• Archives of Plastic Surgery
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• v.42 no.3
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• pp.302-308
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• 2015

Background In the literature on nipple-sparing mastectomy (NSM) with one-stage immediate implant reconstruction, contralateral symmetrisation has drawn little attention, with many surgeons still performing standard cosmetic mammaplasty procedures. However, standard implant-based mammaplasty usually does not result in proper symmetry with the mastectomy side, especially regarding breast projection, overall shape, and volume distribution. Methods We retrospectively reviewed 19 consecutive patients undergoing unilateral NSM with immediate prosthetic reconstruction and contralateral simultaneous symmetrisation by using the tailored reduction/augmentation mammaplasty technique between June 2012 and August 2013. Results The average follow-up time was 13 months (range, 10-24 months). No major complications, such as infection, haematoma, and nipple-areola complex necrosis, were experienced. Conclusions Our experience suggests that simultaneous contralateral symmetrisation with tailored reduction/augmentation mammaplasty after unilateral immediate implant reconstruction after NSM facilitates durable and pleasant symmetric outcomes.

• Archives of Reconstructive Microsurgery
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• v.14 no.2
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• pp.125-130
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• 2005

The purpose of this study is to introduce a sensory restoration in reconstructed breast with free TRAM flap to evaluate recovery aspect and recovery quantity. 144 patients underwent breast reconstruction with free TRAM flap by authors and were followed up at the out patient clinique. We discovered that sensory of operated breast was recoverd. We divide the breast into 5 region (upper medial, lower medial, upper lateral, lower lateral, nipple areolar complex) for examining the sensory restoration. Sense of upper medial region & upper lateral region is recovered more quickly than other region. Touch sensation was recovered more quickly than pain sensation, temperature sensation, vibratory sensation. After about 1 year all protective sensation was recovered in all patient. We discovered that severe postop scar and irradiation of breast is related to delayed sensory recovery, age and size of flap is not related to sensory recovery.

• Journal of Korean Traditional Oncology
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• v.28 no.1
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• pp.25-31
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• 2023

Objectives: With antibiotic resistance one of the biggest threats to global health, we report a case of surgical site infection (SSI) after breast cancer surgery that improved only with the treatment of Taglisodog-eum (托裏消毒飮), Korean herbal medicine, without the use of antibiotics. Methods: The patient diagnosed with ductal carcinoma in situ of left breast underwent nipple areola skin sparing mastectomy and reconstruction using deep inferior epigastric perforator flap. About a month later, superficial SSI occurred at the incision site of breast cancer surgery with general weakness, and Taglisodog-eum treatment was started. To evaluate the effectiveness of the treatment, we compared the infection site conditions before and after treatment. Results: About three weeks after taking Taglisodog-eum, the SSI improved along with the improvement of general weakness. Conclusions: This study shows that Taglisodog-eum may be effective for SSI after breast cancer surgery, and the potential for alternatives to reduce antibiotic use and antibiotic resistance.

• Archives of Plastic Surgery
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• v.46 no.6
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• pp.544-549
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• 2019

Background As the indications for postmastectomy radiotherapy expand, innovative solutions are required to reduce operative complications and reconstructive failure after prosthetic breast reconstruction. In this study, we investigated the effectiveness of acellular dermal matrix (ADM) inlay grafts in preventing postoperative wound dehiscence of irradiated breasts in the context of prosthetic breast reconstruction. Methods A retrospective analysis was conducted of 45 patients who received two-stage prosthetic reconstruction and radiotherapy following mastectomy. An ADM graft was placed beneath the incisional site during the second-stage operation in 19 patients using marionette sutures, whereas the control group did not receive the ADM reinforcement. Patient demographics and complications such as wound dehiscence, capsular contracture, peri-prosthetic infection, cellulitis, and seroma were compared between the two groups. Results During an average follow-up period of 37.1 months, wound dehiscence occurred significantly less often in the ADM-reinforced closure group (0%) than in the non-ADM group (23.1%) (P=0.032). There was no significant difference between the two groups in relation to other complications, such as capsular contracture, postoperative infection, or seroma. Conclusions The ADM inlay graft is a simple and easily reproducible technique for preventing incisional dehiscence in the setting of radiotherapy after prosthetic breast reconstruction. The ADM graft serves as a buttress to offload tension during healing and provides a mechanical barrier against pathogens. Application of this technique may serve to reduce complications in prosthetic breast reconstruction after radiotherapy.

• Asian Pacific Journal of Cancer Prevention
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• v.15 no.21
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• pp.9233-9239
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• 2014

Background: We aimed to evaluate the estrogen receptor (ER), progesterone receptor (PR), and human epidermal growth factor receptor 2 (HER2) expression discordance in matched pairs of primary breast cancer and lymph node metastasis specimens and determine the effect of discordance on prognosis. Materials and Methods: Among all patients diagnosed with lymph node metastases from 2004 to 2007, primary tumors and paired lymph node metastases were resected from 209 patients. The status of ER, PR, and HER2 expression was analyzed immunohistochemically in 200, 194, and 193 patients, respectively. Discordance was correlated with prognosis. Results: Biomarker discordance between primary tumors and paired lymph node metastases was 25.0% (50/200) for ER status, 28.9% (56/194) for PR status, and 14.0% (27/193) for HER2 status. ER positivity was a significant independent predictor of improved survival when analyzed in primary tumors and lymph node metastases. Patients with PR-positive primary tumors and paired lymph node metastases displayed significantly enhanced survival compared to patients with PR-positive primary tumors and PR-negative lymph node metastases. Patients with ER- and PR-positive primary tumors and paired lymph node metastases who received endocrine therapy after surgery displayed significantly better survival than those not receiving endocrine therapy. Similalry treated patients with PR-negative primary tumors and PR-positive paired lymph node metastases also displayed better survival than those not receiving endocrine therapy. Conclusions: Biomarker discordance was observed in matched pairs of primary tumors and lymph node metastases. Such cases displayed poor survival. Thus, it is important to reassess receptor biomarkers used for lymph node metastases.

• Archives of Plastic Surgery
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• v.45 no.3
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• pp.246-252
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• 2018

Background Slim patients or those with large breasts may be ineligible for breast reconstruction with an abdominal flap, as the volume of the flap may be insufficient. This study aimed to establish that abdominal tissue-based breast reconstruction can be well suited for Korean patients, despite their thin body habitus. Methods A total of 252 patients who underwent postmastectomy breast reconstruction with an abdominal flap from October 2006 to May 2013 were retrospectively reviewed. The patients' age and body mass index were analyzed, and a correlation analysis was performed between the weight of the mastectomy specimen and that of the initial abdominal flap. Results The average weights of the mastectomy specimen and initial abdominal flap were 451.03 g and 644.95 g, respectively. The ratio of the weight of the mastectomy specimen to that of the initial flap was $0.71{\pm}0.23$. There was a strong positive linear relationship between the weight of the mastectomy specimen and that of the initial flap (Pearson correlation coefficient, 0.728). Thirty nulliparous patients had a final-to-initial flap weight ratio of $0.66{\pm}0.11$. The 25 patients who underwent a contralateral procedure had a ratio of $0.96{\pm}0.30$. The adjusted ratio of the final flap weight to the initial flap weight was $0.66{\pm}0.12$. Conclusions Breast weight had a strong positive relationship with abdominal flap weight in Koreans. Abdominal flaps provided sufficient soft tissue for breast reconstruction in most Korean patients, including nulliparous patients. However, when the mastectomy weight is estimated to be >700 g, a contralateral reduction procedure may be considered.

• Asian Pacific Journal of Cancer Prevention
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• v.13 no.8
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• pp.4063-4066
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• 2012

To determine the clinical outcome of breast cancer BI-RADS 4 lesions and seek a more effective management guideline, we conducted a retrospective study of all BI-RADS4 patients diagnosed between 2003-2008 with follow up time not less than 2 years. A total of 392 cases of BI-RADS 4 were identified and 320 could be sub-categorised as 4a, 4b and 4c. Overall malignant positive results were 7.65, 38.7 and 58.percent, respectively. In all cases assigned to the close follow up group, no malignancy was detectable (P<0.02). The results of the study suggested that BI-RADS sub-categories have benefit for cancer diagnosis and treatment decisions of clinicians and it might be possible to set up a safe follow-up guideline in selected groups of patients to minimize un-necessary tissue biopsy for breast cancer detection.

• Asian Pacific Journal of Cancer Prevention
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• v.15 no.15
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• pp.6137-6143
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• 2014

Limited numbers of epidemiological studies have examined the relationship between adipokines and breast cancer survival. Preoperative serum levels of obesity-related adipokines (leptin and adiponectin) were here measured in 370 breast cancer patients, recruited from two hospitals in Korea. We examined the association between those adipokines and disease-free survival (DFS). The TNM stage, ER status and histological grade were aslo assessed in relation to breast cancer survival. Elevated adiponectin levels were associated with reduced DFS of breast cancer ($P_{trend}=0.03$) among patients with normal body weight, predominantly in postmenopausal women. There was no association of leptin with breast cancer survival. In conclusion, our study suggests that high levels of adiponectin at diagnosis are associated with breast cancer survival among women with normal body weight.

• Asian Pacific Journal of Cancer Prevention
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• v.15 no.13
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• pp.5377-5381
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• 2014

Purpose: The aim of this study was to investigate the differences in quality of life in patients who received breast conserving surgery (BCS) or modified radical mastectomy (MRM) for breast cancer. Materials and Methods: A total of 100 women with breast cancer who underwent either BCS or MRM between September 2011 and April 2012 at a private health center and completed their chemotherapy and radiation therapy cycles were included in the study. To assess the quality of life, we used a demographic questionnaire, the European Organization for the Research and Treatment of Cancer Quality of Life Questionnaire (EORTC QLQ-C30) and the Quality of Life assessment in Breast Cancer (EORTC QLQ-BR23). Results: Using QLQ-C30, we found that patients who underwent BCS had better functional status and fewer symptoms than patients who underwent MRM. In QLQ-BR23, independent factors improving the functional scales were BCS, higher level of education and marital status (married); independent factors improving symptoms were BCS, higher level of education, younger age and low and normal body mass index (BMI). In QLQ-C30, independent factors affecting the functional and symptom scales were only BCS and higher level of education. Conclusions: We determined that patients who received BCS had better functional status and less frequent symptoms than patients who underwent MRM.

• Journal of Breast Disease
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• v.6 no.2
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• pp.39-45
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• 2018

Purpose: Dieckol, a phlorotannin compound isolated from Ecklonia cava, has been reported to have antioxidant, antiviral, anti-inflammatory, and anticancer properties. The purpose of this study was to investigate its anticancer effects on human breast cancer cell lines. Methods: In this study, the viability of two human breast cancer cell lines SK-BR-3 and MCF-7 was investigated after dieckol treatment using a WST-1 assay. Apoptosis and cell cycle distribution were assayed via Annexin V-fluorescein isothiocyanate and propidium iodide staining followed by flow cytometric analysis. Immunoblotting analysis was also performed using Bax/Bcl-2 to determine whether the dieckol-induced apoptosis was mediated by the intrinsic apoptotic pathway. Results: In a dose dependent manner, dieckol reduced the number of viable cells and increased the number of apoptotic cells. The effect of dieckol on the cell cycle distribution was analyzed using flow cytometry. Dieckol treatment significantly increased the percentage of MCF-7 and SK-BR-3 in the G2/M phase. Immunoblot analysis revealed that 24 hours of dieckol exposure increased the Bax/Bcl-2 ratio. Conclusion: Dieckol induced cytotoxicity in MCF-7 and SK-BR-3 human breast cancer cells inducing apoptosis and cell cycle arrest. Therefore, it is suggested that dieckol may be a potential therapeutic agent for breast cancer.