• Title/Summary/Keyword: 유방암 환자

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Bilateral Triple Negative Invasive Ductal Breast Carcinoma in a BRCA1 Mutation Carrier with Discrepant Pathologic Response to Neoadjuvant Chemotherapy (BRCA 유전자 변형 환자의 양측 삼중음성 유방암의 선행화학요법에 대한 상이한 반응)

  • Gi Won Shin;Young Mi Park;Tae Hyun Kim;Anbok Lee;Ha Young Park;Hye Kyoung Yoon;Young Jin Heo;Jin Wook Baek;Yoo Jin Lee
    • Journal of the Korean Society of Radiology
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    • v.81 no.2
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    • pp.428-435
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    • 2020
  • Herein, we report a case of synchronous bilateral triple negative invasive ductal breast carcinoma in a patient with discrepant pathologic response to neoadjuvant chemotherapy. Right and left breast cancer stages at the initial diagnosis were T1cN0M0 and T4dN3aM0, respectively. The patient was identified as a BRCA1 mutation carrier and treated with four cycles of adriamycin and cyclophosphamide, followed by four cycles of docetaxel. Bilateral breast cancer stages decreased with the first regimen. However, the bilateral breast cancers showed discrepant responses to chemotherapy with docetaxel. The right breast cancer showed a continuous tumor volume reduction while the left breast cancer showed marked progression. Finally, the tumor size was 0.3 cm and 12 cm in the right and left mastectomy specimens, respectively. As bilateral breast cancers of the same subtype may show discrepant responses to neoadjuvant chemotherapy, close monitoring and follow-up imaging are required to avoid delayed surgery.

$^{99m}Tc$-Tetrofosmin Scintimammography in Suspected Breast Cancer Patients: Comparison with $^{99m}Tc$-MIBI (유방암이 의심되는 환자에서 $^{99m}Tc$-Tetrofosmin을 이용한 유방스캔: $^{99m}Tc$-MIBI와 비교)

  • Kim, Seong-Jang;Kim, In-Ju;Kim, Yong-Ki;Bae, Young-Tae
    • The Korean Journal of Nuclear Medicine
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    • v.34 no.2
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    • pp.119-128
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    • 2000
  • Purpose: The aim of this study was to investigate the diagnostic role of $^{99m}Tc$-Tetrofosmin in detection of breast cancer and compared with that of $^{99m}Tc$-MIBI. Material and Methods: Forty-eight patients with a clinically palpable mass or abnormal mammographic or ultrasonographic findings had $^{99m}Tc-MIBI\;and\;^{99m}Tc$-Tetrofosmin scintimammographies after intravenous injection of 925 MBq of radiopharmaceuticals. The scintimammographs were correlated with histopathologic findings. Results: Thirty-three patients were diagnosed with breast cancer and 15 patients with benign breast diseases. The numbers of true positive, true negative, false positive, and false negative cases of $^{99m}Tc$-MIBI scintimammography were 29, 10, 5, and 4 respectively. The sensitivity, specificity, positive predictive value, and negative predictive value of $^{99m}Tc$-MIBI scintimammographies were 87.8%, 66.7%, 85.3%, and 71.4% respectively. The numbers of true positive, true negative, false positive, and false negative cases of $^{99m}Tc$-Tetrofosmin were 31,10, 5, and 2 respectively. The sensitivity, specificity, positive predictive value, negative predictive value of $^{99m}Tc$-Tetrofosmin were 93.9%, 66.7%, 86.1%, and 73.3% respectively. One patient was false negative in both $^{99m}Tc-MIBI\;and\;^{99m}Tc$-Tetrofosmin acintimammographies and its size was 0.5 cm. Conclusion: $^{99m}Tc-Tetrofosmin\;and\;^{99m}Tc-MIBI$ were non-invasive and useful in detection of breast cancer and $^{99m}Tc$-Tetrofosmin was comparable to the $^{99m}Tc$-MIBI in detection of primary breast cancer.

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The Effect of Tai-Chi Exercise on the Function of Shoulder Joint, Heart Rate in Breast Cancer Patients (타이치(Tai-Chi) 운동이 유방암 수술환자의 어깨관절 가동범위와 심박동수 변화에 미치는 영향)

  • Kim, Cheol-Woo;Kwak, Yi-Sub;Kim, Yi-Soon;Kim, Kyung-Chul;Kim, Hee-Eun
    • Journal of Life Science
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    • v.20 no.3
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    • pp.345-349
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    • 2010
  • Good health-related quality of life is regarded as the goal of elderly residential care. Treatment for breast cancer produces side effects that diminish functional capacity and quality of life among survivors. Tai-Chi exercise offers the benefits of fitness and health. Tai-chi has been claimed to generate beneficial effects with respect to a wide range of diseases. The object of this research is to evaluate the effects of tai chi exercise on shoulder joint movement and cardiovascular function in elderly breast cancer patients. The subjects were 40 patients residing in B metropolitan city, who had undergone surgery for breast cancer within 2 months. They underwent post-operative radiotherapy and an anti-cancer chemical treatment. They practiced tai-chi exercise for 60 min a day, four times a week for 12 weeks under the direction of a special tai-chi instructor. Shoulder joint movement and heart rate, were measured before and after the experiment. The results were as follows; Shoulder joint movement, including flexion, extention, adduction and abduction, significantly increased (p<0.05) after treatment, and heart rates significantly decreased after treatment (p<0.05). From the results, Tai-Chi exercise was shown to be extremely effective in improving shoulder joint movement and heart rate in elderly breast cancer patients. Further study is needed in this area.

Distress and Associated Factors in Patients with Breast Cancer Surgery : A Cross-Sectional Study (유방암 수술환자의 디스트레스 및 연관인자 : 단면연구)

  • Lee, Sang-Shin;Rim, Hyo-Deog;Woo, Jungmin
    • Korean Journal of Psychosomatic Medicine
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    • v.26 no.2
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    • pp.77-85
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    • 2018
  • Objectives : This study aimed to investigate the level of distress using the distress thermometer (DT) and the factors associated with distress in postoperative breast cancer (BC) patients. Methods : DT and WHOQOL-BREF (World Health Organization Quality of Life Scale Abbreviated Version) along with sociodemographic variables were assessed in patients undergoing surgery for their first treatment of BC within one week postoperatively. The distress group consisted of participants with a DT score ${\geq}4$. The prevalence and associative factors of distress were examined by descriptive, univariable, and logistic regression analysis. Results : Three hundred seven women were recruited, and 264 subjects were finally analyzed. A total of 173 (65.5%) were classified into the distress group. The distress group showed significantly younger age (p=0.045), living without a spouse (p=0.032), and worse quality of life (QOL) as measured by overall QOL (p=0.009), general health (p=0.005), physical health domain (p<0.000), and psychological health domain (p=0.002). The logistic regression analysis showed that patients aged 40-49 years were more likely to experience distress than those aged ${\geq}60years$ (Odds ratios [OR]=2.992, 95% confidence interval [CI] 1.241-7.215). Moreover, the WHOQOL-BREF physical health domain was a predictive factor of distress (OR=0.777, 95% CI 0.692-0.873). Conclusions : A substantial proportion of patients are experiencing significant distress after BC surgery. It would be expected that distress management, especially in the middle-aged patients and in the domain of physical QOL (e.g., pain, insomnia, fatigue), from the early BC treatment stage might reduce chronic distress.

A Study on the Wearing Conditions of Mastectomy Bras and Breast Prosthesis (유방암 환자용 브래지어에 대한 착용실태조사)

  • 이경미;최혜선
    • Journal of the Korean Society of Clothing and Textiles
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    • v.25 no.4
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    • pp.697-706
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    • 2001
  • There are approximately 1,000 patients who undergo mastectomies each year in Korea. However, there is no company who manufactures mastectomy brassieres and breast prosthesis in Korea. The purpose of this study is to evaluate the wearing conditions of the imported mastectomy brassieres with breast prosthesis and to develop the better-fitted and comfortable mastectomy brassieres in reasonable price. 254 patients participated in this survey. In the results of our survey, 117 out of the 254 patients were wearing mastectomy brassieres and breast prostheses, which have been imported mostly from USA. The degree of satisfaction at wearing mastectomy brassieres was low. The patients generally feel hot when wearing mastectomy brassieres, specially in summer and also pointed out the heavy weight of breast prosthesis and the discomfort in wearing mastectomy brassiere for a long period of time.

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Evaluation of Dose Reduction of Cardiac Exposure Using Deep-inspiration Breath Hold Technique in Left-sided Breast Radiotherapy (좌측 유방암 방사선 치료에서 깊은 들숨 호흡법을 이용한 심장 선량 감소 평가)

  • Jung, Joo-Young;Kim, Min-Joo;Jung, Jae-Hong;Lee, Seu-Ran;Suh, Tae-Suk
    • Progress in Medical Physics
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    • v.24 no.4
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    • pp.278-283
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    • 2013
  • Breast cancer is the leading cause of cancer death in women worldwide and the number of women breast cancer patient was increased continuously. Most of breast cancer patient has suffered from unnecessary radiation exposure to heart, lung. Low radiation dose to the heart could lead to the worsening of preexisting cardiovascular lesions caused by radiation induced pneumonitis. Also, several statistical reports demonstrated that left-sided breast cancer patient showed higher mortality than right-sided breast cancer patient because of heart disease. In radiation therapy, Deep Inspiration Breath Hold (DIBH) technique which the patient takes a deep inspiration and holds during treatment and could move the heart away from the chest wall and lung, has showed to lead to reduction in cardiac volume and to minimize the unnecessary radiation exposure to heart during treatment. In this study, we investigated the displacement of heart using DIBH CT data compared to free-breathing (FB) CT data and radiation exposure to heart. Treatment planning was performed on the computed tomography (CT) datasets of 10 patients who had received lumpectomy treatments. Heart, lung and both breasts were outlined. The prescribed dose was 50 Gy divided into 28 fractions. The dose distributions in all the plans were required to fulfill the International Commission on Radiation Units and Measurement specifications that include 100% coverage of the CTV with ${\geq}95%$ of the prescribed dose and that the volume inside the CTV receiving >107% of the prescribed dose should be minimized. Scar boost irradiation was not performed in this study. Displacement of heart was measured by calculating the distance between center of heart and left breast. For the evaluation of radiation dose to heart, minimum, maximum and mean dose to heart were calculated. The present study demonstrates that cardiac dose during left-sided breast radiotherapy can be reduced by applying DIBH breathing control technique.

Quantitative and cell count analysis of Breat cancer cell nuclei by Immunohisto-chemical stained tissue section (면역조직화학염색에 의한 유방암 세포핵의 정량적 분석과 세포수에 의한 분석)

  • 허민권;최흥국;서정욱
    • Proceedings of the Korea Multimedia Society Conference
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    • 1998.10a
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    • pp.243-247
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    • 1998
  • 전자현미경 영상인 유방암 조직세포의 암 분포 정도를 알기 위해, 조직세포중 암이 퍼진 부분과 그렇지 않은 부분에 대해 정량적 분석과 세포수에 의한 분석을 비교하여 보았다. 유방암 조직세포의 면역조직화함염색에서 암이 있는 세포핵은 갈색으로 나타났고, 그렇지 않은 세포는 푸른색으로 나타났다. 이것은 환자를 진단하고 예지하는데 있어서 중요한 요인으로 작용하지만 지금까지는 의사의 주관적인 생각이 다분히 포함된 판단에 의존할 수 밖에 없었다. 의료영상이미지의 시각적 표현을 위해 RGB칼라를 HLS칼라로 변환하여 사용하였으며, 이것은 시각적으로 좀 더 쉽게 갈색세포핵과 푸픈색 세포핵을 구분하게 해 주었다. 두 세포핵을 분리하기 위해 히스트그램의 임계치와 Box classification의 두 알고리즘의 사용하여 추출하였다. 그리고 추출한 세포핵들에 대해 각각 정량적인 분석과 세포수에 의한 분석을 하였다. 이러한 실험은 시각적 병리정밀검사에 좋은 보조도구로 사용될 수 있을 것이다.

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Effects of Obesity on Survival Rate and Disease-free Survival Rate of Breast Cancer Patients sub-classified according to Reproductive History and Age (출산력과 연령으로 그룹화한 유방암 환자에서 비만이 생존율 및 무병생존율에 미치는 영향)

  • Oh, Yeong-Kyong;Hwang, Seon-Young
    • Journal of the Korea Academia-Industrial cooperation Society
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    • v.18 no.3
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    • pp.105-114
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    • 2017
  • The purpose of this study was to examine the effects of obesity at diagnosis on the prognosis of Korean breast cancer patients after classifying them according to their reproductive history and age by comparing the overall survival rate (OS) and disease-free survival rate (DFS). This study is a retrospective cohort study using 4181 breast cancer cases at one of the medical centers in Korea during the 3 year period from 2006 to 2008. We confirmed the levels of death and recurrence through a follow-up study completed in May 30. 2015. In conclusion, the parous patients had a lower OS than the non-parous patients (p=.000), and the younger patients below 40 years old had a lower OS and DFS than those who were 40 years old or older (p=.003, p=.000), while obesity did not affect the OS and DFS significantly. However, several subgroups in which obesity affected the OS and DFS were found after classifying the patients according to their reproductive history and age. For the subgroups classified by reproductive history, the obese patients had a lower OS and DFS than the non-obese patients in the subgroup in which the patients have a reproductive history (p=.001, p=.005). For the subgroups classified according to age, the obese patients had a lower OS and DFS than the non-obese patients in the subgroup in which the patients were 40 years old or older (p=.005, p=.014). Obesity affected the OS and DFS in the subgroup in which the patients were 40 years old or older and had a reproductive history (p=.000, p=.003). The results of this study show that obesity has an effect on the prognosis of breast cancer patients in the subgroups classified by reproductive history and age, whereas it has no effect on the OS and DFS of the patients when they are examined in their entirety. It also suggests that appropriate nursing intervention is needed for the subgroups in which obesity has effects on prognosis.

A Case of Tamoxifen-Associated Rapid Growing and Multiple Endometrial Polyps (타목시펜 사용과 연관되어 빠르게 진행하는 다발성 자궁내막폴립 1예)

  • Lee, Hee-Jun;Kim, Hoon;Ku, Seung-Yup;Han, Won-Shik;Kim, Seok-Hyun;Choi, Young-Min;Kim, Jung-Gu;Moon, Shin-Yong
    • Clinical and Experimental Reproductive Medicine
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    • v.37 no.2
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    • pp.173-179
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    • 2010
  • The antiestrogen tamoxifen is currently the most commonly used adjuvant treatment of breast cancer with antiestrogenic effect on mammary tissue. However, it is also associated with endometrial abnormalities, including hyperplasia, polyps, carcinoma, mostly interpreted as evidence of estrogenic effect on the endometrium. Previously, tamoxifen-associated polyp in breast cancer has been reported in the literature. Most studies had a long follow-up period and tamoxifen-associated polyp developed more than 1 year after tamoxifen treatment. In this case, we report an unusual case of rapid growing and multiple endometrial polyps that were developed only after 3 months' tamoxifen treatment in a postmenopausal breast cancer patient who received quadrant mastectomy with a brief review of literature.

Conservative Surgery and Primary Radiotherapy for Early Bresst Cancer: Yonsei Cancer Center Experience (조기 유방암에서 보존적 수술후 방사선치료: 연세암센터 경험)

  • Suh Chang Ok;Lee Hy De;Lee Kyung Sik;Jung Woo Hee;Oh Ki Keun;Kim Gwi Eon
    • Radiation Oncology Journal
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    • v.12 no.3
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    • pp.337-347
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    • 1994
  • Breast conserving surgery and irradiation is now accepted as preferable treatment method for the patients with stage I and II breast cancer. Our institution activated team approach for breast conservation in 1991 and treated one hundred and fourty patients during the next three years. Purpose : To present our early experience with eligibility criteria, treatment techniques, and the morbidities of primary radiotherapy. Materials and Methods: Sixty four patients with early stage breast cancer who received breast conserving treatment between January 1991 and December 1992 were evaluated. All patients received partial mastectomy(wide excision to quadrantectomy) and axillary node dissection followed by radiotherapy. Total dose of 4500-5040 cGy in 5-5 1/2 weeks was given to entire involved breast and boost dose of 1000-2000 cGy in 1-2 weeks was given to the primary tumor site. Linac 4 MV X-ray was used for breast irradiation and electron beam was used for boost. Thirty five Patients received chemotherapy before or after radiotherapy. Patients characteristics, treatment techniques, and treatment related morbidities were analyzed. Results : Age distribution was ranged from 23 to 59 year old with median age of 40. Twenty-seven patients had T1 lesions and 34 patients had T2 lesions. In three patients, pathologic diagnosis was ductal carcinoma in situ. Thirty-seven Patients were N0 and 27 patients were Nl. There were three recurrences, one in the breast and two distant metastases during follow-up period(6-30 months, median 14 months). Only one breast recurrence occured at undetected separate lesion with microcalcifications on initial mammogram. There was no serious side reaction which interrupted treatment courses or severe late complication. Only one symptomatic radiation pneumonitis and one asymptomatic radiation pneumonitis were noted. Conclusions: Conservative surgery and primary radiotherapy for early breast cancer is Proven to be safe and comfortable treatment method without any major complication. Long-term follow up is needed to evaluate our treatment results in terms of loco-regional control rate, survival rate, and cosmetic effect.

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