• Asian Pacific Journal of Cancer Prevention
• /
• v.15 no.24
• /
• pp.10791-10795
• /
• 2015

Background: Phyllodes tumors of the breast are rare fibroepithelial lesions, so relatively little is known about this disease entity. The present study was designed to identify differences in clinical features between benign borderline and malignant phyllodes tumors. Materials and Methods: Data from 246 women with phyllodes tumors of the breast treated in Cancer Hospital Chinese Academy of Medical Sciences between 2002 and 2012 were collected and analyzed, including age at presentation, age at treatment, course, size of primary tumor, location, histological type, type of surgery and treatment, local recurrence, distant metastasis, fibroadenoma history, disease-free survival and number of mitosis per 10hpf. There are 125 (55%) benign, 55 (24%) borderline and 47 (21%) malignant tumors. Results: In univariate analysis, average age at presentation, average age at treatment, size of primary tumor, ulceration or not, type of primary surgery, distant metastasis and number of mitosis per 10 hpf turned out to be statistically different among the three PT types (p=0.014, 0.018, <0.000, 0.003, <0.000, 0.001 and <0.000, respectively), while recurrence and disease-free survival (DFS) demonstrated trends for statistical significance (P =0.055 and 0.060, respectively). Multivariate analysis revealed distant metastasis and excision were significantly different in benign, borderline and malignant phyllodes tumors of the breast (p=0.041 and 0.018, OR=0.061 and 0.051). At the same time, size of primary tumor with p=0.052 tended to be different between groups (OR=1.127). However, age at treatment, ulceration and DFS showed no statistically significant variation (p=0.400, 0.286 and 0.413, respectively). Conclusions: Benign borderline and malignant phyllode tumors have different distant metastasis risk, different primary tumor size and different surgical procedures, and malignant PTs are more likely to be bigger and to metastasize.

• Asian Pacific Journal of Cancer Prevention
• /
• v.14 no.6
• /
• pp.3815-3817
• /
• 2013

Background: Breast cancer is a common cancer worldwide. With the establishment of Thailand's population-based cancer registry and availability of complete data from 2002-2011, it is of interest to investigate the epidemiologic and clinic-pathological profiles of breast cancer based on the population-based registry data. Methods: The data of all breast cancer patients in the registry for the period of 2002-2011 were included. All medical records of the patients diagnosed from documents of National Cancer Registry of Thailand were retrieved and the following information abstracted: age, clinical characteristics, and histological variables. Thailand census data for the period of 2002-2011 were used to provide the general population's statistics on age, gender, and other related demographic factors. Results: Over the 10 year-period, 7,711 breast cancer cases were included. The disease incidence under age 40 years was relatively low (4.13/$10^5$) while the incidence in the age groups 40 and older was very high (39.2/$10^5$). The vast majority of breast cancer cases (88.8%) were diagnosed by histology as primary lesions in the breast. The most common of patients with breast cancer (36.4%) had regional lymph node involvement and the most common of histopathology diagnosed in patients (84.2%) was an infiltrating duct carcinoma. Conclusions: This study showed a high incidence of breast cancer in older subjects, and high rate of breast cancer in Thailand. Future studies should explore clinical and molecular disease patterns.

• Asian Pacific Journal of Cancer Prevention
• /
• v.15 no.1
• /
• pp.315-320
• /
• 2014

Purpose: The purpose of this study was to investigate the recurrence pattern and characteristics of patients based on the 2013 St. Gallen surrogate molecular subtypes after breast-conserving surgery (BCS) in Chinese women. Methods: This retrospective analysis included 709 consecutive breast cancer patients undergoing BCS from 1999-2010 at our institution. Five different surrogate subtypes were created using combined expression of the estrogen receptor, progesterone receptor, and human epidermal growth factor receptor-2. Locoregional relapse-free survival (LRRFS), distant metastasis-free survival (DMFS), and disease-free survival (DFS) rates were calculated. Results: The 5-year LRRFS, DMFS, and DFS rates were 90.5%, 88.2%, and 81.5%, respectively. Multivariate analysis revealed that young age, node-positive disease, and HER2 enrichment were independent prognostic factors in LRRFS patients. There was also an independent prognostic role of lymph node-positive disease in DMFS and DFS patients. Patients with luminal A tumors had the most favorable prognosis, with LRRFS, DMFS, and DFS rates of 93.2%, 91.5%, and 87.4% at 5 years, respectively. Conversely, HER-2-enriched tumors exhibited the highest rate of locoregional recurrence (20.6%). Conclusion: Surrogate subtypes present with significant differences in RFS, DMFS, and LRRFS. Luminal A tumors have the best prognosis, whereas HER2-enriched tumors have the poorest.

• Journal of Breast Cancer
• /
• v.21 no.4
• /
• pp.442-446
• /
• 2018

Purpose: The definition of nodal pathologic complete response (pCR) after a neoadjuvant chemotherapy (NAC) just included the evaluation of axillary lymph node (ALN) without internal mammary lymph node. This study aimed to evaluate the feasibility of internal mammary-sentinel lymph node biopsy (IM-SLNB) in patients with breast cancer who underwent NAC. Methods: From November 2011 to 2017, 179 patients with primary breast cancer who underwent operation after NAC were included in this study. All patients received radiotracer injection with modified injection technology. IM-SLNB would be performed on patients with internal mammary sentinel lymph node (IMSLN) visualization. Results: Among the 158 patients with cN+ disease, the rate of nodal pCR was 36.1% (57/158). Among the 179 patients, the visualization rate of IMSLN was 31.8% (57/179) and was 12.3% (7/57) and 87.7% (50/57) among those with $cN_0$ and cN+ disease, respectively. Furthermore, the detection rate of IMSLN was 31.3% (56/179). The success rate of IM-SLNB was 98.2% (56/57). The IMSLN metastasis rate was 7.1% (4/56), and all of them were accompanied by ALN metastasis. The number of positive ALNs in patients with IMSLN metastasis was 3, 6, 8, and 9. The pathology nodal stage had been changed from $pN_1/pN_2$ to $pN_{3b}$. The pathology stage had been changed from IIA/IIIA to IIIC. Conclusion: Patients with visualization of IMSLN should perform IM-SLNB after NAC, especially for patients with cN+ disease, in order to complete lymph nodal staging. IM-SLNB could further improve the definition of nodal pCR and guide the internal mammary node irradiation.

• Asian Oncology Nursing
• /
• v.8 no.2
• /
• pp.120-127
• /
• 2008

Purpose: The purpose of this study was secondary analysis to explore about risk factors with breast cancer on a basis of primary literature. Methods: This study was searched articles by using CINAHL, MEDLINE, Riss4u, Internet website regarding breast cancer. This study searched for the journal published in Korea and foreign countries from 2000 to 2008, about risk factors of breast cancer. This study was reviewed 42 articles (5 experimental study, 35 survey, 1 qualitative study, 1 report) suitable for the research objectives. Results: Magnitude of risk breast cancer (++) was age, geographic region, family history, mutations in BRCA1, BRCA2 genes and in other penetrance genes, radiation, history of benign breast disease, late age of menopause, early age of menarch, nulliparity and older age at first birth, high mammographic breast density, high insulin-like growth factor 1 level. Magnitude of risk factor (+) was hormone replacement therapy, oral contraceptives use, obesity, tall stature, alcohol consumption, high prolactin level, high saturated fat and well-done meat intake, polymorphisms in low penetrance gene, high socioeconomic status. Conclusion: A breast cancer screening protocol according to magnitude of risk factors is needed for disease prevention. The nurses need to educate and counsel women with risk factors of breast cancer.

• Asian Pacific Journal of Cancer Prevention
• /
• v.14 no.6
• /
• pp.3779-3784
• /
• 2013

Aims: To determine the clinical, pathological and prognostic features associated with triple-negative breast cancer (TNBC). Methods: Clinical and histologic data of 21,749 breast cancer patients who were treated at Tianjin Medical University Cancer Institute and Hospital between July 2002 and December 2011 were collected. Patients were divided into two groups: those with TNBC and those with other types of breast cancer. Patients and tumor characteristics were compared between the two groups using the Chi-square test. The prognostic results of 9,823 patients in the study population were also analyzed to determine long-term survival rates in the two groups of breast cancer patients. Results: Among the breast cancer patients treated in our hospital between 2003 and 2011, 10.4%-13.5% of them had triple-negative breast cancers. Data analyses revealed significant differences in disease onset age, family history of breast cancer, tumor size, tumor histologic grade, lymph note positivity and metastatic status between TNBC and non-TNBC patients. There were also significant differences in 5-year, 7-year and 9-year disease-free and 7-year and 9-year overall survival probability between the groups. Conclusions:TNBC are associated with younger disease onset age, larger tumor size, higher rate of axillary lymph node positivity, and higher tumor histologic grade. TNBC is also related to family history of breast cancer, increased metastatic risk and poor prognosis.

• Molecules and Cells
• /
• v.39 no.3
• /
• pp.258-265
• /
• 2016

In metastatic breast cancer, the acquisition of malignant traits has been associated with the increased rate of cell growth and division, mobility, resistance to chemotherapy, and invasiveness. While screening for the key regulators of cancer metastasis, we observed that neurotrophin receptor TrkB is frequently overexpressed in breast cancer patients and breast cancer cell lines. Additionally, we demonstrate that TrkB expression and clinical breast tumor pathological phenotypes show significant correlation. Moreover, TrkB expression was significantly upregulated in basal-like, claudin-low, and metaplastic breast cancers from a published microarray database and in patients with triple-negative breast cancer, which is associated with a higher risk of invasive recurrence. Interestingly, we identified a new TrkB-regulated functional network that is important for the tumorigenicity and metastasis of breast cancer. We demonstrated that TrkB plays a key role in regulation of the tumor suppressors Runx3 and Keap1. A markedly increased expression of Runx3 and Keap1 was observed upon knockdown of TrkB, treatment with a TrkB inhibitor, and in TrkB kinase dead mutants. Additionally, the inhibition of PI3K/AKT activation significantly induced Runx3 and Keap1 expression. Furthermore, we showed that TrkB enhances metastatic potential and induces proliferation. These observations suggest that TrkB plays a key role in tumorigenicity and metastasis of breast cancer cells through suppression of Runx3 or Keap1 and that it is a promising target for future intervention strategies for preventing tumor metastasis and cancer chemoprevention.

• Journal of Breast Disease
• /
• v.6 no.2
• /
• pp.73-78
• /
• 2018

Primary angiosarcoma of the breast is extremely rare and is observed in 0.0005% to 0.05% of primary breast tumor cases. The diagnosis of this tumor is difficult due to its undefined characteristics. Radiologic findings are often nonspecific and appear completely normal in one-third of patients with primary angiosarcomas. The prognosis is usually poor, and the treatment choices include mastectomy or wide excision. Radiotherapy and chemotherapy produce varying results. We report a patient with primary angiosarcoma of the breast to further our understanding of the characteristics of this tumor and facilitate the correct diagnosis of breast angiosarcoma.

• The Korean Journal of Cytopathology
• /
• v.4 no.1
• /
• pp.1-8
• /
• 1993

This study was performed in order to evaluate the accuracy and the usefulness of the fine needle aspiration cytology (FNAC) on the breast lesions, to compare the FNAC findings between fibroadenoma and fibrocystic disease, and to determine the accuracy of cytologic Black's nuclear grading. The subjects in this study were 110 cases of FNAC, later confirmed by biopsy, between January 1988 and December 1991. The results are as follows ; 1 Comparison between the results of the FNAC and the histologic findings revealed that FNAC had a sensitivity of 96.6%, a specificity of 100%, a false negative rate of 3.4% a false positive rate of 0.0%, and an overall diagnostic accuracy of 98.2%. 2 Semi-quantitative evaluation of epithelial celluarity, stroma, and naked nuclei in the smears of aspirate showed high celluarity in 56.7% of the aspirates from fibroadenoma and in 0% of those from fibrocystic disease. Abundant stroma was found in 46.7% of the fibroadenoma and none of fibrocystic disease. Numerous naked nuclei were found in 60% of the fibroadenoma and 4.5% of the fibrocystic disease. The overall diagnostic accuracy was 98% 3. In order to determine the accuracy of Black's nuclear grading of FNAC on breast carcinoma, we retrospectively studied 38 cases of ductal carcinomas diagnosed by FNAC with subsequent histologic confirmation. The concordance rate with histology was 94.7%. These results suggest that FNAC of breast is a diagnostically accurate method, and provide for the preoperative differential diagnosis between fibroadenoma and fibrocystic disease. Our results also suggest that the evaluation of nuclear grading of FNAC can predict clinical outcome and decide the way of management of breast cancer.

• International journal of advanced smart convergence
• /
• v.2 no.2
• /
• pp.36-39
• /
• 2013

It is becoming more important as the growing of health information and increasing in cancer patients diagnose over the time gradually. Among the various types of cancer, we focuses on breast cancer diagnosis. The accuracy of breast cancer diagnosis is increasing when the diagnosis is based on evidence and statistics. To do this we use the weka data mining tools and analysis algorithms significantly associated with the decision tree uses rules. In addition, the data pre-processing and cross-validation are used to increase the reliability of the results. The number and cause of the disease becomes important to increase evidence-based medical doctors. As the evidence-based medical, the data obtained from patients in the past through the disease by calculating the probability for future patients to diagnose and predict disease and treatment plan. It can be found by improving the survival rate plays an important role.