary's Hospital, College of Medicine, The Catholic University of Korea, Seoul, Republic of Korea
| | - Gun Dong Lee
- Department of Laboratory Medicine, Seoul St. Mary's Hospital, College of Medicine, The Catholic University of Korea, 222, Banpo-daero, Seocho-gu, Seoul, 06591, Republic of Korea
| | - Dong-Seok Jeon
- Department of Laboratory Medicine, Keimyung University School of Medicine, Daegu, South Korea
| | - Keun Ho Lee
- Department of Obstetrics and Gynecology, College of Medicine, The Catholic University of Korea, Seoul, Republic of Korea
| | - Soo Young Hur
- Department of Obstetrics and Gynecology, College of Medicine, The Catholic University of Korea, Seoul, Republic of Korea
| | - Byung Joo Chae
- Department of Surgery, College of Medicine, The Catholic University of Korea, Seoul, Republic of Korea
| | - Byung Joo Song
- Department of Surgery, College of Medicine, The Catholic University of Korea, Seoul, Republic of Korea
| | - Myungshin Kim
- Department of Laboratory Medicine, Seoul St. Mary's Hospital, College of Medicine, The Catholic University of Korea, 222, Banpo-daero, Seocho-gu, Seoul, 06591, Republic of Korea.,Catholic Genetic Laboratory Center, Seoul St. Mary's Hospital, College of Medicine, The Catholic University of Korea, Seoul, Republic of Korea
| | - Yonggoo Kim
- Department of Laboratory Medicine, Seoul St. Mary's Hospital, College of Medicine, The Catholic University of Korea, 222, Banpo-daero, Seocho-gu, Seoul, 06591, Republic of Korea.,Catholic Genetic Laboratory Center, Seoul St. Mary's Hospital, College of Medicine, The Catholic University of Korea, Seoul, Republic of Korea
| |
Collapse
|
17
|
Kim IH, Lee JE, Youn HJ, Song BJ, Chae BJ. Cardioprotective Effect of Dexrazoxane in Patients with HER2-Positive Breast Cancer Who Receive Anthracycline Based Adjuvant Chemotherapy Followed by Trastuzumab. J Breast Cancer 2017; 20:82-90. [PMID: 28382098 PMCID: PMC5378583 DOI: 10.4048/jbc.2017.20.1.82] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.4] [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: 10/24/2016] [Accepted: 01/31/2017] [Indexed: 12/17/2022] Open
Abstract
Purpose We intended to determine whether dexrazoxane (DZR) is cardioprotective during administration of adjuvant anthracycline-based chemotherapy followed by a 1-year trastuzumab treatment. Methods The medical records of 228 patients who underwent surgical resection and received adjuvant chemotherapy with trastuzumab for human epidermal growth factor receptor type 2 (HER2)-positive breast cancer between January 2010 and December 2014 were reviewed. Approximately 25% of patients received DZR prior to each administration of doxorubicin during doxorubicin with cyclophosphamide (AC) chemotherapy. DZR was not administered during the 1-year trastuzumab maintenance period. Rates of cardiac events (reduction in left ventricular ejection fraction [LVEF] by 10% or more; reduction in absolute LVEF to <45%) and cardiac event-free duration (CFD) were examined. The trastuzumab interruption rate was also assessed. Results Twelve percent of patients experienced a cardiac event. Repeated-measures analysis of variance for ejection fraction revealed a significant main effect of time, and a significant group (DZR)×time interaction. The group treated with adjuvant chemotherapy and DZR experienced significantly lower frequencies of cardiac events than the adjuvant chemotherapy only group. In multivariate analysis, DZR administration was associated with significantly fewer cardiac events. Moreover, DZR administration was an independent good prognostic factor for CFD. Only one patient (2.3%) experienced early interruption of trastuzumab in the adjuvant chemotherapy with DZR group due to cardiac toxicity, whereas 10 patients (7.6%) experienced a trastuzumab stop event in the adjuvant chemotherapy only group. Conclusion DZR is cardioprotective in HER2-positive breast cancer patients who received adjuvant chemotherapy with trastuzumab. A large cohort randomized trial is needed to determine if DZR has an effect on trastuzumab interruption and completion of 12-month trastuzumab. Because cardiac toxicity has a significant negative effect on trastuzumab maintenance and quality of life, DZR administration could be considered concomitantly with anthracycline-based adjuvant chemotherapy with trastuzumab.
Collapse
Affiliation(s)
- In-Ho Kim
- Division of Medical Oncology, Department of Internal Medicine, Seoul St. Mary's Hospital, The Catholic University of Korea College of Medicine, Seoul, Korea
| | - Ji Eun Lee
- Division of Medical Oncology, Department of Internal Medicine, Seoul St. Mary's Hospital, The Catholic University of Korea College of Medicine, Seoul, Korea
| | - Ho-Joong Youn
- Division of Cardiology, Department of Internal Medicine, Seoul St. Mary's Hospital, The Catholic University of Korea College of Medicine, Seoul, Korea
| | - Byung Joo Song
- Division of Breast-Thyroid Surgery, Department of Surgery, Seoul St. Mary's Hospital, The Catholic University of Korea College of Medicine, Seoul, Korea
| | - Byung Joo Chae
- Division of Breast-Thyroid Surgery, Department of Surgery, Seoul St. Mary's Hospital, The Catholic University of Korea College of Medicine, Seoul, Korea
| |
Collapse
|
18
|
Yeo MK, Kim HE, Kim SH, Chae BJ, Song BJ, Lee A. Clinical usefulness of the free web-based image analysis application ImmunoRatio for assessment of Ki-67 labelling index in breast cancer. J Clin Pathol 2017; 70:715-719. [PMID: 28298390 PMCID: PMC5537563 DOI: 10.1136/jclinpath-2016-204162] [Citation(s) in RCA: 12] [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: 10/06/2016] [Revised: 02/04/2017] [Accepted: 02/23/2017] [Indexed: 02/06/2023]
Abstract
Aims Ki-67 is a prognostic marker in breast cancer; however, the use of the Ki-67 labelling index (LI) in clinical practice requires a consistent and easily accessible scoring method. The present study evaluated the use of the free internet-based image analysis program ImmunoRatio to score Ki-67 LI in breast cancer in comparison with manual counting. Methods Ki-67 immunohistochemical detection was performed in 577 breast cancer cases, and the Ki-67 LI was determined by ImmunoRatio and manual counting. Results The Ki-67 LI determined by ImmunoRatio correlated well with that obtained by manual counting. The concordance rate between ImmunoRatio and manual counting was excellent (κ coefficient of 0.881) at a Ki-67 LI cut-off value of 20%. Cases with high Ki-67 LI by ImmunoRatio were associated with poor overall survival, in particular in the hormone receptor positive group. Conclusions The web-based automated image analysis program ImmunoRatio is an attractive alternative to manual counting to determine the Ki-67 LI in breast cancer.
Collapse
Affiliation(s)
- Min-Kyung Yeo
- Department of Hospital Pathology, The Catholic university of Korea, College of Medicine, Seoul, Republic of Korea.,Department of Pathology, Chungnam National University School of Medicine, Daejeon, Republic of Korea
| | - Hee Eun Kim
- Department of Hospital Pathology, The Catholic university of Korea, College of Medicine, Seoul, Republic of Korea
| | - Sung Hun Kim
- Department of Radiology, The Catholic University of Korea, Seoul St. Mary's Hospital, Seoul, Republic of Korea
| | - Byung Joo Chae
- Department of Surgery, The Catholic University of Korea, Seoul St. Mary's Hospital, Seoul, Republic of Korea
| | - Byung Joo Song
- Department of Surgery, The Catholic University of Korea, Seoul St. Mary's Hospital, Seoul, Republic of Korea
| | - Ahwon Lee
- Department of Hospital Pathology, The Catholic university of Korea, College of Medicine, Seoul, Republic of Korea
| |
Collapse
|
19
|
Kim HS, Eom YH, Song BJ, Chae BJ. Abstract P2-05-29: The molecular subtype has greater influence on prognosis of breast cancer than age at diagnosis. Cancer Res 2017. [DOI: 10.1158/1538-7445.sabcs16-p2-05-29] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
Abstract
This abstract was withdrawn by the authors.
Collapse
Affiliation(s)
- HS Kim
- Seoul St. Mary's Hospital, College of Medicine, The Catholic University of Korea, Seoul, Korea
| | - YH Eom
- Seoul St. Mary's Hospital, College of Medicine, The Catholic University of Korea, Seoul, Korea
| | - BJ Song
- Seoul St. Mary's Hospital, College of Medicine, The Catholic University of Korea, Seoul, Korea
| | - BJ Chae
- Seoul St. Mary's Hospital, College of Medicine, The Catholic University of Korea, Seoul, Korea
| |
Collapse
|
20
|
Lee J, Song BJ, Chae BJ, Lee A, Kim SH, Kang BJ. Abstract P6-09-42: The role of serum neutrophil-to-lymphocyte ratio (NLR) in triple-negative breast cancer. Cancer Res 2017. [DOI: 10.1158/1538-7445.sabcs16-p6-09-42] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
Abstract
This abstract was not presented at the symposium.
Collapse
Affiliation(s)
- J Lee
- Division of Medical Oncology, Seoul, Republic of Korea; Surgery; Hospital Pathology; Radiology; Breast Cancer Multidisciplinary Team, Seoul St. Mary's Hospital; The Catholic University of Korea
| | - BJ Song
- Division of Medical Oncology, Seoul, Republic of Korea; Surgery; Hospital Pathology; Radiology; Breast Cancer Multidisciplinary Team, Seoul St. Mary's Hospital; The Catholic University of Korea
| | - BJ Chae
- Division of Medical Oncology, Seoul, Republic of Korea; Surgery; Hospital Pathology; Radiology; Breast Cancer Multidisciplinary Team, Seoul St. Mary's Hospital; The Catholic University of Korea
| | - A Lee
- Division of Medical Oncology, Seoul, Republic of Korea; Surgery; Hospital Pathology; Radiology; Breast Cancer Multidisciplinary Team, Seoul St. Mary's Hospital; The Catholic University of Korea
| | - SH Kim
- Division of Medical Oncology, Seoul, Republic of Korea; Surgery; Hospital Pathology; Radiology; Breast Cancer Multidisciplinary Team, Seoul St. Mary's Hospital; The Catholic University of Korea
| | - BJ Kang
- Division of Medical Oncology, Seoul, Republic of Korea; Surgery; Hospital Pathology; Radiology; Breast Cancer Multidisciplinary Team, Seoul St. Mary's Hospital; The Catholic University of Korea
| |
Collapse
|
21
|
Kim HS, Eom YH, Song BJ, Chae BJ. Abstract P2-05-28: BCL2 is a prognostic marker for subtype specific breast cancer. Cancer Res 2017. [DOI: 10.1158/1538-7445.sabcs16-p2-05-28] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
Abstract
This abstract was withdrawn by the authors.
Collapse
Affiliation(s)
- HS Kim
- Seoul St. Mary's Hospital, College of Medicine, The Catholic University of Korea, Seoul, Korea
| | - YH Eom
- Seoul St. Mary's Hospital, College of Medicine, The Catholic University of Korea, Seoul, Korea
| | - BJ Song
- Seoul St. Mary's Hospital, College of Medicine, The Catholic University of Korea, Seoul, Korea
| | - BJ Chae
- Seoul St. Mary's Hospital, College of Medicine, The Catholic University of Korea, Seoul, Korea
| |
Collapse
|
22
|
Kim SH, Lee HS, Kang BJ, Song BJ, Kim HB, Lee H, Jin MS, Lee A. Dynamic Contrast-Enhanced MRI Perfusion Parameters as Imaging Biomarkers of Angiogenesis. PLoS One 2016; 11:e0168632. [PMID: 28036342 PMCID: PMC5201289 DOI: 10.1371/journal.pone.0168632] [Citation(s) in RCA: 39] [Impact Index Per Article: 4.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/27/2016] [Accepted: 12/05/2016] [Indexed: 11/19/2022] Open
Abstract
Hypoxia in the tumor microenvironment is the leading factor in angiogenesis. Angiogenesis can be identified by dynamic contrast-enhanced breast MRI (DCE MRI). Here we investigate the relationship between perfusion parameters on DCE MRI and angiogenic and prognostic factors in patients with invasive ductal carcinoma (IDC). Perfusion parameters (Ktrans, kep and ve) of 81 IDC were obtained using histogram analysis. Twenty-fifth, 50th and 75th percentile values were calculated and were analyzed for association with microvessel density (MVD), vascular endothelial growth factor (VEGF) and conventional prognostic factors. Correlation between MVD and ve50 was positive (r = 0.33). Ktrans50 was higher in tumors larger than 2 cm than in tumors smaller than 2 cm. In multivariate analysis, Ktrans50 was affected by tumor size and MVD with 12.8% explanation. There was significant association between Ktrans50 and tumor size and MVD. Therefore we conclude that DCE MRI perfusion parameters are potential imaging biomarkers for prediction of tumor angiogenesis and aggressiveness.
Collapse
Affiliation(s)
- Sung Hun Kim
- Department of Radiology, Seoul St. Mary’s Hospital, College of Medicine, The Catholic University of Korea, Seoul, Republic of Korea
| | - Hyeon Sil Lee
- Department of Radiology, Seoul St. Mary’s Hospital, College of Medicine, The Catholic University of Korea, Seoul, Republic of Korea
| | - Bong Joo Kang
- Department of Radiology, Seoul St. Mary’s Hospital, College of Medicine, The Catholic University of Korea, Seoul, Republic of Korea
| | - Byung Joo Song
- Deparment of General Surgery, Seoul St. Mary’s Hospital, College of Medicine, The Catholic University of Korea, Seoul, Republic of Korea
| | - Hyun-Bin Kim
- Department of Biostatistics, Clinical Research Coordinating Center, College of Medicine, The Catholic University of Korea, Seoul, Republic of Korea
| | - Hyunyong Lee
- Department of Biostatistics, Clinical Research Coordinating Center, College of Medicine, The Catholic University of Korea, Seoul, Republic of Korea
| | - Min-Sun Jin
- Department of Hospital Pathology, Seoul St. Mary’s Hospital, College of Medicine, The Catholic University of Korea, Seoul, Republic of Korea
| | - Ahwon Lee
- Department of Hospital Pathology, Seoul St. Mary’s Hospital, College of Medicine, The Catholic University of Korea, Seoul, Republic of Korea
- * E-mail:
| |
Collapse
|
23
|
Choi JJ, Kim SH, Kang BJ, Song BJ. Detectability and Usefulness of Automated Whole Breast Ultrasound in Patients with Suspicious Microcalcifications on Mammography: Comparison with Handheld Breast Ultrasound. J Breast Cancer 2016; 19:429-437. [PMID: 28053632 PMCID: PMC5204050 DOI: 10.4048/jbc.2016.19.4.429] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.8] [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: 06/21/2016] [Accepted: 09/19/2016] [Indexed: 11/30/2022] Open
Abstract
Purpose The purpose of this study was to prospectively evaluate the detectability and usefulness of automated whole breast ultrasound (AWUS) and to compare it with handheld breast ultrasound (HHUS) in cases with suspicious microcalcifications identified by mammography. Methods Forty-two patients with 43 suspicious microcalcifications (25 malignant and 18 benign) detected by mammography underwent AWUS, HHUS, and histol-ogic examination. With knowledge of the mammographic findings, HHUS was performed to assess the visibility of the microcalcifications and the presence of associated masses or ductal changes. Two radiologists reviewed the AWUS images in consensus using the same methods employed for HHUS. Detectability of AWUS was compared with that of HHUS and was correlated with histologic and mammographic findings. Results Of the 43 lesions, 32 (74.4%) were detectable by AWUS and 31 (72.1%) by HHUS. No significant differences in sensitivity were found between the two methods (p=0.998). AWUS detected 96% (24/25) of malignant microcalcifications and 44.4% (8/18) of benign microcalcifications. AWUS was more successful in the detection of malignant vs. benign lesions (96.0% vs. 44.4%, p=0.002), lesions >10 mm vs. ≤10 mm in size (86.7% [26/30] vs. 46.2% [6/13], p=0.009), lesions with a fine pleomorphic or linear shape vs. a round or amorphous or coarse heterogeneous shape (94.7% [18/19] vs. 58.3% [14/24], p=0.021), and lesions associated with a mass or architectural distortion vs. without obvious changes on mammography (100% [19/19] vs. 54.2% [13/24], p=0.022). Conclusion Detectability of AWUS was comparable to that of HHUS in cases where suspicious microcalcifications were identified on mammography. Therefore, AWUS might be helpful in the performance of ultrasound-guided percutaneous procedures for highly suspicious microcalcifications.
Collapse
Affiliation(s)
- Jae Jeong Choi
- Department of Radiology, Dongtan Sacred Heart Hospital, Hallym University Medical Center, Hwaseong, Korea
| | - Sung Hun Kim
- Department of Radiology, Seoul St. Mary's Hospital, The Catholic University of Korea College of Medicine, Seoul, Korea
| | - Bong Joo Kang
- Department of Radiology, Seoul St. Mary's Hospital, The Catholic University of Korea College of Medicine, Seoul, Korea
| | - Byung Joo Song
- Department of General Surgery, Seoul St. Mary's Hospital, The Catholic University of Korea College of Medicine, Seoul, Korea
| |
Collapse
|
24
|
Hong YR, Song BJ, Jung SS, Kang BJ, Kim SH, Chae BJ. Predictive Factors for Upgrading Patients with Benign Breast Papillary Lesions Using a Core Needle Biopsy. J Breast Cancer 2016; 19:410-416. [PMID: 28053629 PMCID: PMC5204047 DOI: 10.4048/jbc.2016.19.4.410] [Citation(s) in RCA: 39] [Impact Index Per Article: 4.9] [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: 04/21/2016] [Accepted: 08/04/2016] [Indexed: 11/30/2022] Open
Abstract
PURPOSE Intraductal papilloma (IDP) is a benign breast disease with malignant potential, for which complete surgical excision is usually recommended. The aim of the present study was to investigate predictive factors for upgrading patients with a benign papillary lesion (BPL). METHODS This study was an observational study using a prospectively collected cohort. In total, 13,049 patients who underwent a core needle biopsy (CNB) for a breast lesion between January 2009 and May 2015 were enrolled. We reviewed all patients with pathologically confirmed BPL from a CNB. RESULTS Surgical treatment was performed for 363 out of a total of 592 lesions. According to the pathological differences, the lowest upgrade rate was shown in IDP without atypia (without atypia, 6.0%; with atypia, 26.8%; papillary neoplasm, 31.5%; p<0.001). The univariate analysis showed that, in IDP without atypia, the age at diagnosis, size of BPL on ultrasonography, and density on mammography were associated with upgrading. The multivariate analysis revealed that age >54 years and lesion size >1 cm were significantly associated with upgrade to malignancy (odds ratio [OR]=4.351, p=0.005 and OR=4.236, p=0.001, respectively). CONCLUSION The indications for surgical treatment can be defined as age >54 years and mass size >1 cm, even in IDP without atypia in the CNB results; this also includes cases of IDP with atypia or papillary neoplasm. Therefore, we suggest that close observation without surgery is sufficient for younger women with a small IDP without atypia.
Collapse
Affiliation(s)
- Young Ran Hong
- Department of Surgery, CHA Bundang Medical Center, CHA University, Seongnam, Korea
| | - Byung Joo Song
- Department of Surgery, The Catholic University of Korea College of Medicine, Seoul, Korea
| | - Sang Seol Jung
- Department of Surgery, CHA Bundang Medical Center, CHA University, Seongnam, Korea
| | - Bong Joo Kang
- Department of Radiology, The Catholic University of Korea College of Medicine, Seoul, Korea
| | - Sung Hun Kim
- Department of Radiology, The Catholic University of Korea College of Medicine, Seoul, Korea
| | - Byung Joo Chae
- Department of Surgery, The Catholic University of Korea College of Medicine, Seoul, Korea.; Cancer Research Institute, The Catholic University of Korea College of Medicine, Seoul, Korea
| |
Collapse
|
25
|
Abstract
PURPOSE B-cell lymphoma 2 (BCL2) is an antiapoptosis protein and an important clinical breast cancer prognostic marker. As the role of BCL2 is dependent on the estrogen receptor (ER) status, this effect might differ according to molecular subtypes. The aim of this study was to evaluate the relationship between the prognostic outcomes and BCL2 expression among the molecular subtypes. METHODS We retrieved the data of 1,356 patients who were newly diagnosed with malignant breast cancer between November 2006 and November 2011. Immunohistochemistry was used to measure ER, progesterone receptor, human epidermal growth factor receptor 2 (HER2), Ki-67, and BCL2 expression. We classified breast cancer into five molecular subtypes based on the 13th St. Gallen International Expert Consensus, including luminal A, luminal B (HER2-negative), luminal B (HER2-positive), HER2-overexpression, and triple-negative subtypes. We analyzed the clinicopathological features and assessed the correlation between BCL2 expression and clinical outcomes, such as relapse-free survival (RFS) and disease-specific survival (DSS) according to the five molecular subtypes. RESULTS A total of 605 cases of breast cancer (53.8%) showed BCL2 expression. BCL2-positive expression was associated with young age (<50 years, p=0.036), lower histological grade (p<0.001), low Ki-67 level (<14%, p<0.001), hormone receptor positivity (p<0.001), HER2 negativity (p<0.001), luminal breast cancer (p<0.001), and low recurrence rate (p=0.016). BCL2-positive expression was also associated with favorable 5-year RFS (p=0.008, 91.4%) and DSS (p=0.036, 95.6%) in all the patients. BCL2-positive expression in luminal A breast cancer resulted in significantly favorable 5-year RFS and DSS (p=0.023 and p=0.041, respectively). However, BCL2 expression was not associated with the prognosis in the other subtypes. CONCLUSION The prognostic role of BCL2 expression in breast cancer is subtype-specific. BCL2 expression differs according to the molecular subtype and is a good prognostic marker for only luminal A breast cancer.
Collapse
Affiliation(s)
- Yong Hwa Eom
- Department of Surgery, Seoul St. Mary's Hospital, College of Medicine, The Catholic University of Korea, Seoul, Korea
| | - Hyung Suk Kim
- Department of Surgery, Seoul St. Mary's Hospital, College of Medicine, The Catholic University of Korea, Seoul, Korea
| | - Ahwon Lee
- Department of Pathology, Seoul St. Mary's Hospital, College of Medicine, The Catholic University of Korea, Seoul, Korea
| | - Byung Joo Song
- Department of Surgery, Seoul St. Mary's Hospital, College of Medicine, The Catholic University of Korea, Seoul, Korea.; Cancer Research Institute, The Catholic University of Korea, Seoul, Korea
| | - Byung Joo Chae
- Department of Surgery, Seoul St. Mary's Hospital, College of Medicine, The Catholic University of Korea, Seoul, Korea.; Cancer Research Institute, The Catholic University of Korea, Seoul, Korea
| |
Collapse
|
26
|
Kim YJ, Kim SH, Lee AW, Jin MS, Kang BJ, Song BJ. Histogram analysis of apparent diffusion coefficients after neoadjuvant chemotherapy in breast cancer. Jpn J Radiol 2016; 34:657-666. [DOI: 10.1007/s11604-016-0570-2] [Citation(s) in RCA: 15] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/14/2016] [Accepted: 07/21/2016] [Indexed: 12/11/2022]
|
27
|
Yang SM, Kim SH, Kang BJ, Song BJ. Extramammary findings on breast MRI: prevalence and imaging characteristics favoring malignancy detection: a retrospective analysis. World J Surg Oncol 2016; 14:119. [PMID: 27098094 PMCID: PMC4839123 DOI: 10.1186/s12957-016-0865-x] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.5] [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: 11/03/2015] [Accepted: 04/12/2016] [Indexed: 12/21/2022] Open
Abstract
Background Little study of the extramammary finding of breast MRIs has been done with only descriptive work of the prevalence of location and malignancy. The purpose of the present study was to assess the prevalence, the location, and the imaging characteristics of the incidentally detected extramammary findings on breast MRI and to determine potential malignant characteristics. Methods The study evaluated extramammary findings in 109 patients who underwent breast MRI for the staging of breast cancer and for the follow-up of post-therapy. Prevalence, the location, clinicopathologic findings of breast cancer size, metastasis, and MRI characteristics were evaluated retrospectively. Malignancy of extramammary findings was determined based on the pathologic examinations and diagnostic images. Results One hundred forty-nine incidental findings were detected in 109 (4.6 %) of 2361 patients, and 69 cases were confirmed or considered to be malignant. The most common site was the bone (43/149, 28.9 %) with malignancy found in 30 (69.8 %) of 43 bone lesions. Less frequent tumor locations were the liver (22.1 %), lung (21.5 %), pleura or chest wall (10.1 %), mediastinum (6.7 %), supraclavicular lymph nodes (LNs) (6.0 %), and others (4.7 %). Findings of significant relevance with malignancy of the extramammary findings included bigger size of breast cancer, presence of LN metastasis, and distant metastasis (P < 0.01). Lesions showing iso- or hypo signal intensity (SI) on T2-weighted imaging (T2WI) (P = 0.000), contrast enhancement (P = 0.000), high SI on diffusion-weighted imaging (DWI) (P = 0.049), low SI on apparent-diffusion-coefficient map relative to DWI (P = 0.000), and multiplicity (P = 0.000) of the extramammary finding were significantly related to malignancy. Conclusions Extramammary findings on breast MRI are not rare. Clinicopathologic features of the breast cancer and MRI features of extramammary findings could be useful in estimating the malignancy of the incidental extramammary finding.
Collapse
Affiliation(s)
- Soung Moon Yang
- Department of Radiology, College of Medicine, Seoul St. Mary's Hospital, The Catholic University of Korea, Banpo-daero 222, Seocho-gu, Seoul, 137-701, Republic of Korea
| | - Sung Hun Kim
- Department of Radiology, College of Medicine, Seoul St. Mary's Hospital, The Catholic University of Korea, Banpo-daero 222, Seocho-gu, Seoul, 137-701, Republic of Korea.
| | - Bong Joo Kang
- Department of Radiology, College of Medicine, Seoul St. Mary's Hospital, The Catholic University of Korea, Banpo-daero 222, Seocho-gu, Seoul, 137-701, Republic of Korea
| | - Byung Joo Song
- Department of General Surgery, College of Medicine, Seoul St. Mary's Hospital, The Catholic University of Korea, Seoul, Republic of Korea
| |
Collapse
|
28
|
Kim HA, Seong MK, Kim EK, Kang E, Park S, Hur MH, Song BJ, Noh WC. Evaluation of the Survival Benefit of Different Chemotherapy Regimens in Patients with T1-2N0 Triple-Negative Breast Cancer. J Breast Cancer 2015; 18:271-8. [PMID: 26472978 PMCID: PMC4600692 DOI: 10.4048/jbc.2015.18.3.271] [Citation(s) in RCA: 12] [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: 01/21/2015] [Accepted: 07/16/2015] [Indexed: 01/03/2023] Open
Abstract
Purpose This study aimed to evaluate the survival benefit of different adjuvant chemotherapy regimens in patients with T1-2N0 triple-negative breast cancer. Methods Of 67,321 patients who were registered in the Korean Breast Cancer Society nationwide database between January 1999 and December 2008, 4,033 patients with T1-2N0 triple-negative breast cancer were included. The overall survival of patients who did not receive adjuvant chemotherapy was compared with those treated with adjuvant anthracycline and cyclophosphamide (AC), 5-fluorouracil, anthracycline, and cyclophosphamide (FAC), or cyclophosphamide, methotrexate, and 5-fluorouracil (CMF). Results The median follow-up was 52.5 months. Chemotherapy was used in 87.4% of patients; it was used more commonly in patients with T2 tumors, those who were younger, had a higher histologic grade, and who showed lymphovascular invasion. The 5-year cumulative overall survival rate was 95.4%. Younger age, breast-conserving surgery, and adjuvant chemotherapy were significantly associated with improved overall survival. The 5-year cumulative overall survival rate of patients who did not receive adjuvant chemotherapy and those treated with AC, FAC, and CMF were 92.5%, 95.9%, 95.3%, and 95.9%, respectively. On multivariate analysis, the administration of any adjuvant chemotherapy regimen was significantly associated with improved overall survival (p=0.038). No significant difference in survival benefit was observed among the three different treatment groups. Conclusion A standard adjuvant chemotherapy regimen with the least drug-related toxicity might be a reasonable treatment for patients with T1-2N0 triple-negative breast cancer.
Collapse
Affiliation(s)
- Hyun-Ah Kim
- Department of Surgery, Korea Cancer Center Hospital, Korea Institute of Radiological & Medical Sciences, Seoul, Korea
| | - Min-Ki Seong
- Department of Surgery, Korea Cancer Center Hospital, Korea Institute of Radiological & Medical Sciences, Seoul, Korea
| | - Eun-Kyu Kim
- Department of Surgery, Seoul National University Bundang Hospital, Seongnam, Korea
| | - Eunyoung Kang
- Department of Surgery, Seoul National University Bundang Hospital, Seongnam, Korea
| | - Seho Park
- Department of Surgery, Yonsei University College of Medicine, Seoul, Korea
| | - Min Hee Hur
- Department of Surgery, Cheil General Hospital and Women's Healthcare Center, Dankook University College of Medicine, Seoul, Korea
| | - Byung Joo Song
- Department of Surgery, Seoul St. Mary's Hospital, The Catholic University of Korea College of Medicine, Seoul, Korea
| | - Woo Chul Noh
- Department of Surgery, Korea Cancer Center Hospital, Korea Institute of Radiological & Medical Sciences, Seoul, Korea
| | | |
Collapse
|
29
|
Shim HJ, Kim SH, Kang BJ, Choi BG, Kim HS, Cha ES, Song BJ. Breast cancer recurrence according to molecular subtype. Asian Pac J Cancer Prev 2015; 15:5539-44. [PMID: 25081661 DOI: 10.7314/apjcp.2014.15.14.5539] [Citation(s) in RCA: 27] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND To evaluate the location of tumor relapse and imaging modality for detection according to the breast cancer subtype: luminal A, luminal B, HER2 positive luminal B, nonluminal HER2 positive, and triple negative. MATERIALS AND METHODS A total of 1244 patients with breast cancer with known estrogen receptor (ER), progesterone receptor (PR), Ki-67 and human epidermal growth factor receptor 2 (HER2), who underwent breast surgery from 2009 to 2012 were analyzed. Patients were classified into the following categories: luminal A (n=458), luminal B (n=241), HER2 positive luminal B (n=227), nonluminal HER2 positive (n=145) and triple negative (n=173). A total of 105 cases of relapse were detected in 102 patients: locoregional recurrence (n=46), recurrence in the contralateral breast (n=28) and distant metastasis (n=31). Comparison of proportions was used to determine the difference between subtypes. RESULTS Relapse rates by subtypes are as follows: luminal A 23 of 458 (5.02%), luminal B 19 of 241 (7.88%), HER2 positive luminal B 15 of 227 (6.61%), nonluminal HER2 postive 19 of 145 (13.10%) and triple negative 29 of 173 (16.76%). Luminal A tumors had the lowest rate of recurrence and had significantly lower recurrence rate in comparison with nonluminal HER2 postive (p=0.0017) and triple negative subtypes (p<0.0001). Compared with all other subtypes except nonluminal HER2 positive, triple negative tumors had the highest rate of tumor recurrence (p<0.01). Triple negatives were most likely to develop contralateral recurrence against all subtypes (p<0.05). Detection rate of locoregional and contralateral tumor recurrence were 28.3% on mammography (n=17/60). CONCLUSIONS Luminal A tumors are associated with a low risk of recurrence while triple negative lesions have a high risk. In case of triple negative tumors, the contralateral breast has much more recurrence as compared with all other subtype. In terms of detection rates, breast USG was the best modality for detecting tumor recurrence, compared with other modalities (p<0.05). Subtyping of breast tumors using a molecular gene expression panel can identify patients who have increased risk of recurrence and allow prediction of locations of tumor recurrence for each subtype.
Collapse
Affiliation(s)
- Hee Jin Shim
- Department of Radiology, Seoul St. Mary's Hospital, The Catholic University of Korea, Seoul, Korea E-mail :
| | | | | | | | | | | | | |
Collapse
|
30
|
Kwak HY, Chae BJ, Eom YH, Hong YR, Seo JB, Bae JS, Jung SS, Song BJ. Is adjuvant chemotherapy omissible in women with T1-2 stage, node-positive, luminal A type breast cancer? J Chemother 2015; 27:290-6. [PMID: 25974160 DOI: 10.1179/1973947815y.0000000015] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/17/2022]
Abstract
PURPOSE The aim of this study was to evaluate whether hormonal breast cancer therapy without systemic chemotherapy is feasible in adjuvant settings in luminal A breast cancer. METHODS A database of 879 patients who underwent breast cancer surgery enrolled between January 2003 and December 2011 was reviewed. Patients with luminal A cancers were selected and grouped into those who received adjuvant hormonal therapy with (group C+) or without (group C - ) adjuvant systemic therapy. RESULTS In a multivariable analysis, axillary lymph node (ALN) metastasis was the only independent factor that revealed significantly different between the two groups in disease-free survival (DFS). The 5-year cumulative DFS was 82.3 versus 76.2% (P = 0.700) and overall survival (OS) was 83.9 versus 100% (P = 0.483) for C+ versus C - breast cancer, respectively. CONCLUSION In our study, adjuvant chemotherapy in luminal A, T1-2N+ cancer showed no significant difference for DFS. We believe that the role of adjuvant chemotherapy for these women with hormonal therapy might have little benefit.
Collapse
|
31
|
Kim EJ, Kim SH, Park GE, Kang BJ, Song BJ, Kim YJ, Lee D, Ahn H, Kim I, Son YH, Grimm R. Histogram analysis of apparent diffusion coefficient at 3.0t: Correlation with prognostic factors and subtypes of invasive ductal carcinoma. J Magn Reson Imaging 2015; 42:1666-78. [PMID: 25919239 DOI: 10.1002/jmri.24934] [Citation(s) in RCA: 78] [Impact Index Per Article: 8.7] [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: 01/14/2015] [Accepted: 04/14/2015] [Indexed: 01/24/2023] Open
Abstract
PURPOSE To evaluate apparent diffusion coefficient (ADC) histogram parameters that show correlations with prognostic factors and subtypes of breast cancer. MATERIALS AND METHODS At 3.0T, various ADC histogram parameters were calculated including the entire tumor volume in 173 invasive ductal carcinomas: the minimum, 10th percentile, mean, median, 90th percentile, and maximum. ADC parameters were correlated with prognostic factors and subtype. RESULTS The mean ADCmedian value was significantly higher in the group with lymph node metastasis, HER2 positivity, and a Ki-67 value <14% than in the group with negativity for lymph node metastasis, HER2 negativity, and a Ki-67 value ≥14% (0.907, 0.978, and 0.941 vs. 0.735, 0.778, and 0.761 × 10(-3) mm(2) /s, respectively) (P < 0.01). There was no significant correlation between ADCmedian and tumor size, histologic grade, estrogen receptor expression, and progesterone receptor expression (P = 0.272, 0.113, 0.261, and 0.181, respectively). For most ADC parameters except for ADCmin , the mean of variable ADC parameters of HER2-positive, luminal A, luminal B-HER2(+), triple-negative, and luminal B-HER2(-) diseases were arranged in descending order (1.175, 0.936, 0.863, 0.811, and 0.665 × 10(-3) mm(2) /s in ADCmedian , respectively) with statistical significant difference (P < 0.001). In multivariate analysis, histologic grade, the Ki-67 index, and HER2 expression were statistically significant explanatory prognostic factors for ADCmedian and the Ki-67 index had the most robust effects on ADC parameters (standardized coefficient = -0.317). CONCLUSION Various ADC parameters were correlated with prognostic factors and subtype, except for ADCmin . HER2 positivity showed high ADC values and high Ki-67 index revealed low ADC values.
Collapse
Affiliation(s)
- Eun Jeong Kim
- Department of Radiology, Seoul St. Mary's Hospital, College of Medicine, Catholic University of Korea, Seoul, Korea
| | - Sung Hun Kim
- Department of Radiology, Seoul St. Mary's Hospital, College of Medicine, Catholic University of Korea, Seoul, Korea
| | - Ga Eun Park
- Department of Radiology, Seoul St. Mary's Hospital, College of Medicine, Catholic University of Korea, Seoul, Korea
| | - Bong Joo Kang
- Department of Radiology, Seoul St. Mary's Hospital, College of Medicine, Catholic University of Korea, Seoul, Korea
| | - Byung Joo Song
- Department of General Surgery, Seoul St. Mary's Hospital, College of Medicine, Catholic University of Korea, Seoul, Korea
| | - Yun Ju Kim
- Department of Radiology, National Cancer Center, Gyeonggi, Korea
| | - Dongeon Lee
- College of Medicine, Catholic University of Korea, Seoul, Korea
| | - Hyunsoo Ahn
- College of Medicine, Catholic University of Korea, Seoul, Korea
| | - Inah Kim
- College of Medicine, Catholic University of Korea, Seoul, Korea
| | | | | |
Collapse
|
32
|
Eom YH, Kim EJ, Chae BJ, Song BJ, Jung SS. The distance between breast cancer and the skin is associated with axillary nodal metastasis. J Surg Oncol 2015; 111:824-8. [DOI: 10.1002/jso.23898] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/05/2014] [Accepted: 01/26/2015] [Indexed: 11/07/2022]
Affiliation(s)
- Yong Hwa Eom
- Department of Surgery; Seoul St. Mary's Hospital; College of Medicine; The Catholic University of Korea; Seoul Korea
| | - Eun Jin Kim
- Department of Surgery; Seoul St. Mary's Hospital; College of Medicine; The Catholic University of Korea; Seoul Korea
| | - Byung Joo Chae
- Department of Surgery; Seoul St. Mary's Hospital; College of Medicine; The Catholic University of Korea; Seoul Korea
| | - Byung Joo Song
- Department of Surgery; Seoul St. Mary's Hospital; College of Medicine; The Catholic University of Korea; Seoul Korea
| | - Sang Seol Jung
- Department of Surgery; Seoul St. Mary's Hospital; College of Medicine; The Catholic University of Korea; Seoul Korea
| |
Collapse
|
33
|
Abstract
The purpose of this study was to describe the technical aspects of gel pad application for automated breast sonography and to show its effects on pain relief, scan coverage, and image quality. Twenty patients underwent 2 sets of automated breast sonography with and without gel pad application and were then asked to provide feedback on the examination-related pain. Scan coverage and image quality were compared quantitatively and qualitatively. The degree of pain was significantly decreased after gel pad application (P < .0001). The scan coverage was expanded particularly at the mid-portion of the breast. Image quality was satisfactory without significant differences between the sets. Gel pad application for automated breast sonography is easy and provides significant pain relief. The scan coverage was expanded, while the image quality was maintained.
Collapse
Affiliation(s)
- Yun Ju Kim
- Department of Radiology, National Cancer Center, Gyeonggi, Korea (Y.J.K.); Departments of Radiology (S.H.K., B.J.K.) and General Surgery (B.J.S.), Seoul St Mary's Hospital, College of Medicine, Catholic University of Korea, Seoul, Korea; and Department of Radiology, Hallym University Medical Center, Hallym University of Korea, Seoul, Korea (S.K.J., J.J.C.)
| | - Sung Hun Kim
- Department of Radiology, National Cancer Center, Gyeonggi, Korea (Y.J.K.); Departments of Radiology (S.H.K., B.J.K.) and General Surgery (B.J.S.), Seoul St Mary's Hospital, College of Medicine, Catholic University of Korea, Seoul, Korea; and Department of Radiology, Hallym University Medical Center, Hallym University of Korea, Seoul, Korea (S.K.J., J.J.C.).
| | - Su Kyung Jeh
- Department of Radiology, National Cancer Center, Gyeonggi, Korea (Y.J.K.); Departments of Radiology (S.H.K., B.J.K.) and General Surgery (B.J.S.), Seoul St Mary's Hospital, College of Medicine, Catholic University of Korea, Seoul, Korea; and Department of Radiology, Hallym University Medical Center, Hallym University of Korea, Seoul, Korea (S.K.J., J.J.C.)
| | - Jae Jeong Choi
- Department of Radiology, National Cancer Center, Gyeonggi, Korea (Y.J.K.); Departments of Radiology (S.H.K., B.J.K.) and General Surgery (B.J.S.), Seoul St Mary's Hospital, College of Medicine, Catholic University of Korea, Seoul, Korea; and Department of Radiology, Hallym University Medical Center, Hallym University of Korea, Seoul, Korea (S.K.J., J.J.C.)
| | - Bong Joo Kang
- Department of Radiology, National Cancer Center, Gyeonggi, Korea (Y.J.K.); Departments of Radiology (S.H.K., B.J.K.) and General Surgery (B.J.S.), Seoul St Mary's Hospital, College of Medicine, Catholic University of Korea, Seoul, Korea; and Department of Radiology, Hallym University Medical Center, Hallym University of Korea, Seoul, Korea (S.K.J., J.J.C.)
| | - Byung Joo Song
- Department of Radiology, National Cancer Center, Gyeonggi, Korea (Y.J.K.); Departments of Radiology (S.H.K., B.J.K.) and General Surgery (B.J.S.), Seoul St Mary's Hospital, College of Medicine, Catholic University of Korea, Seoul, Korea; and Department of Radiology, Hallym University Medical Center, Hallym University of Korea, Seoul, Korea (S.K.J., J.J.C.)
| |
Collapse
|
34
|
Kim SH, Kim KH, Park HS, Yoo H, Chae BJ, Bae JS, Jung SS, Song BJ. Factors related with metastasis of right retroesophageal lymph nodes in papillary thyroid cancer. MINERVA CHIR 2015; 70:1-5. [PMID: 25650649] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 06/04/2023]
Abstract
AIM Right retroesophageal lymph nodes (RRLNs) should be involved in central lymph nodes (CLNs) dissection in patients with papillary thyroid cancer (PTC). This study assessed the incidence and factors related to RRLNs metastasis. METHODS From January 2008 to March 2010, 129 patients who underwent total thyroidectomy with CLNs dissection including RRLNs were enrolled. The predictive value of RRLNs metastasis was assessed. RESULTS Twenty six (20.1%) of 129 patients exhibited nodal metastasis in RRLNs. Metastasis of RRLNs was associated with large tumor size (>1 cm; P<0.01), multiplicity (P=0.03), preoperative LN enlargement (P<0.01), metastasis of non-retroesophageal lateral LN (P<0.01) and large number of CLNs metastases (P<0.01) in univariate analysis. Multivariate analysis revealed that tumor size (>1 cm) and metastasis of non-retroesophageal lateral LN were independent correlates of RRLNs metastases. CONCLUSION RRLNs may be removed during operation for PTC, particularly in patients with tumor >1 cm and lateral LN metastases.
Collapse
Affiliation(s)
- S H Kim
- Department of Surgery Catholic University of Korea Seoul, Republic of Korea -
| | | | | | | | | | | | | | | |
Collapse
|
35
|
Kim JY, Kim SH, Kim YJ, Kang BJ, An YY, Lee AW, Song BJ, Park YS, Lee HB. Enhancement parameters on dynamic contrast enhanced breast MRI: do they correlate with prognostic factors and subtypes of breast cancers? Magn Reson Imaging 2015; 33:72-80. [DOI: 10.1016/j.mri.2014.08.034] [Citation(s) in RCA: 83] [Impact Index Per Article: 9.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/05/2014] [Accepted: 08/10/2014] [Indexed: 01/04/2023]
|
36
|
Kim JY, Kim YJ, Kim SH, Kang BJ, Song BJ. Invasive ductal carcinoma of the breast in a 14-year-old girl. Pediatr Radiol 2014; 44:1446-9. [PMID: 24997789 DOI: 10.1007/s00247-014-3003-3] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/14/2014] [Revised: 02/16/2014] [Accepted: 04/09/2014] [Indexed: 10/25/2022]
Abstract
Breast cancer is rare in children and adolescents. In particular, there are very few cases of invasive ductal carcinoma in childhood. We report a case of invasive ductal carcinoma of the breast in a 14-year-old girl presenting as a palpable mass. While the tumor demonstrated a relatively benign appearance on ultrasound, magnetic resonance imaging revealed typical malignant features. Several polymorphisms of single nucleotide variation were observed on gene analysis. The patient underwent breast conserving surgery and received subsequent concurrent chemo-radiation therapy. An awareness that ductal carcinoma of the breast rarely occurs in children is important to detect early stage breast cancer.
Collapse
Affiliation(s)
- Joo Yeon Kim
- Department of Radiology, Seoul St. Mary's Hospital, College of Medicine, The Catholic University of Korea, 222 Banpo-daero, Seocho-Gu, Seoul, Korea
| | | | | | | | | |
Collapse
|
37
|
Kwak HY, Chae BJ, Eom YH, Hong YR, Seo JB, Lee SH, Song BJ, Jung SS, Bae JS. Does papillary thyroid carcinoma have a better prognosis with or without Hashimoto thyroiditis? Int J Clin Oncol 2014; 20:463-73. [PMID: 25312294 DOI: 10.1007/s10147-014-0754-7] [Citation(s) in RCA: 27] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/17/2014] [Accepted: 09/16/2014] [Indexed: 01/21/2023]
Abstract
BACKGROUND It has been reported that the BRAF (V600E) mutation is related to a low frequency of background Hashimoto thyroiditis (HT); however, there are not many factors known to be related to the development of HT. The aim of this study was to determine whether patients with both papillary thyroid carcinoma (PTC) and HT show aggressive features, by investigating the clinicopathological features of HT in patients with PTC. METHODS A database of patients with PTC who underwent thyroidectomy between October 2008 and August 2012 was collected and reviewed. All 2464 patients were offered a thyroidectomy, and DNA was extracted from the atypical cells in the surgical specimens for detection of the BRAF (V600E) mutation. Clinical and pathological characteristics were also investigated. RESULTS Four hundred and fifty-two of 1945 (23.2%) patients were diagnosed with HT, and of these, 119 (72.1%) had a BRAF (V600E) mutation. HT was not significantly associated with the BRAF (V600E) mutation (P < 0.001) and extrathyroidal extensions (P = 0.005) but was associated with a low stage (P = 0.011) and female predominance (P < 0.001). In a subgroup analysis for gender, HT was associated with a low probability of BRAF (V600E) mutations in both genders (P < 0.001 for both females and males). Also, recurrence was significantly associated with HT (OR 0.297, CI 0.099-0.890, P = 0.030), lymph node ratio (OR 2.545, CI 1.092-5.931, P = 0.030), and BRAF (V600E) mutation (OR 2.075, CI 1.021-4.217, P = 0.044). However, there was no relationship with clinicopathological factors or with death. CONCLUSIONS Our results show that HT in patients with PTC is associated with a low probability of BRAF (V600E) mutations. Moreover, HT was correlated with some factors that were associated with less aggressive clinical features and inversely related to recurrence. Therefore, these results may be useful to predict whether PTC concurrent with HT exhibits a better prognosis than PTC alone.
Collapse
Affiliation(s)
- Hee Yong Kwak
- Department of Surgery, Korea University College of Medicine, Seoul, Republic of Korea
| | | | | | | | | | | | | | | | | |
Collapse
|
38
|
Park HS, Lee A, Chae BJ, Bae JS, Song BJ, Jung SS. Expression of receptor activator of nuclear factor kappa-B as a poor prognostic marker in breast cancer. J Surg Oncol 2014; 110:807-12. [DOI: 10.1002/jso.23737] [Citation(s) in RCA: 30] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/28/2014] [Accepted: 07/07/2014] [Indexed: 12/31/2022]
Affiliation(s)
- Hyung Seok Park
- Department of Surgery; Yonsei University College of Medicine; Seoul Republic of Korea
| | - Ahwon Lee
- Department of Hospital Pathology; Seoul St. Mary's Hospital; The Catholic University College of Medicine; Seoul Republic of Korea
| | - Byung Joo Chae
- Department of Surgery; The Catholic University of Korea College of Medicine; Seoul Republic of Korea
| | - Ja-Seong Bae
- Department of Surgery; The Catholic University of Korea College of Medicine; Seoul Republic of Korea
| | - Byung Joo Song
- Department of Surgery; The Catholic University of Korea College of Medicine; Seoul Republic of Korea
| | - Sang Seol Jung
- Department of Surgery; The Catholic University of Korea College of Medicine; Seoul Republic of Korea
| |
Collapse
|
39
|
Kim EJ, Kim SH, Kang BJ, Choi BG, Song BJ, Choi JJ. Diagnostic value of breast MRI for predicting metastatic axillary lymph nodes in breast cancer patients: diffusion-weighted MRI and conventional MRI. Magn Reson Imaging 2014; 32:1230-6. [PMID: 25072504 DOI: 10.1016/j.mri.2014.07.001] [Citation(s) in RCA: 38] [Impact Index Per Article: 3.8] [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: 04/27/2014] [Accepted: 07/21/2014] [Indexed: 02/06/2023]
Abstract
PURPOSES To evaluate the diagnostic value of diffusion-weighted MRI (DWI) and combination of conventional MRI and DWI to predict metastatic axillary lymph nodes in breast cancer. MATERIALS AND METHODS Two hundred fifty-two breast cancer patients with 253 axillae were included. The morphological parameters on axial T2-weighted images without fat saturation and apparent diffusion coefficient (ADC) values were retrospectively analyzed. An independent t-test/chi-square test and receiver operating characteristics (ROC) curve analysis were used. RESULTS On conventional MRI, short and long axis length, maximal cortical thickness, relative T2 value, loss of fatty hilum (p<0.001 for each), and eccentric cortical thickening (p<0.003) were statistically significantly different between the metastatic and nonmetastatic groups. The short axis to long axis ratio was not a statistically significant parameter. The ADC value was significantly different between the 2 groups, with an AUC that was higher than that of conventional MR parameters (AUC, 0.815; threshold, ≤0.986×10-3 mm(2)/sec; sensitivity, 75.8%; specificity, 83.9%). Using the adopted thresholds for each parameter, a total number of findings suggesting malignancy of 4 or higher was determined as the threshold, with high specificity (90.1%). CONCLUSION Using conventional MRI and DWI, we can evaluate the axilla in breast cancer with high specificity.
Collapse
Affiliation(s)
- Eun Jeong Kim
- Department of Radiology, Seoul St. Mary's Hospital, College of Medicine, The Catholic University of Korea
| | - Sung Hun Kim
- Department of Radiology, Seoul St. Mary's Hospital, College of Medicine, The Catholic University of Korea.
| | - Bong Joo Kang
- Department of Radiology, Seoul St. Mary's Hospital, College of Medicine, The Catholic University of Korea
| | - Byung Gil Choi
- Department of Radiology, Seoul St. Mary's Hospital, College of Medicine, The Catholic University of Korea
| | - Byung Joo Song
- General Surgery, Seoul St. Mary's Hospital, College of Medicine, The Catholic University of Korea
| | | |
Collapse
|
40
|
Kim YJ, Kim SH, Kang BJ, Park CS, Kim HS, Son YH, Porter DA, Song BJ. Readout-segmented echo-planar imaging in diffusion-weighted mr imaging in breast cancer: comparison with single-shot echo-planar imaging in image quality. Korean J Radiol 2014; 15:403-10. [PMID: 25053898 PMCID: PMC4105801 DOI: 10.3348/kjr.2014.15.4.403] [Citation(s) in RCA: 46] [Impact Index Per Article: 4.6] [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: 01/10/2014] [Accepted: 04/12/2014] [Indexed: 11/29/2022] Open
Abstract
Objective The purpose of this study was to compare the image quality of standard single-shot echo-planar imaging (ss-EPI) and that of readout-segmented EPI (rs-EPI) in patients with breast cancer. Materials and Methods Seventy-one patients with 74 breast cancers underwent both ss-EPI and rs-EPI. For qualitative comparison of image quality, three readers independently assessed the two sets of diffusion-weighted (DW) images. To evaluate geometric distortion, a comparison was made between lesion lengths derived from contrast enhanced MR (CE-MR) images and those obtained from the corresponding DW images. For assessment of image parameters, signal-to-noise ratio (SNR), lesion contrast, and contrast-to-noise ratio (CNR) were calculated. Results The rs-EPI was superior to ss-EPI in most criteria regarding the qualitative image quality. Anatomical structure distinction, delineation of the lesion, ghosting artifact, and overall image quality were significantly better in rs-EPI. Regarding the geometric distortion, lesion length on ss-EPI was significantly different from that of CE-MR, whereas there were no significant differences between CE-MR and rs-EPI. The rs-EPI was superior to ss-EPI in SNR and CNR. Conclusion Readout-segmented EPI is superior to ss-EPI in the aspect of image quality in DW MR imaging of the breast.
Collapse
Affiliation(s)
- Yun Ju Kim
- Department of Radiology, Seoul St. Mary's Hospital, College of Medicine, The Catholic University of Korea, Seoul 137-701, Korea
| | - Sung Hun Kim
- Department of Radiology, Seoul St. Mary's Hospital, College of Medicine, The Catholic University of Korea, Seoul 137-701, Korea
| | - Bong Joo Kang
- Department of Radiology, Seoul St. Mary's Hospital, College of Medicine, The Catholic University of Korea, Seoul 137-701, Korea
| | - Chang Suk Park
- Department of Radiology, Incheon St. Mary's Hospital, College of Medicine, The Catholic University of Korea, Incheon 403-720, Korea
| | - Hyeon Sook Kim
- Department of Radiology, St. Paul Hospital, College of Medicine, The Catholic University of Korea, Seoul 130-709, Korea
| | - Yo Han Son
- Healthcare Sector, Siemens Ltd., Seoul 120-837, Korea
| | | | - Byung Joo Song
- Department of General Surgery, Seoul St. Mary's Hospital, College of Medicine, The Catholic University of Korea, Seoul 137-701, Korea
| |
Collapse
|
41
|
Kim YJ, Kim SH, Choi BG, Kang BJ, Kim HS, Cha ES, Song BJ. Impact of Radiotherapy on Background Parenchymal Enhancement in Breast Magnetic Resonance Imaging. Asian Pac J Cancer Prev 2014; 15:2939-43. [DOI: 10.7314/apjcp.2014.15.7.2939] [Citation(s) in RCA: 15] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/10/2022] Open
|
42
|
Kwak HY, Chae BJ, Park YG, Kim SH, Chang EY, Kim EJ, Song BJ, Jung SS, Bae JS. Comparison of surgical outcomes between papillary thyroid cancer patients treated with the Harmonic ACE scalpel and LigaSure Precise instrument during conventional thyroidectomy: a single-blind prospective randomized controlled trial. J Surg Res 2014; 187:484-9. [DOI: 10.1016/j.jss.2013.11.1093] [Citation(s) in RCA: 14] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/25/2013] [Revised: 11/02/2013] [Accepted: 11/15/2013] [Indexed: 01/22/2023]
|
43
|
Heo DS, Choi H, Yeom MY, Song BJ, Oh SJ. Serum levels of matrix metalloproteinase-9 predict lymph node metastasis in breast cancer patients. Oncol Rep 2014; 31:1567-72. [PMID: 24481627 DOI: 10.3892/or.2014.3001] [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] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/18/2013] [Accepted: 01/13/2014] [Indexed: 11/06/2022] Open
Abstract
Matrix metalloproteinases (MMPs) are proteolytic enzymes that play important roles in cancer progression and metastasis. Although serum MMP expression is known to correlate with the primary lesion of breast cancer, there has yet to be a study regarding the correlation between serum MMP expression and metastatic lesions, particularly lymph nodes. The present study evaluated the correlation of serum and lymph node MMP expression with axillary node metastasis. The preoperative serum levels of MMP-2 and MMP-9 in 77 patients with breast cancer and in 10 patients with benign breast tumor were determined by ELISA and zymography. One hundred and twelve axillary lymph nodes were collected for zymography during breast cancer surgery. Significantly higher serum levels of MMP-2 and MMP-9 were found in breast cancer patients compared to patients with benign tumor. High serum levels of MMP-2 and MMP-9 were significantly associated with node metastasis. ELISA and zymography results for serum MMP-2 and MMP-9 correlated significantly, with a Pearson correlation coefficient (r) of 0.76 for MMP-2 (P=0.001) and 0.81 for MMP-9 (P=0.001). In terms of lymph node, total MMP-2, MMP-9 and MMP-9 activity were significantly higher in metastatic than in non-metastatic nodes. There was a correlation between serum and lymph node MMP-9 levels on zymographic measurements (r=0.34, P=0.011), but not in terms of MMP-2 levels. Serum MMP-9 levels may have a diagnostic value for predicting axillary node metastasis.
Collapse
Affiliation(s)
- Dong Sik Heo
- Department of Surgery, Incheon St. Mary's Hospital, College of Medicine, The Catholic University of Korea, Incheon, Republic of Korea
| | - Hoon Choi
- Department of Surgery, Incheon St. Mary's Hospital, College of Medicine, The Catholic University of Korea, Incheon, Republic of Korea
| | - Mi Young Yeom
- Department of Clinical Research Laboratory, Incheon St. Mary's Hospital, College of Medicine, The Catholic University of Korea, Incheon, Republic of Korea
| | - Byung Joo Song
- Department of Surgery, Seoul St. Mary's Hospital, College of Medicine, The Catholic University of Korea, Seoul, Republic of Korea
| | - Se Jeong Oh
- Department of Surgery, Incheon St. Mary's Hospital, College of Medicine, The Catholic University of Korea, Incheon, Republic of Korea
| |
Collapse
|
44
|
Park HS, Chae BJ, Song BJ, Jung SS, Han W, Nam SJ, Youn HJ, Ko BK, Kim DW. Effect of Axillary Lymph Node Dissection after Sentinel Lymph Node Biopsy on Overall Survival in Patients with T1 or T2 Node-positive Breast Cancer: Report from the Korean Breast Cancer Society. Ann Surg Oncol 2013; 21:1231-6. [DOI: 10.1245/s10434-013-3350-6] [Citation(s) in RCA: 15] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/23/2012] [Indexed: 12/14/2022]
|
45
|
Kim TY, Kim SH, Kang BJ, Kim HS, Cha ES, Kim JY, Song BJ. Characterization of the enhancing lesions on dynamic contrast enhanced magnetic resonance imaging in patients with interstitial mammoplasty. Eur J Radiol 2013; 82:2205-11. [DOI: 10.1016/j.ejrad.2013.09.008] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/10/2013] [Revised: 07/31/2013] [Accepted: 09/09/2013] [Indexed: 10/26/2022]
|
46
|
Myong JH, Choi BG, Kim SH, Kang BJ, Lee A, Song BJ. Imaging features of complex sclerosing lesions of the breast. Ultrasonography 2013; 33:58-64. [PMID: 24936496 PMCID: PMC4058973 DOI: 10.14366/usg.13015] [Citation(s) in RCA: 3] [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: 10/16/2013] [Revised: 10/31/2013] [Accepted: 11/27/2013] [Indexed: 11/21/2022] Open
Abstract
Purpose: The purpose of this study was to evaluate the imaging features of complex sclerosing lesions of the breast and to assess the rate of upgrade to breast cancer. Methods: From March 2008 to May 2012, seven lesions were confirmed as complex sclerosing lesions by ultrasonography-guided core needle biopsy. Final results by either surgical excision or follow-up imaging studies were reviewed to assess the rate of upgrade to breast cancer. Two radiologists retrospectively analyzed the imaging findings according to the Breast Imaging Reporting and Data System classification.
Results: Five lesions underwent subsequent surgical excision and two of them revealed ductal carcinoma in situ (n=1) and invasive ductal carcinoma (n=1). Our study showed a breast cancer upgrade rate of 28.6% (2 of 7 lesions). Two lesions were stable on imaging follow-up beyond 1 year. The mammographic features included masses (n=4, 57.1%), architectural distortion (n=2, 28.6%), and focal asymmetry (n=1, 14.3%). Common B-mode ultrasonographic features were irregular shape (n=6, 85.7%), spiculated margin (n=5, 71.4 %), and hypoechogenicity (n=7, 100%). The final assessment categories were category 4 (n=6, 85.7%) and category 5 (n=1, 14.3%). Conclusion: The complex sclerosing lesions were commonly mass-like on mammography and showed the suspicious ultrasonographic features of category 4. Due to a high underestimation rate, all complex sclerosing lesions by core needle biopsy should be excised.
Collapse
Affiliation(s)
- Joo Hwa Myong
- Departments of Radiology, Seoul St. Mary's Hospital, The Catholic University of Korea College of Medicine, Seoul, Korea
| | - Byung Gil Choi
- Departments of Radiology, Seoul St. Mary's Hospital, The Catholic University of Korea College of Medicine, Seoul, Korea
| | - Sung Hun Kim
- Departments of Radiology, Seoul St. Mary's Hospital, The Catholic University of Korea College of Medicine, Seoul, Korea
| | - Bong Joo Kang
- Departments of Radiology, Seoul St. Mary's Hospital, The Catholic University of Korea College of Medicine, Seoul, Korea
| | - Ahwon Lee
- Departments of Pathology, Seoul St. Mary's Hospital, The Catholic University of Korea College of Medicine, Seoul, Korea
| | - Byung Joo Song
- Departments of Surgery, Seoul St. Mary's Hospital, The Catholic University of Korea College of Medicine, Seoul, Korea
| |
Collapse
|
47
|
Chung WB, Yi JE, Jin JY, Choi YS, Park CS, Park WC, Song BJ, Youn HJ. Early cardiac function monitoring for detection of subclinical Doxorubicin cardiotoxicity in young adult patients with breast cancer. J Breast Cancer 2013; 16:178-83. [PMID: 23843850 PMCID: PMC3706863 DOI: 10.4048/jbc.2013.16.2.178] [Citation(s) in RCA: 17] [Impact Index Per Article: 1.5] [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: 03/05/2013] [Accepted: 05/26/2013] [Indexed: 11/30/2022] Open
Abstract
PURPOSE As doxorubicin cardiotoxicity is considered irreversible, early detection of cardiotoxicity and prevention of overt heart failure is essential. Although there are monitoring guidelines for cardiotoxicity, optimal timing for early detection of subclinical doxorubicin cardiotoxicity is still obscure. The purpose of this study is to determine optimal timing of cardiac monitoring and risk factors for early detection of doxorubicin cardiotoxicity in young adult patients with breast cancer. METHODS Medical records of 1,013 breast cancer patients diagnosed from January 2009 to December 2010 is being reviewed and analyzed. Properly monitored patients are defined as patients who underwent transthoracic echocardiography before and after the chemotherapy. The definition of subclinical cardiotoxicity (SC) either decreases left ventricular ejection fraction (LVEF) more than 10% or the LVEF declines under 55% from baseline without heart failure symptoms. RESULTS Twenty-nine out of 174 (16.7%) properly monitored young adult female patients (mean age, 52±10 years old) developed SC. The mean interval of cardiac evaluation of SC group was 5.5±3.0 months. Among the risk factors, the history of coronary artery disease, cumulative dose of doxorubicin ≥300 mg/m(2) and use of trastuzumab after doxorubicin therapy were associated with development of SC. At cumulative dose of doxorubicin 244.5 mg/m(2), SC can be predicted (sensitivity, 71.4%; specificity, 70.9%; area under the curve, 0.741; 95% confidence interval, 0.608-0.874; p=0.001). CONCLUSION In young adult patients with breast cancer, SC was common at cumulative dose of doxorubicin <300 mg/m(2) and early performance of cardiac monitoring before reaching the conventional critical dose of doxorubicin might be a proper strategy for early detection of SC.
Collapse
Affiliation(s)
- Woo-Baek Chung
- Division of Cardiology, Department of Internal Medicine, The Catholic University of Korea College of Medicine, Seoul, Korea
| | | | | | | | | | | | | | | |
Collapse
|
48
|
Kwak HY, Chae BJ, Bae JS, Kim EJ, Chang EY, Kim SH, Jung SS, Song BJ. Feasibility of sentinel lymph node biopsy in breast cancer patients clinically suspected of axillary lymph node metastasis on preoperative imaging. World J Surg Oncol 2013; 11:104. [PMID: 23693028 PMCID: PMC3663684 DOI: 10.1186/1477-7819-11-104] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.7] [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: 12/21/2012] [Accepted: 05/12/2013] [Indexed: 11/29/2022] Open
Abstract
Background Generally, sentinel lymph node biopsy (SLNB) is performed in patients with clinically negative axillary lymph node (LN). This study was to assess imaging techniques in axillary LN staging and to evaluate the feasibility of SLNB in patients clinically suspected of axillary LN metastasis on preoperative imaging techniques (SI). Methods A prospectively maintained database of 767 breast cancer patients enrolled between January 2006 and December 2009 was reviewed. All patients were offered preoperative breast ultrasound, magnetic resonance imaging, and positron emission tomography scanning. SI patients were regarded as those for whom preoperative imaging was “suspicious for axillary LN metastasis” and NSI as “non-suspicious for axillary LN metastasis” on preoperative imaging techniques. Patients were subgrouped by presence of SI and types of axillary operation, and analyzed. Results For 323 patients who received SLNB, there was no statistically significant difference in axillary recurrence (P=0.119) between SI and NSI groups. There also was no significant difference in axillary recurrence between SLNB and axillary lymph node dissection (ALND) groups in 356 SI patients (P=0.420). The presence of axillary LN metastasis on preoperative imaging carried 82.1% sensitivity and 45.9% specificity for determining axillary LN metastasis on the final pathology. Conclusions SLNB in SI patents is safe and feasible. Complications might be avoided by not performing ALND. Therefore, we recommend SLNB, instead of a direct ALND, even in SI patients, for interpreting the exact nodal status and avoiding unnecessary morbidity by performing ALND.
Collapse
Affiliation(s)
- Hee Yong Kwak
- Department of Surgery, Catholic University of Korea, College of Medicine, Seoul, Republic of Korea
| | | | | | | | | | | | | | | |
Collapse
|
49
|
Kim SH, Kang BJ, Choi BG, Choi JJ, Lee JH, Song BJ, Choe BJ, Park S, Kim H. Radiologists' performance for detecting lesions and the interobserver variability of automated whole breast ultrasound. Korean J Radiol 2013; 14:154-63. [PMID: 23482698 PMCID: PMC3590325 DOI: 10.3348/kjr.2013.14.2.154] [Citation(s) in RCA: 37] [Impact Index Per Article: 3.4] [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: 07/10/2012] [Accepted: 10/08/2012] [Indexed: 11/15/2022] Open
Abstract
Objective To compare the detection performance of the automated whole breast ultrasound (AWUS) with that of the hand-held breast ultrasound (HHUS) and to evaluate the interobserver variability in the interpretation of the AWUS. Materials and Methods AWUS was performed in 38 breast cancer patients. A total of 66 lesions were included: 38 breast cancers, 12 additional malignancies and 16 benign lesions. Three breast radiologists independently reviewed the AWUS data and analyzed the breast lesions according to the BI-RADS classification. Results The detection rate of malignancies was 98.0% for HHUS and 90.0%, 88.0% and 96.0% for the three readers of the AWUS. The sensitivity and the specificity were 98.0% and 62.5% in HHUS, 90.0% and 87.5% for reader 1, 88.0% and 81.3% for reader 2, and 96.0% and 93.8% for reader 3, in AWUS. There was no significant difference in the radiologists' detection performance, sensitivity and specificity (p > 0.05) between the two modalities. The interobserver agreement was fair to good for the ultrasonographic features, categorization, size, and the location of breast masses. Conclusion AWUS is thought to be useful for detecting breast lesions. In comparison with HHUS, AWUS shows no significant difference in the detection rate, sensitivity and the specificity, with high degrees of interobserver agreement.
Collapse
Affiliation(s)
- Sung Hun Kim
- Department of Radiology, Seoul St. Mary's Hospital, College of Medicine, The Catholic University of Korea, Seoul 137-701, Korea
| | | | | | | | | | | | | | | | | |
Collapse
|
50
|
Purohit V, Rapaka R, Kwon OS, Song BJ. Roles of alcohol and tobacco exposure in the development of hepatocellular carcinoma. Life Sci 2013; 92:3-9. [PMID: 23123447 PMCID: PMC3822918 DOI: 10.1016/j.lfs.2012.10.009] [Citation(s) in RCA: 49] [Impact Index Per Article: 4.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/14/2012] [Revised: 10/01/2012] [Accepted: 10/10/2012] [Indexed: 12/11/2022]
Abstract
The purpose of this report is to summarize the roles of alcohol and tobacco exposure in the development of hepatocellular carcinoma (HCC). Chronic heavy alcohol exposure is a major risk factor for HCC, which is the most frequent type of liver cancer. Alcohol ingestion may initiate and or promote the development of HCC by: 1) acetaldehyde-DNA adduct formation; 2) cytochrome P4502E1-associated reactive oxygen species (ROS) generation , lipid peroxidation, p53 mutation, and conversion of pro-carcinogens to carcinogens; 3) iron accumulation that leads to ROS generation, lipid peroxidation, p53 mutation, and initiation of inflammatory cascade via nuclear factor-KappaB (NF-kB) activation; 4) glutathione depletion leading to oxidative stress; 5) s-adenosylmethionine (SAM) depletion and associated DNA hypomethylation of oncogenes ; 6) retinoic acid depletion and resultant hepatocyte proliferation via up-regulation of activator protein-1 (AP-1); 7) initiating an inflammatory cascade through increased transfer of endotoxin from intestine to liver, Kupffer cell activation via CD14/toll-like receptor-4 (TLR-4), oxidative stress, NF-kB or early growth response-1(Egr-1) activation, and generation of inflammatory cytokines and chemokines; 8) induction of liver fibrosis; and 9) decreasing the number and/or function of natural killer cells. Tobacco exposure is also a risk factor for HCC. It may contribute to the initiation and promotion of HCC due the presence of mutagenic and carcinogenic compounds as well as by causing oxidative stress due to generation of ROS and depletion of endogenous antioxidants. Simultaneous exposure to alcohol and tobacco is expected to promote the development of HCC in an additive and/or synergistic manner.
Collapse
Affiliation(s)
- Vishnudutt Purohit
- Chemistry and Physiological Systems Research Branch, Division of Basic Neuroscience & Behavioral Research, National Institute on Drug Abuse, National Institutes of Health, Bethesda, MD 20892, USA.
| | | | | | | |
Collapse
|