• Radiation Oncology Journal
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• v.32 no.3
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• pp.132-137
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• 2014

Purpose: To evaluate non-sentinel lymph node (LN) status after sentinel lymph node biopsy (SNB) in patients with breast cancer and to identify the predictive factors for disease failure. Materials and Methods: From January 2006 to December 2007, axillary lymph node (ALN) dissection after SNB was performed for patients with primary invasive breast cancer who had no clinical evidence of LN metastasis. A total of 320 patients were treated with breast-conserving surgery and radiotherapy. Results: The median age of patients was 48 years, and the median follow-up time was 72.8 months. Close resection margin (RM) was observed in 13 patients. The median number of dissected SNB was two, and that of total retrieved ALNs was 11. Sentinel node accuracy was 94.7%, and the overall false negative rate (FNR) was 5.3%. Eleven patients experienced treatment failure. Local recurrence, regional LN recurrence, and distant metastasis were identified in 0.9%, 1.9%, and 2.8% of these patients, respectively. Sentinel LN status were not associated with locoregional recurrence (p > 0.05). Close RM was the only significant factor for disease-free survival (DFS) in univariate and multivariate analysis. The 5-year overall survival, DFS, and locoregional DFS were 100%, 96.8%, and 98.1%, respectively. Conclusion: In this study, SNB was performed with high accuracy and low FNR and high locoregional control was achieved.

• Asian Pacific Journal of Cancer Prevention
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• v.16 no.12
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• pp.5081-5084
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• 2015

Background: Breast cancer is a malignant tumor that starts from cells of the breast and is seen mainly in women. It's the most common cancer in women worldwide and is a major threat to health. The purpose of this study was to fit a Cox proportional hazards model for prediction and determination of years of survival in Iranian patients. Materials and Methods: A total of 366 patients with breast cancer in the Cancer Research Center were included in the study. A Cox proportional hazard model was used with variables such as tumor grade, number of removed positive lymph nodes, human epidermal growth factor receptor 2 (HER2) expression and several other variables. Kaplan-Meier curves were plotted and multi-years of survival were evaluated. Results: The mean age of patients was 48.1 years. Consumption of fatty foods (p=0.033), recurrence (p<0.001), tumor grade (p=0.046) and age (p=0.017) were significant variables. The overall 1- year, 3-year and 5-year survival rates were found to be 93%, 75% and 52%. Conclusions: Use of covariates and the Cox proportional hazard model are effective in predicting the survival of individuals and this model distinguished 4 effective factors in the survival of patients.

• Korean Journal of Adult Nursing
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• v.27 no.6
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• pp.728-741
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• 2015

Purpose: The purpose of the study was to explore and describe the experience of pursuing complementary and alternative medicine (CAM) in breast cancer patients. Methods: Ten women with breast cancer participated in the study. Data were collected through individual in-depth unstructured and individualized interviews with each participant from February to July, 2015. Theoretical sampling was used upto the point of theoretical saturation. Data were analyzed using Corbin & Strauss's grounded theory methodology. Results: Through open coding, 22 sub-categories, and 13 categories were identified. Analysis revealed that the core category was 'endless management of mind and body for healing', which consisted of four phases; exploring, applying, grasping, and integrating. Through this process, the participants utilized various action/interactional strategies such as 'dealing with information', 'trying out blindly', 'enduring volitionally', 'experiencing effects on mind and body,' and 'grasping one's own way.' The consequences of these strategies were integrating the habit of health remedy into one's life, becoming a main agent for change, and tolerating one's weak body. Conclusion: In-depth understanding of the CAM pursuing experiences of patients with breast cancer would guide clinical nurses and policy makers to develop effective interventions and policies for better supporting them with regard to the usage of CAM.

• Asian Oncology Nursing
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• v.12 no.1
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• pp.35-43
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• 2012

Purpose: The purpose of the study was to identify the effect of a comprehensive education program on knowledge, self-efficacy for self-management, and coping style among newly diagnosed patients with breast cancer. Methods: This study used a one group pretest-posttest design. Data were collected from April to September, 2010 at a cancer-specific hospital in Goyang, Korea. One hundred forty three women received a comprehensive education program consisting of 3 sessions composed of 8 themes was conducted by several experts (nurses, doctors, dietitians and clinical psychologists) for 3.5 hours a day for 3 days (1 day before and 2 days after the operation). Results: This study showed that knowledge and self-efficacy for self-management significantly increased after education (p<.001). In terms of coping style, however, only the subscale, 'anxious preoccupation', significantly improved (p=.001) among 5 sub-scales of coping style after education. Conclusion: A comprehensive education program for newly diagnosed patients with breast cancer was effective for increasing the knowledge and self-efficacy for self-management of breast cancer, in addition to decreasing the coping style of 'anxious preoccupation'. However, it did not improve other coping style. Therefore, other strategies for improving coping style are needed.

• Radiation Oncology Journal
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• v.35 no.1
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• pp.32-38
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• 2017

Purpose: Several accelerated partial breast radiation (APBR) techniques have been investigated in patients with early-stage breast cancer (BC); however, the optimal treatment delivery techniques remain unclear. We evaluated the feasibility and toxicity of APBR delivered using intensity-modulated radiation therapy (IMRT) in elderly patients with stage I BC, using a novel fractionation schedule. Materials and Methods: Forty-two patients aged ${\geq}65$ years, with stage I BC who underwent breast conserving surgery were enrolled in a phase I/II study evaluating APBR using IMRT. Forty eligible patients received 40 Gy in 4 Gy daily fractions. Patients were assessed for treatment related toxicities, and cosmesis, before APBR, during, and after completion of the treatment. Results: The median age was 73 years, median tumor size 0.8 cm and the median follow-up was 54 months. The 5-year locoregional control was 97.5% and overall survival 90%. Erythema and skin pigmentation was the most common acute adverse event, reported by 27 patients (69%). Twenty-six patients (65%) reported mild pain, rated 1-4/10. This improved at last follow-up to only 2 (15%). Overall the patient and physician reported worst late toxicities were lower than the baseline and at last follow-up, patients and physicians rated cosmesis as excellent/good in 93% and 86 %, respectively. Conclusion: In this prospective trial, we observed an excellent rate of tumor control with daily APBR. The acceptable toxicity profile and cosmetic results of this study support the use of IMRT planned APBR with daily schedule in elderly patients with early stage BC.

• Archives of Plastic Surgery
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• v.45 no.1
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• pp.37-44
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• 2018

Background Oncoplastic surgery is being increasingly performed in Korean women; however, unlike Westerners, Korean women usually have small to moderate-sized breasts. To achieve better outcomes in reconstructed breasts, several factors should be considered to determine the optimal surgical method. Methods A total of 108 patients who underwent oncoplastic surgery from January 2013 to December 2016 were retrospectively investigated. We used various methods, including glandular tissue reshaping, latissimus dorsi (LD) flap transposition, and reduction oncoplasty, to restore the breast volume and symmetry. Results The mean weight of the tumor specimens was 40.46 g, and the ratio of the tumor specimen weight to breast volume was 0.12 g/mL in the patients who underwent glandular tissue reshaping (n=59). The corresponding values were 101.47 g and 0.14 g/mL, respectively, in the patients who underwent reduction oncoplasty (n=17), and 82.54 g and 0.20 g/mL, respectively, in those treated with an LD flap (n=32). Glandular tissue reshaping was mostly performed in the upper outer quadrant, and LD flap transposition was mostly performed in the lower inner quadrant. No major complications were noted. Most patients were satisfied with the aesthetic results. Conclusions We report satisfactory outcomes of oncoplastic surgical procedures in Korean patients. The results regarding specimen weight and the tumor-to-breast ratio of Asian patients will be a helpful reference point for determining the most appropriate oncoplastic surgical technique.

• Women's Health Nursing
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• v.17 no.5
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• pp.439-446
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• 2011

Purpose: Early diagnosis is the primary method aimed at controlling breast cancer. The purpose of this study was to analyze some factors affecting the performance of mammography screening among women with a family history of breast cancer in Korea. Methods: This study applied a descriptive design method through structured self-report questionnaires. The Care Seeking Behavior Theory provided a theoretical framework for the study. Factors measured in this study represent demographic, clinical, and psychosocial variables including anxiety, barriers, utility, habits, perception, and facilitators. A total of 212 participants, of at least 20 years old, were sampled from April 8, 2010 to March 31, 2011. The data was analyzed by logistic regression method using the Statistical Package for the Social Science 18.0 software. Results: Of the 212 participants, 122 women (57.5%) went through mammography screening. The results of the analysis showed that (a) age (Odds Ratio [OR] =1.10, p<.001), (b) facilitating influences (OR=1.83, p=.008), (c) perception of mammography importance (OR=1.92, p=.011), (d) barriers to mammography (OR=0.60, p=.031), and (e) utility of mammography (OR=2.01, p=.050) significantly affect mammography screening. Conclusion: The results underscore the impact that psychosocial variables in obtaining mammography have on adherence to screening. Women with a family history of breast cancer should be given accurate information and recommendation about mammography by healthcare provider and a regular source of healthcare.

• Korean Journal of Clinical Oncology
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• v.14 no.2
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• pp.102-107
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• 2018

Purpose: Cardiotoxicity is a serious late complication of breast cancer treatment. Individual treatment risk of specific drugs has been investigated. However, studies on the evaluation of the composite risk of chemotherapeutic agents are limited. Methods: We retrospectively analyzed the medical records of breast cancer patients who received adjuvant treatment and had available serial echocardiography results. Patients were assigned to subgroups based on chemotherapy containing anthracyclines (A), anthracyclines and taxanes (A+T), and radiotherapy (RT). The development of cardiac disease and serial ejection fraction (EF) were reviewed. EF decline up to 10% from baseline was considered grade 1 cardiotoxicity and EF decline >20% or absolute value <50% was considered grade 2 cardiotoxicity. The most recent medical records and echocardiography results over 1 year of chemotherapy completion were also reviewed. Late cardiotoxicity was defined as a lack of recovery of EF decline or aggravated EF decline from baseline. Results: In total, 123 patients were evaluated. A small reduction in EF was observed after chemotherapy in both chemotherapy groups. There were no significant differences between groups A and A+T in EF decline following chemotherapy. We could not find any differences in composite risk between the chemotherapy groups and the RT group during follow-up. Late cardiotoxicity was seen in 15.45% of patients. During follow-up, three patients were diagnosed with dilated cardiomyopathy. Conclusion: There was no significant composite risk elevation following adjuvant treatment of breast cancer. However, late cardiotoxicity was considerable and further research in this direction is necessary.

• The Journal of Korean Academic Society of Nursing Education
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• v.27 no.2
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• pp.95-106
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• 2021

Purpose: The purpose of this study was to examine the effects of a smart-care services program for breast cancer survivors on cognitive function and physical health. Methods: A quasi-experimental control group pretest posttest design was used. Subjects were recruited in D city, and data were collected from July 2017 to February 2018. The experimental group (n=24) participated in the smart-care services program, whereas the control group (n=26) received conventional management. The smart-care services program consisted of addressing cognitive function problems arising from chemotherapy, diet, exercise, head/neck massage and self-monitoring using smartphone applications and smart bands. All participants underwent assessments at baseline, at 6 weeks, and at 12 weeks. Data were analyzed using descriptive statistics (frequency, percentage, mean and standard deviation), a chi-squared test, t-test, and repeated measures ANOVA. Results: After the smart-care services program, significant differences were found between the groups in cognitive function (F=18.91, p<.001) and sleep time (F=9.25, p<.001). No significant differences were found between the groups in caloric consumption after the program. Conclusion: The smart-care services program significantly improved the level of cognitive function and sleep time for breast cancer survivors. The use of this smart-care services program for breast cancer survivors might be an effective nursing intervention tool for improving cognitive function and health behaviors.

• Journal of Korean Academy of Nursing
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• v.49 no.4
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• pp.375-385
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• 2019

Purpose: This study aimed to develop and test a structural model for chemotherapy-related cognitive impairment of breast cancer patients based on a literature review and Hess and Insel's chemotherapy-related cognitive change model. Methods: The Participants consisted of 250 patients who were ${\geq}19$ years of age. The assessment tools included the Menopause Rating Scale, Symptom Experience Scale, Hospital Anxiety and Depression Scale, Everyday Cognition, and Functional Assessment of Cancer Therapy-Breast Cancer. Data were analyzed using the SPSS 21.0 and AMOS 21.0 programs. Results: The modified model was a good fit for the data. The model fit indices were ${\chi}^2=423.18$ (p<.001), ${\chi}^2/df=3.38$, CFI=.91, NFI=.91, TLI=.89, SRMR=.05, RMSEA=.09, and AIC=515.18. Chemotherapy-related cognitive impairment was directly influenced by menopausal symptoms (${\beta}=.38$, p=.002), depression and anxiety (${\beta}=.25$, p=.002), and symptom experiences (${\beta}=.19$, p=.012). These predictors explained 47.7% of the variance in chemotherapy-related cognitive impairment. Depression and anxiety mediated the relations among menopausal symptoms, symptom experiences, and with chemotherapy related cognitive impairment. Depression and anxiety (${\beta}=-.51$, p=.001), symptom experiences (${\beta}=-.27$, p=.001), menopausal symptoms (${\beta}=-.22$, p=.008), and chemotherapy-related cognitive impairment (${\beta}=-.15$, p=.024) had direct effects on the quality of life and these variables explained 91.3%. Conclusion: These results suggest that chemotherapy-related toxicity is highly associated with cognitive decline and quality of life in women with breast cancer. Depression and anxiety increased vulnerability to cognitive impairment after chemotherapy. Nursing intervention is needed to relieve chemotherapy-related toxicity and psychological factor as well as cognitive decline for quality of life in patients undergoing chemotherapy.