• Journal of the Korean Society of Radiology
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• v.10 no.4
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• pp.271-278
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• 2016

This study was fulfilled to evaluate the absorbed dose of breast and adjacent organs using MIRD type phantom in brachytherapy of breast cancer. The absorbed dose was analyzed assuming left or right breast is source organ which is $^{103}Pd$ or $^{192}Ir$. As a result, $^{192}Ir$ dose is higher than $^{103}Pd$ in source organ and also in contralateral breast. Particularly, significant adjacent organs are lung, liver, heart and contralateral breast in brachytherapy of breast cancer.

• Journal of the Korean Society of Radiology
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• v.14 no.3
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• pp.295-301
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• 2020

Radiation exposure exposed during mammography, which is performed for early examination of breast cancer, has also been suggested as a cause of carcinogenesis in the past, and scattered rays generated during examination may cause unnecessary radiation exposure to surrounding organs. In this study, the Monte Carlo simulation was used to evaluate the human organ doses exposed during conventional mammography, and to estimate the dose reduction effect for each organ when using 3D printing materials for radiation protection by scattered rays. As a result of organ dose evaluation, the breast on the opposite side of the examination was about 22.0% of the breast on the test side and about 58.6% on the eye, which was highly influenced by the scattering-ray. When using the 3D printing shield to protect it, the breast on the opposite side of the test showed an effective dose reduction effect at a thickness of 1 mm.

• Radiation Oncology Journal
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• v.23 no.4
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• pp.230-235
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• 2005

Purpose: To evaluate the contralateral breast dose using a virtual wedge compared with that using a Physical wedge and an open beam in a Siemens linear accelerator. Materials and Methods: The contralateral breast dose was measured using diodes placed on a humanoid phantom. Diodes were placed at 5.5 cm (position 1), 9.5 cm (position 2), and 14 cm (position 3) along the medial-lateral line from the medial edge of the treatment field. A 6-MV photon beam was used with tangential irradiation technique at 50 and 230 degrees of gantry angle. Asymmetrically collimated $17{\times}10cm$ field was used. for the first set of experiment, four treatment set-ups were used, which were an open medial beam with a 30-degree wedged lateral beam (physical and virtual wedges, respectively) and a 15-degree wedged medial beam with a 15-degree wedged lateral beam (physical and virtual wedges, respectively). The second set of experiment consists of setting with medial beam without wedge, a 15-degree wedge, and a 50-degree wedge (physical and virtual wedges, respectively). Identical monitor units were delivered. Each set of experiment was repeated for three times. Results: In the first set of experiment, the contralateral breast dose was the highest at the position 1 and decreased in order of the position 2 and 3. The contralateral breast dose was reduced with open beam on the medial side ($2.70{\pm}1.46%$) compared to medial beam with a wedge (both physical and virtual) ($3.25{\pm}1.59%$). The differences were larger with a physical wedge ($0.99{\pm}0.18%$) than a virtual wedge ($0.10{\pm}0.01%$) at all positions. The use of a virtual wedge reduced the contralateral breast dose by 0.12% to 1.20% of the proscribed dose compared to a physical wedge with same technique. In the second experiment, the contralateral breast dose decreased in order of the open beam, the virtual wedge, and the physical wedge at the position 1, and it decreased in order of a physical wedge, an open beam, and a virtual wedge at the position 2 and 3. Conclusion: The virtual wedge equipped in a Siemens linear accelerator was found to be useful in reducing dose to the contralateral breast. Our additional finding was that the surface dose distribution from the Siemens accelerator was different from a Varian accelerator.

• The Journal of Korean Society for Radiation Therapy
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• v.26 no.2
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• pp.329-336
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• 2014

Purpose : To evaluate the dose on a contralateral breast and the usefulness of shielding according to the distance between the contralateral breast and the side of the beam by breast size when patients who got breast implant receive radiation therapy. Materials and Methods : We equipped 200 cc, 300 cc, 400 cc, and 500 cc breast model on the human phantom (Rando-phantom), acquired CT images (philips 16channel, Netherlands) and established the radiation treatment plan, 180 cGy per day on the left breast (EclipseTM ver10.0.42, Varian Medical Systems, USA) by size. We set up each points, A, B, C, and D on the right(contralateral) breast model for measurement by size and by the distance from the beam and attached MOSFET at each points. The 6 MV, 10 MV and 15 MV X-ray were irradiated to the left(target) breast model and we measured exposure dose of contralateral breast model using MOSFET. Also, at the same condition, we acquired the dose value after shielding using only Pb 2 mm and bolus 3 mm under the Pb 2 mm together. Results : As the breast model is bigger from 200 cc to 500 cc, The surface of the contralateral breast is closer to the beam. As a result, from 200 cc to 500 cc, on 180 cGy basis, the measurement value of the scattered ray inclined by 3.22 ~ 4.17% at A point, 4.06 ~ 6.22% at B point, 0.4~0.5% at C point, and was under 0.4% at D point. As the X-ray energy is higher, from 6 MV to 15 MV, on 180 cGy basis, the measurement value of the scattered ray inclined by 4.06~5% at A point, 2.85~4.94% at B point, 0.74~1.65% at C point, and was under 0.4% at D point. As using Pb 2 mm for shield, scattered ray declined by average 9.74% at A and B point, 2.8% at C point, and is under 1% at D point. As using Pb 2 mm and bolus together for shield, scattered ray declined by average 9.76% at A and B point, 2.2% at C point, and is under 1% at D point. Conclusion : Commonly, in case of patients who got breast implant, there is a distance difference by breast size between the contralateral breast and the side of beam. As the distance is closer to the beam, the scattered ray inclined. At the same size of the breast, as the X-ray energy is higher, the exposure dose by scattered ray tends to incline. As a result, as low as possible energy wihtin the plan dose is good for reducing the exposure dose.

• Investigative Magnetic Resonance Imaging
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• v.12 no.2
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• pp.161-169
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• 2008

Purpose : The aim of this study was to evaluate the usefulness of MRI performed after excisional biopsy to diagnose residual cancer and additional lesions. Materials and Methods : A total of 16 patients who had breast cancer diagnosed by excisional biopsy underwent preoperative breast MRI between March 2005 and August 2007 were included. MRI findings were considered positive for residual cancer if focal, thick, or irregular rim enhancement or adjacent enhancing lesion was identified around the postoperative biopsy cavity. And additional lesions separated from biopsy cavity including multifocal, multicentric, or contralateral lesion were evaluated. We evaluated the diagnostic accuracy of MRI, comparing MRI with histopathologic finding, and the impact of MRI on surgical planning. Results : The sensitivity and specificity of MRI for detecting residual disease considering rim enhancement were 85.7%(6/7) and 55.6%(5/9). Additional lesions including multifocal, multicentric, or contralateral lesion were found in 6 patients. In 7 patients, results of MRI findings changed surgical treatment planning. Conclusion : The pattern of rim enhancement on MRI after excisional biopsy is not differential point to evaluate remnant lesion. But MRI has an important role to help the detection of multifocal or multicentric, or contralateral breast malignancies, resulting in beneficial change in surgical treatment planning.

• Investigative Magnetic Resonance Imaging
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• v.14 no.2
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• pp.121-125
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• 2010

Purpose : The purpose of this study was to evaluate the diagnostic accuracy of 3.0-T breast MRI for detecting additional breast cancer soon after the initial diagnosis of breast cancer. Materials and Methods : From March to June 2009, 101 patients recently diagnosed breast cancer underwent breast MRI and surgery. Parameters analyzed on MRI were total extent of tumor, suspicious findings of multifocal, multicentric, or contralateral cancer. The diagnosis of MRI-detected cancer was confirmed by means of biopsy or surgical specimen evaluation after the localization. Results : MRI showed 37 additional suspicious findings in 34 patients. Twenty nine findings were true-positive (29/37, 78.4%), including 16 cases of multifocality, 11 cases of multicentricity and 2 cases of contralateral cancer. Among these cancers, 13 (44.8%) were ductal carcinoma in situ (DCIS) and 16 (55.1%) were infiltrating cancer. Eight findings were false-positive (8/37, 21.6%) including 6 cases of benign disease and 2 cases of high-risk lesions. Conclusion : In women with recently diagnosed breast cancer, 3.0-T MR imaging showed additional suspicious findings in 33.7%. The sensitivity and specificity for detecting additional breast cancer was 100% and 89.3%, respectively.

• The Journal of Korean Society for Radiation Therapy
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• v.27 no.2
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• pp.175-181
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• 2015

Purpose : To evaluate Contralateral Breast Doses with Supine and Prone Positions for tangential Irradiation techniques for left-sided breast Cancer Materials and Methods : We performed measurements for contralateral doses using Human Phantom at each other three plans (conventional technique, Field-in-Field, IMRT, with prescription of 50 Gy/25fx). For the measurement of contralateral doses we used Glass dosimeters on the 4 points of Human Phantom surface (0 mm, 10 mm, 30 mm, 50 mm). For the position check at every measurements, we had taken portal images using EPID and denoted the incident points on the human phantom for checking the constancy of incident points. Results : The contralateral doses in supine position showed a little higher doses than those in prone position. In the planning study, contralateral doses in the prone position increased mean doses of 1.2% to 1.8% at each positions while those in the supine positions showed mean dose decreases of 0.8% to 0.9%. The measurements using glass dosimeters resulted in dose increases (mean: 2.7%, maximum: 4% of the prescribed dose) in the prone position. In addition, the delivery techniques of Field-in-field and IMRT showed mean doses of 3% higher than conventional technique. Conclusion : We evaluated contralateral breast doses depending on different positions of supine and prone for tangential irradiations. For the phantom simulation of set-up variation effects on contralateral dose evaluation, although we used humanoid phantom for planning and measurements comparisons, it would be more or less worse set-up constancy in a real patient. Therefore, more careful selection of determination of patient set-up for the breast tangential irradiation, especially in the left-sided breast, should be considered for unwanted dose increases to left lung and heart. In conclusion, intensive patient monitoring and improved patient set-up verification efforts should be necessary for the application of prone position for tangential irradiation of left-sided breast cancer.

• Journal of the Korean Society of Radiology
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• v.8 no.4
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• pp.155-161
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• 2014

Mammography is mostly performed by series projection on both breasts. While taking mammography, it is less than average glandular dose of 3 mGy which regulated. But mammography is exposed much more doses actually, due to additional or series projection. Also, it is difficult to recognize around organ dose except exposed breast. Using mathematical simulation of radiation exposure body in mammography, we studied around organ dose distribution by changing thickness(25, 30, $50{\mu}m$) of filter and relative absorption dose rate which set on basis of exposed breast. as a result, when setting of basis of exposed breast, dose of opposite breast is more affected approximately from 79.26 to 86.31%. when using $25{\mu}m$ of filter thickness than $30{\mu}m$, $50{\mu}m$ of filter thickness in Mo/Mo, W/Rh combination which used actually, absorbed dose rates for opposite breast and around organ were low.

• Tuberculosis and Respiratory Diseases
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• v.56 no.1
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• pp.91-96
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• 2004

Primary lung cancer frequently metastasizes to distant organs. But breast is a very rare site of metastasis. So, accurate diagnosis is essential to rule out primary breast cancer. A 62-year old woman who had complained of cough was diagnosed as small cell lung carcinoma of the right lower lobe. She had a 2.5cm sized lobular mass in left upper mid portion of breast. Sonoguided breast biopsy revealed small cell carcinoma consistent with metastatis from primary lung cancer. She also had bone metastses to the scapula and the vertebrae. We report the case of metastatic breast cancer from small cell lung carcinoma.

• Archives of Plastic Surgery
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• v.36 no.1
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• pp.29-32
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• 2009

Purpose: Introduction of the mammary implant through the abdominal route has been well known since late 1960s, but the use of transabdominal route for contralateral breast augmentation in transverse rectus abdominis musculocutaneous (TRAM) flap breast reconstruction patients has not been reported in Korean literature. The authors report their experience with technical points as well as the selection of the appropriate patients. Methods: Simultaneous contralateral augmentation mammaplasty through transabdominal route was performed in 11 patients who underwent TRAM breast reconstruction from August 2003 to May 2008 with a mean follow up of 27 months. The pocket was created under direct vision: 3 subglandular, 7 subpectoral, and 1 dual plane was dissected. Eight saline and 3 silicone gel implants were used with an average volume of 165 cc. Results: There were no complications such as infection, hematoma, implant displacement, and capsular contracture. The result was well maintained throughout the follow up period. Conclusion: Transabdominal route could be recommended in selected patients for contralateral augmentation in TRAM breast reconstruction.