• Title/Summary/Keyword: 초기 유방암

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Radical Radiotherapy with Lumpectomy (wide excisional biopsy) for Early Breast Cancer -A Case Report and Review of Literature- (초기 유방함의 근치적 방사선치료)

  • Oh, Won-Young;Whang, In-Soon
    • Radiation Oncology Journal
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    • v.6 no.2
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    • pp.283-288
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    • 1988
  • However, long-term results of retrospective studies suggest that, for the great majority of individuals, mastectomy or conservative surgery with radiation therapy were be equally effective. The results at 5 and 10 years from prospective randomized trials indicate that survival following primary radiation therapy for early breast cancer is equivalent to that fellowing mastectomy. When competently Performed, Primary radiation therapy gives highly satisfactory cosmetic results and acceptably low rates of local tumor recurrence. A number of controversial issues remain concerning patient evaluation and selection and the optimal techniques of treatment, both surgical and radiotherapeutic. In addition, further work is needed to clearity the best way to integrate primary radiotherapy with adjuvant systemic treatment. And further follow-up of these patients with primary radiation therapy for early beast cancer will be required for ultimate proof of the relative merits. A case which was conservative surgery and radical irradiation of early breast cancer with review of literatures will be done.

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Kinematic Analysis of a Mastication Model Employing the 6-DOF Parallel Mechanism (6자유도의 병렬기구를 사용한 저작 모델의 기구학적 분석)

  • Khang, G.;Tsutsumi, Sadami
    • Journal of Biomedical Engineering Research
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    • v.20 no.4
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    • pp.479-484
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    • 1999
  • 본 연구에서는 사람의 턱 운동과 턱 사이에 작용하는 힘(혹은 압력)을 그대로 나타낼 수 있는 저작로봇을 개발하는 것을 궁극적인 목표로 한다. 이러한 저작로봇이 개발되면, 치과의사가 환자의 턱운동에 나타나는 병변을 진단하고 치료하는데 큰 도움이 될 것으로 사료된다. 또한 , 본 연구에 채택한 병렬기구(parallel mechanism)에대한 순기구학적( forward kinematics)분석은 일반적인 병렬기구의 실계에도 응용될 것으로 기대된다. 본 연구진이 1차적으로 설계한 모델은 베이스와 플랫폼(platform), 그리고 이 둘을 연결하는 3개의 다리로 구성되어 있다. 다리와 플랫폼은 3자유도의 관절로 다리와 베이스는 1자유도의 경첩 관절로 연결되어 있으며, 이 3개의 경첩 관절은 베이스 위의 수평면에서 직선을 따라 움직인다. 경첩 관절의 수평 변위와 세 다리의 길이가 주어졌을 때 플랫폼의 위치와 오리엔테이션을 구하는 순기구학의 해( 解)를 계산해내는 알고리즘을 개발하였다. 이 알고리즘의 특징은 매 순간 오차를 계산하여 이 오차가 줄어드는 방향으로 나아가도록 시간간격(time step)을 조절하는 것이다. 본 알고리즘은 현재 가장 보편적으로 사용되고 있는 뉴튼-렙슨 방법에 비하여 3가지 장점을 나타내고 있다. 우선 , 초기치(initial guess)에 관계없이 수렴한다는 것이다. 또한, 본 알고리즘은 뉴튼-렙슨 방법에 비하여 수렴속도가 훨씬 빠르며, 연산 시간이 매우 짧아져 실제적인 실시간 적용에 적합하다. 마지막으로, 뉴튼-렙슨 방법에서는 여러 개의 해 가운데 어느 곳으로 수렴할 지 예측 할수 없으나 본 알고리즘에서는 초기치에 가장 가까운 해로 수렴한다. 이러한 순기구학의 다중성(multiplicity)문제를 해결하기 위하여 두 개의 조건을 제시하였으며, 이를 적용한 시뮬레이션 결과에 의하면 항상 원하는 해(true solution)에 수렴할 수 있었다.발생량의 감소를 기대 할 수 있는 친환경기술로 유지관리비를 최소화할 수 있는 장점이 있었다. 않은 사람들 중 미래의 검진실행의지에 건강소식지가 영향을 미친 경우는 48.7%였다. 보건교육을 받은 후 유방암 자가검진 실천율은 사업군에서 53.9%로 받기 전의 27.3%보다 증가하였으나 대조군의 경우는 별 차이가 없었다. 연령별로는 60대가 가장 높았고 사업군에서 검진율의 증가분은 30대가 가장 컸다. 교육수준별로는 사업군은 고졸이, 대조군은 전문대졸이 가장 높았고 사업군에서 검진율의 증가분은 고졸에서 가장 컸다. 보건교육 후 유방암과 관련된 건강지식의 정도는 사업군이 3.7점으로 대조군보다 유의하게 높았으며, 유방암 자가검진법을 실천하는 사람들의 동기는 ‘일반 대중매체의 영향’이 가장 많았으며 건강소식지가 동기인 경우도 20.4%였다. 사업군에서 건강소식지가 유방암 자가검진법 실천에 영향을 미친 경우가 79.6%였으며 유방암 자가검진법에 관한 보건교육을 받고 실천하지 않은 사람들 중 미래의 실천의지에 건강소식지가 영향을 미친 경우는 43.6%였다. 이상의 소견에서 지역주민을 대상으로 인쇄매체를 통한 보건교육은 인쇄물만으로도 쉽게 실천 할 수 있는 유방암 자가검진법이 가장 효과적이었으며, 자궁암검진에 관해서도 검진을 받을 수 있도록 지역사회의 보건의료의 하부구조를 정비하여 제도적 장치를 마련하고 정보를 제공한다면 자궁암검진 실천율도 증가할 것이다.고 12.9% 의 발달율을 보여 유의적인 차이를 보이지 않았다. 이상의 결과로 보아 핵이식 수정란을 효율적으로 생산하기 위하여 수핵난자의 세포질에 ionomycin 과 DMAP 의 혼합처리로 탈핵난자의 활성화를 유도하는 것이 효율을 증진시킬 수 있었다고 본다. 또한 공핵수정란을 수정 후 90시간과 114시간 개별 배양하여 할구를 공핵체로 핵이식에 이용하였을 때도 그룹배양에 비하여 효율이 떨어지지 않음을 알 수 있었으며, 수정란의 할구

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Automatic Detection of Initial Positions for Mass Segmentation in Digital Mammograms (디지털 마모그램에서 Mass형 유방암 분할을 위한 초기 위치 자동 검출)

  • Lee, Bong-Ryul;Lee, Myeong-Jin
    • Journal of Korea Multimedia Society
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    • v.13 no.5
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    • pp.702-709
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    • 2010
  • The performance of mass segmentation is greatly influenced by an initial position of a mass. Some researchers performed mass segmentation with the initial position of a mass given by radiologists. The purpose of our research is to find the initial position for mass segmentation and to notify the segmented mass to radiologists without any additional information on mammograms. The proposed system consists of breast segmentation by region growing and opening operations, decision of an initial seed with characteristics of masses, and mass segmentation by a level set segmentation. A seed for mass segmentation is set based on mass scoring measure calculated by block-based variances and masked information in a sub-sampled mammogram. We used a DDSM database to evaluate the system. The accuracy of mass detection is 78% sensitivity at 4 FP/image, and it reached 92% if multiple views for masses were considered.

Development of Automatic Cluster Algorithm for Microcalcification in Digital Mammography (디지털 유방영상에서 미세석회화의 자동군집화 기법 개발)

  • Choi, Seok-Yoon;Kim, Chang-Soo
    • Journal of radiological science and technology
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    • v.32 no.1
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    • pp.45-52
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    • 2009
  • Digital Mammography is an efficient imaging technique for the detection and diagnosis of breast pathological disorders. Six mammographic criteria such as number of cluster, number, size, extent and morphologic shape of microcalcification, and presence of mass, were reviewed and correlation with pathologic diagnosis were evaluated. It is very important to find breast cancer early when treatment can reduce deaths from breast cancer and breast incision. In screening breast cancer, mammography is typically used to view the internal organization. Clusterig microcalcifications on mammography represent an important feature of breast mass, especially that of intraductal carcinoma. Because microcalcification has high correlation with breast cancer, a cluster of a microcalcification can be very helpful for the clinical doctor to predict breast cancer. For this study, three steps of quantitative evaluation are proposed : DoG filter, adaptive thresholding, Expectation maximization. Through the proposed algorithm, each cluster in the distribution of microcalcification was able to measure the number calcification and length of cluster also can be used to automatically diagnose breast cancer as indicators of the primary diagnosis.

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Family Members' Caregiving Experience for Middle-aged and Elderly Breast Cancer Survivors at Early Stages (중·고령 초기 유방암 생존자를 돌보는 가족의 경험)

  • Park, So-Young;Park, Hyangkyung;Koo, Hyang Na;Baek, Jung Yun;Noh, Eunjeong
    • 한국노년학
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    • v.40 no.1
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    • pp.111-130
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    • 2020
  • This qualitative study aims to understand family members' caregiving experience for middle-aged and elderly breast cancer survivors at early stages. A total of four families of breast cancer survivors were given focus group interviews(FGI), and an additional family was interviewed individually. The thematic analyses of the FGI and individual in-depth interview discussions revealed the following four themes: first, day-to-day feelings like walking on thin ice (entangled emotions with each treatment stage, regret of watching a survivor's pain, fear of recurrence and death, concerns of changes in family relationships, and various feelings experienced as a daughter), second, caregiving has become a mainstay in my life (unfamiliar and unskilled care, losing my life), third, beginning to recover and different experiences between a survivor and a family caregiver (not understanding a survivor's pain from the abyss, forgetting that the survivor is still a cancer patient and that treating him or her casually), and fourth, moving forward (hope that things will be better, taking care of myself to prevent exhaustion). Based on the results of this study, we proposed social welfare services and policy measures to reflect the psychosocial needs of family caregivers of breast cancer survivors and support family caregivers during the care process.

Digital Breast Tomosynthesis as a Breast Cancer Screening Tool for Women with Gynecologic Cancer (부인암을 가진 여성에서 유방암의 선별검사로서의 디지털 유방단층 촬영술)

  • Da-hoon Kim;Jin Chung;Eun-Suk Cha;Jee Eun Lee;Jeoung Hyun Kim
    • Journal of the Korean Society of Radiology
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    • v.81 no.4
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    • pp.886-898
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    • 2020
  • Purpose The purpose of our study was to evaluate digital breast tomosynthesis as a breast cancer screening modality for women with gynecologic cancer. Materials and Methods This retrospective study included patients with underlying gynecologic malignancies who underwent screening digital breast tomosynthesis for breast cancer. The cancer detection rate, recall rate, sensitivity, specificity, and positive predictive value (PPV) were calculated. PPV1 was defined as the percentage of all positive screening exams that have a tissue diagnosis of cancer within a year. PPV2 was defined as the percentage of all diagnostic exams (and Breast Imaging Reporting and Data System category 4, 5 from screening setting) with a recommendation for tissue diagnosis that have cancer within a year. PPV3 was defined as the percentage of all known biopsies actually performed that resulted in a tissue diagnosis of cancer within the year. For each case of screen-detected cancer, we analyzed the age, type of underlying gynecologic malignancy, breast density, imaging features, final Breast Imaging Reporting and Data System assessment, histologic type, T and N stages, molecular subtype, and Ki-67 index. Results Among 508 patients, 7 with breast cancer were identified after a positive result. The cancer detection rate was 13.8 per 1000 screening exams, and the recall rate was 17.9%. The sensitivity was 100%, and the specificity was 83.2%. The false negative rate was 0 per 1000 exams. The PPV1, PPV2, and PPV3 were 7.7, 31.8, and 31.8, respectively. Conclusion Digital breast tomosynthesis may be a promising breast cancer screening modality for women with gynecologic cancer, based on the high cancer detection rate, high sensitivity, high PPV, and high detection rate of early-stage cancer observed in our study.

Long-term Results of Breast-conserving Surgery and Radiation Therapy in Early Breast Cancer (초기 유방암의 유방보존수술과 방사선치료의 장기추적결과)

  • Kim, Jin-Hee;Byun, Sang-Jun
    • Radiation Oncology Journal
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    • v.27 no.3
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    • pp.153-162
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    • 2009
  • Purpose: To evaluate the long-term results after breast-conserving surgery and radiation therapy in early breast cancer in terms of failure, survival, and cosmesis. Materials and Methods: One hundred fifty-four patients with stage I and II breast cancer were treated with conservative surgery plus radiotherapy between January 1992 and December 2002 at the Keimyung University Dongsan Medical Center. According to TNM stage, 93 patients were stage I, 50 were IIa, and 11 were IIb. The affected breasts were irradiated with 6 MV photons to 50.4 Gy in 28 fractions over 5.5 weeks with a boost irradiation dose of 10~16 Gy to the excision site. Chemotherapy was administered in 75 patients and hormonal therapy in 92 patients with tamoxifen. Follow-up periods were 13~179 months, with a median of 92.5 months. Results: The 5- and 10-year overall survival rates were 97.3% and 94.5%, respectively. The 5- and 10-year disease-free survival (5YDFS and 10YDFS, respectively) rates were 92.5% and 88.9%, respectively; the ultimate 5YDFS and 10YDFS rates after salvage treatment were 93.9% and 90.2%, respectively. Based on multivariate analysis, only the interval between surgery and radiation therapy ($\leq$6 weeks vs. >6 weeks, p=0.017) was a statistically significant prognostic factor for DFS. The major type of treatment failure was distant failure (78.5%) and the most common distant metastatic site was the lungs. The cosmetic results were good-to-excellent in 96 patients (80.7%). Conclusion: Conservative surgery and radiation for early stage invasive breast cancer yielded excellent survival and cosmetic results. Radiation therapy should be started as soon as possible after breast-conserving surgery in patients with early breast cancer, ideally within 6 weeks.

Relationship Between pSUV of $^{18}F$-FDG PET/CT and Pathological Diagnosis in Breast Cancer (유방암에서 $^{18}F$-FDG PET/CT의 pSUV와 병리학적 진단과의 연관성)

  • Kim, Mi-Young
    • Journal of radiological science and technology
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    • v.36 no.4
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    • pp.305-311
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    • 2013
  • The purpose of this study was to evaluate the Pathological Diagnosis associated with pSUV uptake of $^{18}F$-FDG PET/CT. We had enrolled 39 women that underwent $^{18}F$-FDG PET/CT before operative. We evaluated whether there was correlation between the pSUV of $^{18}F$-FDG PET/CT and prognostic factors. As a results, pSUV level increase according to tumor size but pSUV had no significant association with tumor size. pSUV of high histologic grade was higher than low histologic grade, and pSUV showed positive correlations with histologic grade. The ER and PR showed significant negative correlations with the pSUV of $^{18}F$-FDG PET/CT. Therefore, our results demonstrated that an correlation exists between pSUV and prognostic factors such as histologic grade, ER and PR.

Preservation through Cloning of Superior Canine Scent Detection Ability for Cancer Screening (복제를 통한 우수한 암탐지 능력의 보존)

  • Kim, Min-Jung;Park, Jung-Eun;Oh, Hyun-Ju;Hong, So-Gun;Kang, Jung-Taek;Rhim, Sang-Hyun;Lee, Dong-Won;Ra, Jung-Chan;Lee, yeong-Chun
    • Journal of Veterinary Clinics
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    • v.32 no.4
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    • pp.352-355
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    • 2015
  • This study was conducted to ascertain whether the scent detection ability of a donor dog having extraordinary talent in cancer detection can be conserved through cloning. A specially trained dog for colorectal cancer detection was cloned, and she was trained and tested to detect breast cancers using breath samples collected from patients and healthy volunteers. Scent detection sensitivity of the clone was 93.3% and specificity was 99.5%, similar with those of donor (91% and 99%). Furthermore, the clone successfully detected early stage of breast cancers. Therefore, superior canine scent detection ability for cancer screening could be preserved through cloning.

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.