• 대한방사선기술학회지:방사선기술과학
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• 제23권1호
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• pp.49-54
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• 2000

It is important to identify modifiable risk factors for breast cancer, because the breast cancer is one of the major causs of mortality among women. Some reported that obesity is a risk factor for breast cancer, but the results are not constant. Many risk factors are related to the duration of estrogenic stimulation of the breast. In general, early menarche and late menopause are positive risk factors. Human breast cancer has different characteristics according to the status of menopause(premenopause and postmenopause). In premenopausal women, about 60% of circulating estrogen is from the ovaries in the form of estradiol, and the remaining 40% is estrogen formed primarily in the adipose(fat) tissue via aromatization of androstenedion from the adrenal glands. After menopause this adipose cell production of estrone is the main source of estrogens and the level of estrone is maintained approximately at premenopausal levels. This study was undertaken to determine the role of body size and body mass index by status of menopause in development of breast cancer using retrospective case/control study. From March 1991 to February 1997 at the Wonkwang University Hospital, the breast cancer cases(n=72) and controls(n=86) were selected. By statistical analysis method, regression analysis, paired T-test and multiple logistic regression were done to estimate the influenced factors same as height, weight, BMI, age at menarche and age at menopause. The following results were obtained : 1. In premenopausal women, age at menarche was showed comparatively high correlation coefficients and BMI was described prominently highly in postmenopause. 2. At the results of multiple regression analysis, age at monarch, BMI and weight were showed as significant variables. In this method, critical factor ($R^2$) was 0.054. 3. Paired samples T-test was undertaken to test mean difference between two groups of cases and controls. The result of test performance showed a significant difference. 4. In comparison with women whose weight less than 50 kg, the ORs for the upper 5th group was 1.82(95% confidence interval). The heaviest women had a higher risk(OR=1.14, 95% confidence interval $1.12{\sim}1.31$, p=0.005). Higher body mass index was significantly associated with increased risk of premenopausal breast cancer (OR=1.01, 95% confidence interval $1.08{\sim}l.18$, p=0.05).

• Korean Journal of Radiology
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• 제21권4호
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• pp.431-441
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• 2020

Objective: To compare the diagnostic performance and interobserver variability of strain ratio obtained from one or two regions of interest (ROI) on breast elastography. Materials and Methods: From April to May 2016, 140 breast masses in 140 patients who underwent conventional ultrasonography (US) with strain elastography followed by US-guided biopsy were evaluated. Three experienced breast radiologists reviewed recorded US and elastography images, measured strain ratios, and categorized them according to the American College of Radiology breast imaging reporting and data system lexicon. Strain ratio was obtained using the 1-ROI method (one ROI drawn on the target mass), and the 2-ROI method (one ROI in the target mass and another in reference fat tissue). The diagnostic performance of the three radiologists among datasets and optimal cut-off values for strain ratios were evaluated. Interobserver variability of strain ratio for each ROI method was assessed using intraclass correlation coefficient values, Bland-Altman plots, and coefficients of variation. Results: Compared to US alone, US combined with the strain ratio measured using either ROI method significantly improved specificity, positive predictive value, accuracy, and area under the receiver operating characteristic curve (AUC) (all p values < 0.05). Strain ratio obtained using the 1-ROI method showed higher interobserver agreement between the three radiologists without a significant difference in AUC for differentiating breast cancer when the optimal strain ratio cut-off value was used, compared with the 2-ROI method (AUC: 0.788 vs. 0.783, 0.693 vs. 0.715, and 0.691 vs. 0.686, respectively, all p values > 0.05). Conclusion: Strain ratios obtained using the 1-ROI method showed higher interobserver agreement without a significant difference in AUC, compared to those obtained using the 2-ROI method. Considering that the 1-ROI method can reduce performers' efforts, it could have an important role in improving the diagnostic performance of breast US by enabling consistent management of breast lesions.

• Archives of Plastic Surgery
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• 제37권5호
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• pp.695-698
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• 2010

Purpose: Supernumerary nipple or polythelia is one of the developmental anomalies occurring at the embryonic stage and this anomaly usually arises from the milk line. While this atypical feature is determined during early developmental stage, it may not come out obviously or become troublesome until puberty or lactation. Moreover, sometimes it is confused with a pigmented nevus. Methods: Case 1, a 18-year-old woman with intramammary supernumerary breast consisted of another nipple with middle sized areola on the right lower breast was admitted for a $2.8{\times}3.1\;cm$-sized mass on the right breast which was starting appeared 1 year earlier. The preliminary cytological examination of the material obtained by needle aspiration biopsy from the mass was revealed by fibroadenoma with no malignant change. The patient had the surgical excision of the mass and accessory breast. Case 2, a 16 year-old woman admitted for intra-areolar polythelia of the left breast, even she doesn't have any family history of polythelia. Since she wanted surgical correction of her atypical nipple for aesthetic and psychological reasons, we reconstructed the areola using transposition flaps in an S-plasty design. Results: Case 1, the excised supernumerary nipple showed following histological features. In the superficial layer, an acanthotic and hyperpigmented epithelium with elongated rete ridges was found. In the dermis, there were follicles with hairs surrounded by hypertrophic sebaceous glands. In the deepest portion, abundant secretory glomerules and excretory ducts of apocrine gland type were observed. Case 2, follow-up visits 3 months after the procedure showed a satisfactory result with good shape and projection of the nipple. Conclusion: We report two cases of aberrant mammary tissue who underwent surgical correction, including complete breast (with nipple, areola, and glandular tissue) and intra-areolar polythelia according to the Kajava's classification, and the results were satisfactory.

• 대한방사선기술학회지:방사선기술과학
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• 제43권1호
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• pp.23-27
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• 2020

In South Korea, female individuals in their forties show a high rate of incidence, with approximately 13% of the patients being <40 years. This statistic is more than twice as high as that in Western countries. It is therefore necessary to identify the risk factors for breast cancer incidence by age and economic activity participation status. Women aged 30 to 59-whether breast cancer patients or those in the control group and having no breast cancer-were appraised from the sample cohort database. The data were analyzed using the statistical software R36.2. To identify the factors affecting breast cancer incidence, the degree of association was determined with HR and 95% CI by means of cox regression analysis. As for the socio-demographic variables, the older the individual, the higher the risk of breast cancer incidence becomes. As for the economic activity variables, those who were dependents (unemployed) and who had higher income (medium and high) were at higher risk of breast cancer incidence, which was statistically significant. The income-adjusted HR (model 1) for breast cancer development associated with the economic activity was 1.452 (95% CI, 1.19-1.77). The body mass index and alcohol intake-adjusted HR (model 2) was 1.431 (95% CI, 1.18-1.74). One needs to pay attention to policy plans regarding women's quality of life, as well as to the risk of breast cancer incidence by their economic activity. In other words, policies need to give post care, instead of focus on early detection and cancer treatment.

• Radiation Oncology Journal
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• 제33권1호
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• pp.50-56
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• 2015

Purpose: To investigate the coverage of axillary lymph node with tangential breast irradiation fields by using virtual lymph node (LN) analysis. Materials and Methods: Forty-eight women who were treated with whole breast irradiation after breast-conserving surgery were analyzed. The axillary and breast volumes were delineated according to the Radiation Therapy Oncology Group (RTOG) contouring atlas. To generate virtual LN contours, preoperative fluorodeoxyglucose positron emission tomography/computed tomography (FDG-PET/CT) scans with identifiable LN were fused with the CT scans, and the virtual LN contour were delineated on the CT. Results: The median level I and II axillary volume coverage percentages at the $V_{D95%}$ line were 33.5% (range, 5.3% to 90.4%) and 0.6% (range, 0.0% to 14.6%), respectively. Thirty-one LNs in 18 patients were delineated (26 in level I and 5 in level II). In the level I axilla, 84.6% of virtual LNs were encompassed by the 95% isodose line. In the level II axilla, by contrast, none of the virtual LNs were encompassed by the 95% isodose volumes. There was a substantial discrepancy between the RTOG contouring atlas-based axillary volume analysis and the virtual LN analysis, especially for the level I axillary coverage. The axillary volume coverage was associated with the body mass index (BMI) and breast volume. Conclusion: The tangential breast irradiation did not deliver adequate therapeutic doses to the axillary region, particularly those in the level II axilla. Patients with small breast volumes or lower BMI showed reduced axillary coverage from the tangential breast fields. For axillary LN irradiation, individualized anatomy-based radiation fields for patients would be necessary.

• Asian Pacific Journal of Cancer Prevention
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• 제17권9호
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• pp.4427-4432
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• 2016

Background: Fear and fatalism have been proposed as factors affecting breast cancer screening, but the evidence is not strong. This study aimed to determine relationships of fear and fatalism with breast cancer screening behavior among Tabriz women in Iran. Materials and Methods: In a cross- sectional study, 370 women referred to 12 health centers in Tabriz were selected with two-stage cluster sampling and data regarding breast cancer screening, fatalism and fear of breast cancer were collected respectively with a checklist for screening performance, Champions Fear and Pow Fatalism Questionnaires. Data were analyzed by logistic regression with SPSS software version 16. Results: Only 43% and 23% of participants had undergone breast self- examination and clinical breast examination. Among women older than 40 years, 38.2% had mammography history and only 2.7% of them had done it annually. Although fatalism and fear had a stimulating effects on breast cancer screening performance th relationships were not significant (P>0.05). There was a negative significant correlation between fear and fatalism (r= -0.24, p=0.000). On logistic regression analysis, age (OR=1.037, p<0.01) and income status (OR= 0.411, p<0.05) significantly explained BSE and age (OR=1.051, p<0.01) and body mass index (OR= 0.879, p<0.01) explained CBE. Also BMI (OR= 0.074, p<0.05) and income status (OR=0.155, p<0.01) was significantly effective for mammography following. Conclusions: Breast cancer screening behavior is inappropriate and affected by family livelihood status and lifestyle leads to weight gain, so that for promoting of screening behaviors, economic support to families, lifestyle modification and public education are suggested.

• Annals of Occupational and Environmental Medicine
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• 제34권
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• pp.5.1-5.10
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• 2022

Background: Some epidemiological studies have estimated exposure among flight attendants with and without breast cancer. However, it is difficult to find a quantitative evaluation of occupational exposure factors related to cancer development individually in the case of breast cancer in flight attendants. That is, most, if not all, epidemiological studies of breast cancer in flight attendants with quantitative exposure estimates have estimated exposure in the absence of individual flight history data. Case presentation: A 41-year-old woman visited the hospital due to a left breast mass after a regular check-up. Breast cancer was suspected on ultrasonography. Following core biopsy, she underwent various imaging modalities. She was diagnosed invasive ductal carcinoma of no special type (estrogen receptor positive in 90%, progesterone receptor positive in 3%, human epidermal growth factor receptor 2/neu equivocal) with histologic grade 3 and nuclear grade 3 in the left breast. Neoadjuvant chemotherapy was administered to reduce the tumor size before surgery. However, due to serious chemotherapy side effects, the patient opted for alternative and integrative therapies. She joined the airline in January, 1996. Out of all flights, international flights and night flights accounted for 94.9% and 26.2, respectively. Night flights were conducted at least four times per month. Moreover, based on the virtual computer program CARI-6M, the estimated dose of cosmic radiation exposure was 78.81 mSv. There were no other personal triggers or family history of breast cancer. Conclusions: This case report shows that the potentially causal relationship between occupational harmful factors and the incidence of breast cancer may become more pronounced when night shift workers who work continuously are exposed to cosmic ionizing radiation. Therefore, close attention and efforts are needed to adjust night shift work schedules and regulate cosmic ionizing radiation exposure.

• 대한세포병리학회지
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• 제9권2호
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• pp.221-225
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• 1998

Malignant tumors of the breast with stromal multinucleated giant cells are rare entity of uncertain clinical significance. There have been few reports on the fine needle aspiration cytologic(FNAC) findings about these rare tumors. We report a FNAC case of invasive mammary carcinoma with osteoclast-like giant cells not only for its rare occurrence but in particular for its distinctive cytologic picture on aspirated material. The patient was a 40-year-old woman who presented with a right breast mass for one month. Mammography showed a well-demarcated rounded mass density without calcification. The aspirates of FNAC were highly cellular and two main cell types were seen; malignant epithelial cells and osteoclast-like multinucleated giant cells. The carcinoma cells occurred singly or arranged in loose clusters with ill-defined cytoplasm, oval nuclei, coarse chromatin and small but distinct nucleoli. The multinucleated giant cells showed variable number of nuclei with prominent nucleoli and abundant dense oxyphilic cytoplasm. The immunocytochemical studies suggested that osteoclast-like giant cells were not of epithelial origin, but rather of histlocytic origin.

• 대한세포병리학회지
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• 제16권1호
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• pp.25-30
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• 2005

Pseudoangiomatous stromal hyperplasia (PASH) was initially described by Vuitch et al. as a benign breast lesion, consisting of mammary stromal proliferations which simulate vascular lesions, and which might be mistaken for a low-grade angiosarcoma. This condition occasionally presents as a palpable mass in postmenopausal women, but is more frequently encountered as an incidental component in premenopausal women. Clinical, radiological, and fine-needle aspiration (FNA) findings associated with this condition can mimic those observed in conjunction with a phyllodes tumor or a fibroadenoma. The cytological features of PASH are generally nonspecific, and its diagnosis by FNA cytology is fairly difficult. In this study, we report a case on PASH, manifesting as a palpable mass.

• 대한영상의학회지
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• 제82권2호
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• pp.417-422
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• 2021

제1형 신경섬유종증은 상염색제 우성으로 유전되는 신경외배영성 질환으로 다양한 악성 종양이 발생할 수 있다. 하지만 유방암이 발생한 보고는 드물다. 이에 저자들은 제1형 신경섬유종증 환자에서 발생한 양측성 유방암 증례를 영상 소견과 함께 보고하고자 한다.