• 대한간호학회지
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• 제39권2호
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• pp.157-165
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• 2009

Purpose: The purpose of this study was to analyze the effects of a cognitive-behavioral nursing intervention on anxiety and depression of patients with breast cancer undergoing radiotherapy. Methods: A nonequivalent control group design was used for the study. The research participants were patients with breast cancer (N=71; experimental group=35, comparison group=36) who received radiotherapy at P university hospital. The experimental group received a 6-week cognitivebehavioral nursing intervention (2 hr/week), which included nursing counseling, education about treatment choices for breast cancer and possible side effects and management strategies during radiotherapy, and rehabilitation exercise. Results: Following the intervention, the experimental group showed significantly lower levels of anxiety (Experimental group=$34.60{\pm}6.35$, Comparison group=$44.63{\pm}9.93$, t=3.552, p<.001) and depression (Experimental group=$10.20{\pm}6.61$, Comparison group=$17.81{\pm}10.85$, t=3.542, p<.001) than the comparison group. Conclusion: The findings from this study showed that cognitive-behavioral counseling applied by nurses is very effective to reduce anxiety and depression among patients with breast cancer. Therefore, providing nursing counseling to broader spectrum of patients with cancer should be considered. Further research would warrant future clinical application of nursing counseling.

• Asian Pacific Journal of Cancer Prevention
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• 제17권8호
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• pp.3911-3916
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• 2016

Background: Triple negative (TN) and triple positive (TP) breast cancers both are aggressive types but TN generally has a shorter survival. Objectives: To compare the clinical characteristics and treatment outcomes for patients with TN versus TP breast cancer and to assess various prognostic factors affecting overall survival. Materials and Methods: A retrospective audit of 85 breast cancer patients was conducted in the Department of Radiation Oncology and Medical Oncology on patients from 2006 to 2013 for whom IHC for ER, PgR and Her-2 neu were available. The patients were stratified into: ER-, PR- and Her-2 neu- (Arm A, n=47) and ER+, PgR+ and Her-2 neu+ (Arm B, n=38). Results: TN subtype had higher numbers of premenopausal and advanced stage patients as compared to TP subtype. The locoregional recurrence (LRR) and distant metastatic rate was also higher in TN subtype but there was no definite pattern in both the arms. Among the prognostic factors, patients with premenopausal status and advanced stage in TN breast cancer had inferior survival (P=0.07) whereas for those with postmenopausal status and early stage there was no survival difference between the two arms. Conclusions: TN subtype tends to be more aggressive in terms of younger age and advanced stage at presentation, higher tumour grade, LRR and metastasis, suggesting need for future research efforts on providing aggressive treatment to these patients. We could attribute better outcome for TP subtype to receptor positivity enabling role of hormonal treatment and targeted therapy, although less number of patients received targeted therapy.

• Archives of Plastic Surgery
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• 제39권5호
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• pp.489-496
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• 2012

Background In Korean women, many of whom have small to moderate-sized breasts, it is difficult to cover a partial breast defect using oncoplastic volume displacement techniques after removal of an adequate volume of tissue during oncologic surgery. In such cases, oncoplastic volume replacement techniques are more useful. Methods From January 2007 to December 2011, 104 women underwent a total of 107 breast-conserving surgeries with various kinds of oncoplastic volume replacement techniques. We used latissimus dorsi (LD) myocutaneous flap for cases in which the resection mass was greater than 150 g. In case with a resection mass less than 150 g, we used regional flaps such as a lateral thoracodorsal flap, a thoracoepigastric flap, or perforator flaps such as an intercostal artery perforator (ICAP) flap or a thoracodorsal artery perforator (TDAP) flap. Results The mean age was 46.1 years, and the average follow-up interval was 10.3 months. The patients underwent oncoplastic volume replacement techniques with a lateral thoracodorsal flap (n=9), thoracoepigastric flap (n=7), ICAP flap (n=25), TDAP flap (n=12), and LD flap (n=54). There was one case of congestion in an LD flap, and two cases of fat necrosis in an ICAP flap. Most of the patients were satisfied with the cosmetic results. Conclusions Oncoplastic volume replacement techniques can be reliable and useful for the correction of breast deformity after breast-conserving surgery, especially in patients with small to moderate-sized breasts.

• Journal of Gastric Cancer
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• 제20권1호
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• pp.106-114
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• 2020

Breast metastases of extramammary malignant neoplasms are rare, with an incidence of 0.3%-2.7% among all malignant mammary tumors. Breast metastases from gastric carcinoma are very rare (<0.1%), and this event is even rarer during pregnancy. Herein, we describe a 39-year-old Caucasian woman with a history of an Epstein-Barr virus-associated gastric carcinoma (EBVaGC) that was characterized by prominent tumor infiltrating lymphocytes. Three years after undergoing radical surgery, the patient developed bilateral breast nodules during her pregnancy. A breast biopsy was performed, and histology confirmed a diagnosis of EBVaGC; tumor cells showed positivity for cytokeratin 8/18 and E-cadherin, and negativity for cytokeratin 7, cytokeratin 20, cytokeratin 5/6, caudal type homebox 2, androgen receptor, mammaglobin, gross cystic disease fluid protein-15, and estrogen and progesterone receptors. We also discuss the main diagnostic pitfalls. To our knowledge, this is the first report of an EBVaGC with lymphoid stroma that developed breast metastases during pregnancy.

• 종양간호연구
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• 제11권3호
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• pp.210-220
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• 2011

Purpose: The aims of this study were to describe and interpret the nature of the experience inherent in the sex life of female breast cancer patients after treatment and understand the meaning behind it. Methods: The participants were 10 female breast cancer patients who were married. Data were collected from March to September 2010. Van Manen's hermeneutic phenomenology was adopted in this qualitative study as a research method. Results: There were 4 essential topics in the participants' experience of sex life; 'Sex life alert' was a result of negative changes in sexual relationships with spouse that they had never experienced before the breast cancer diagnosis; 'Precarious situation for pending divorce' was an experience of deteriorated sex life because of the failure to overcome 'sex life alert'; 'Sublimation of the difficulties by discovering an alternative solution' was an experience of discovering a solution to overcome the 'sex life alert'. 'Leaving it as unsettled' was an experience of a condition in which the participants did not have any intension to resolve the difficulties in sex life due to the lack of appropriate support, thus tried to ignore the challenges faced. Conclusion: This study illustrates the necessity to develop proper nursing intervention on the issues related to sex life among breast cancer patients. Given the fact that the sexual topics are often considered taboo in day to day nursing practice, special attention and efforts need to be given in this area to build up nursing knowledge and evidence-based practice.

• Archives of Plastic Surgery
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• 제47권4호
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• pp.333-339
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• 2020

Background The purpose of this study was to compare the anatomical features of the internal mammary vessels (IMVs) at the second and third intercostal spaces (ICSs) with regard to their use as recipient vessels in deep inferior epigastric artery perforator (DIEP) flap breast reconstruction. Methods A total of 38 consecutive DIEP breast reconstructions in 36 patients were performed using IMVs as recipient vessels between March 2017 and August 2018. The intraoperative findings and postoperative complications were analyzed. Anatomical analyses were performed using intraoperative measurements and computed tomography (CT) angiographic images. Results CT angiographic analysis revealed the mean diameter of the deep inferior epigastric artery to be 2.42±0.27 mm, while that of the deep inferior epigastric vein was 2.91±0.30 mm. A larger mean vessel diameter was observed at the second than at the third ICS for both the internal mammary artery (2.26±0.32 mm vs. 1.99±0.33 mm, respectively; P=0.001) and the internal mammary vein (IMv) (2.52±0.46 mm vs. 2.05±0.42 mm, respectively; P<0.001). Similarly, the second ICS was wider than the third (18.08±3.72 mm vs. 12.32±2.96 mm, respectively; P<0.001) and the distance from the medial sternal border to the medial IMv was greater (9.49±2.28 mm vs. 7.18±2.13 mm, respectively; P<0.001). Bifurcations of the IMv were found in 18.4% of cases at the second ICS and in 63.2% of cases at the third ICS. Conclusions The IMVs at the second ICS had more favorable anatomic features for use as recipient vessels in DIEP flap breast reconstruction than those at the third ICS.

• Archives of Plastic Surgery
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• 제41권5호
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• pp.535-541
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• 2014

Background Patients having unilateral breast reconstruction often require a second stage procedure on the contralateral breast to improve symmetry. In order to provide immediate symmetry and minimize the frequency and extent of secondary procedures, we began performing simultaneous contralateral balancing operations at the time of initial reconstruction. This study examines the indications, safety, and efficacy of this approach. Methods One-hundred and two consecutive breast reconstructions with simultaneous contralateral balancing procedures were identified. Data included patient age, body mass index (BMI), type of reconstruction and balancing procedure, specimen weight, transfusion requirement, complications and additional surgery under anesthesia. Unpaired t-tests were used to compare BMI, specimen weight and need for non-autologous transfusion. Results Average patient age was 48 years. The majority had autologous tissue-only reconstructions (94%) and the rest prosthesis-based reconstructions (6%). Balancing procedures included reduction mammoplasty (50%), mastopexy (49%), and augmentation mammoplasty (1%). Average BMI was 27 and average reduction specimen was 340 grams. Non-autologous blood transfusion rate was 9%. There was no relationship between BMI or reduction specimen weight and need for transfusion. We performed secondary surgery in 24% of the autologous group and 100% of the prosthesis group. Revision rate for symmetry was 13% in the autologous group and 17% in the prosthesis group. Conclusions Performing balancing at the time of breast reconstruction is safe and most effective in autologous reconstructions, where 87% did not require a second operation for symmetry.

• 대한간호학회지
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• 제46권3호
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• pp.327-337
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• 2016

Purpose: The purpose of this study was to construct and test a structural equation model on resilience of breast cancer patients receiving chemotherapy. Methods: Participants were 204 patients with breast cancer who received chemotherapy treatment. They participated in a structured interview, which included social support, depression, symptom experience, self-efficacy, hope, resilience, and infection prevention behaviors. Data were analyzed using SPSS/WIN 20.0 and AMOS 18.0. Results: Lower depression (${\gamma}=-.33$, p=.020) and symptom experience (${\gamma}=-.31$, p=.012) and higher self-efficacy (${\gamma}=.32$, p=.005) and hope (${\gamma}=.48$, p=.016) were influenced by higher social support. Greater resilience was influenced by lower symptom experience (${\beta}=-.18$, p=.016), higher self-efficacy (${\beta}=.49$, p=.023), and higher hope (${\beta}=.46$, p=.012), and these predictors explained 66.7% of variance in resilience. Greater resilience (${\beta}=.54$, p =.009) made an impact on greater infection prevention behaviors. Resilience mediated the relations of symptom experience (${\beta}=-.10$ p=.013), self-efficacy (${\beta}=.27$, p=.006) and hope (${\beta}=.25$, p=.009) with infection prevention behaviors. These predictors explained 24.9% of variance in infection prevention behaviors. Conclusion: The findings of the study suggest that breast cancer patients with greater resilience who are receiving chemotherapy participate in increased infection prevention behaviors. Further research should be conducted to seek intervention strategies that improve breast cancer patients' resilience.

• 여성건강간호학회지
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• 제22권3호
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• pp.182-190
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• 2016

Purpose: This study was done to identify effects of cognitive function and cancer coping on quality of life among women with breast cancer treated with antineoplastic agents. Methods: The study was correlational research and participants were 145 women with breast cancer who had received antineoplastic agents. Data were collected from October to November, 2015 via online replies. Cognitive function was measured with the Functional Assessment of Cancer Therapy-Cognitive Function Version-3 (FACT-Cog), cancer coping, with the Korean Cancer Coping Questionnaire (K-CCQ), and quality of life with the Functional Assessment of Cancer Therapy-Breast Version-4 (FACT-B). Data were analyzed using descriptive statistics, t-test, ANOVA, $Scheff{\acute{e}}$ test, ANCOVA, Bonferroni test, partial correlation coefficient, and hierarchical multiple regression with SPSS 21. Results: Cognitive functions, total individual coping, and interpersonal coping explained 42% of quality of life. Cognitive function (${\beta}=.35$, p<.001) was the best predictor of quality of life, followed by total individual coping (${\beta}=.34$, p<.001), and interpersonal coping (${\beta}=.26$, p<.001). Conclusion: Results indicate that cognitive function and cancer coping are meaningful factors for quality of life among breast cancer survivors. Therefore when developing intervention programs for these women, content on cognitive function and coping skills as well as coping resources should be included.

• 여성건강간호학회지
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• 제20권1호
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• pp.72-82
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• 2014

Purpose: This study was conducted to investigate sexual behaviors and influencing factors affecting premenopausal women who have breast cancer and have undergone surgery. Methods: Seventy premenopausal women, ranging between 35~55 years of age, were included in this study. Sexual behaviors were evaluated using the WSBQ-F (Wilmoth Sexual Behaviors Questionnaire-Female). The in-depth interview was analyzed utilizing content analysis. Results: There were no significant differences regarding the type of surgery, age, time of marriage, education level, occupation, chemotherapy, use of Tamoxifen, and radiotherapy in the sexual activities of premenopausal women with breast cancer. However, quality-related information utilizing qualitative in-depth interviews, revealed 3 issues regarding sexual behaviors.. Participants reported physical discomfort such as vaginal dryness, dyspareunia, emotional changes such as decrease in sexual confidence, and interaction-related changes such as mandatory sexual life, sexual intimacy with one's partner, and being more active sexual behaviors. Conclusion: There were complex changes associated with sexual behavior after surgery for women with breast cancer which included various events related to stress regarding sexual behavior. Communication between women with breast cancer, their partners, and medical caregivers has a ability to maximize the sense of sexual wellbeing while minimizing the sexual crises.