• Journal of the Korean Society of Radiology
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• v.6 no.1
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• pp.63-71
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• 2012

This study aimed to evaluate the accuracy of breast cancer diagnosis of digital mammography which is in the highest interest of breast imaging test, and to investigate the characteristics of breast cancer patients. For this purpose, 57 breast cancer patients who underwent breast imaging test were examined between May 2010 and June 2011. The average age of the breast cancer patients was 50.8 years old, and the most frequently occurring location was the upper outer quadrant (UOQ), accounting for 33.3%. By age, the highest occurrence rate of breast cancer was the age group of 40~49, accounting for 42.1%. As for the breast composition of the breast cancer patients, fatty breast accounted for 31.6% (18/57) and dense breast for 68.4% (39/57), indicating that nearly 70% of the breast cancer patients have dense breast. It was found that the detection rate of breast cancer was the highest (45.3%) when both microcalcification and mass are simultaneously present in the radiographic lesion of the breast imaging. In dense breast, the mass without microcalcification was lower in detection rate than fatty breast. Accordingly, the mass is the cause of raising the false negative rate in dense breast. The findings show that the false negative rate of digital mammography was 7.0% and the sensitivity 93.0%. Also, the false negative rate of dense breast was 12.8%, and the sensitivity 87.2%, indicating that the sensitivity to breast cancer in this study was higher than the dense breast of previously reported screen film mammography.

• Investigative Magnetic Resonance Imaging
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• v.23 no.1
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• pp.46-54
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• 2019

Purpose: The aim of this study was to evaluate the diagnostic performance of a computer-aided detection (CAD) system used with automated breast ultrasonography (ABUS) for suspicious lesions detected on breast MRI, and CAD-false lesions. Materials and Methods: We included a total of 40 patients diagnosed with breast cancer who underwent ABUS (ACUSON S2000) to evaluate multiple suspicious lesions found on MRI. We used CAD ($QVCAD^{TM}$) in all the ABUS examinations. We evaluated the diagnostic accuracy of CAD and analyzed the characteristics of CAD-detected lesions and the factors underlying false-positive and false-negative cases. We also analyzed false-positive lesions with CAD on ABUS. Results: Of a total of 122 suspicious lesions detected on MRI in 40 patients, we excluded 51 daughter nodules near the main breast cancer within the same quadrant and included 71 lesions. We also analyzed 23 false-positive lesions using CAD with ABUS. The sensitivity, specificity, positive predictive value, and negative predictive value of CAD (for 94 lesions) with ABUS were 75.5%, 44.4%, 59.7%, and 62.5%, respectively. CAD facilitated the detection of 81.4% (35/43) of the invasive ductal cancer and 84.9% (28/33) of the invasive ductal cancer that showed a mass (excluding non-mass). CAD also revealed 90.3% (28/31) of the invasive ductal cancers measuring larger than 1 cm (excluding non-mass and those less than 1 cm). The mean sizes of the true-positive versus false-negative mass lesions were $2.08{\pm}0.85cm$ versus $1.6{\pm}1.28cm$ (P < 0.05). False-positive lesions included sclerosing adenosis and usual ductal hyperplasia. In a total of 23 false cases of CAD, the most common (18/23) cause was marginal or subareolar shadowing, followed by three simple cysts, a hematoma, and a skin wart. Conclusion: CAD with ABUS showed promising sensitivity for the detection of invasive ductal cancer showing masses larger than 1 cm on MRI.

• Asian Pacific Journal of Cancer Prevention
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• v.13 no.11
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• pp.5385-5389
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• 2012

Introduction: Sentinel lymph node biopsy (SLNB) is a precise procedure for lymphatic staging in early breast cancer. In a valid SLNB procedure, axillary lymph node dissection (ALND) can be omitted in nodenegative cases without compromising patient safety. In this study, detection rate, accuracy and false negative rate of SLNB for breast cancer was evaluated in a setting with simple modified conventional pathology facilities without any serial sectioning or immunohistochemistry. Material and Medthod: Patients with confirmed breast cancer were enrolled in the study. SLNB and ALND were performed in all cases. Lymph node metastasis was evaluated in SLN and in nodes removed by ALND to determine the false negative rate. Pathologic assessment was carried out only by modified conventional technique with only 3 sections. Detection rate was determined either by lymphoscintigraphy or during surgery. Results: 78 patients with 79 breast units were evaluated. SLN was detected in 75 of 79 cases (95%) in lymphoscintigraphy and 76 of 79 cases (96%) during surgery. SLN metastases was detected in 30 of 75 (40%) cases either in SLNB and ALND groups. Accuracy of SLNB method for detecting LN metastases was 92%. False negative rate was 3 of 30 of positive cases: 10%. In 7 of 10 cases with axillary lymphadenopathy, LN metastastates was detected. Conclusion: SLNB is recommended for patients with various tumor sizes without palpable lymph nodes. In modified conventional pathologic examination of SLNs, at least macrometastases and some micrometastases could be detected similar to ALND. Consequently, ALND could be omitted in node-negative cases with removal of all palpable LNs. We conclude that SLNB, as one of the most important developments in breast cancer surgery, could be expanded even in areas without sophisticated pathology facilities.

• Journal of radiological science and technology
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• v.34 no.1
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• pp.1-7
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• 2011

The purpose of this study is to evaluate the diagnostic accuracy of breast cancer from mammography images and to investigate the characteristics of patients who was diagnosed as a breast cancer. The subjects for this study were 85 patients who underwent breast imaging test with screen-film method and investigated from March 2010 to October 2010. The average age of the subjects is 51.9 years old. The 43.5% of onsets were located at the upper outer quadrant (UOQ). In terms of the age group, group for 40-49 ages were highest 37.6 (32/85)%. As for breast composition, fatty and dense breast were 30.6% (26/85) and 69.4% (59/85) respectively. The average age of the patients with fatty breast is 62.4 years old, whereas those with dense breast was 46.5 years old. The false negative rate of mammography images was 27.1% (23/85) and the sensitivity of mammography was 72.9% (62/85). The false negative rate of the patients with dense breast was 32.2% (19/59). the sensitivity of them was 67.8% (40/59).

• Asian Pacific Journal of Cancer Prevention
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• v.17 no.3
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• pp.1149-1155
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• 2016

Background: Examination of sentinel lymph node (SLN) biopsies provides accurate nodal staging for breast cancer and plays a key role in patient management. Procurement of SLNs and the methods used to process specimens are equally important. Increasing the level of detail in histopathological examination of SLNs increases detection of metastatic tumours but will also increase the burden of busy laboratories and thus may not be carried out routinely. Recommendation of a reasonable standard in SLN examination is required to ensure high sensitivity of results while maintaining a manageable practice workload. Materials and Methods: Twenty-four patients with clinically node-negative breast cancer were recruited. Combined radiotracer and blue dye methods were used for identification of SLNs. The nodes were thinly sliced and embedded. Serial sectioning and immunohistochemical (IHC) staining against AE1/AE3 were performed if initial H&E sections of the blocks were negative. Results: SLNs were successfully identified in all patients. Ten cases had nodal metastases with 7 detected in SLNs and 3 detected only in axillary nodes (false negative rate, FNR=30%). Some 5 out of 7 metastatic lesions in the SLNs (71.4%) were detected in initial sections of the thinly sliced tissue. Serial sectioning detected the remaining two cases with either micrometastases or isolated tumour cells (ITC). Conclusions: Thin slicing of tissue to 3-5mm thickness and serial sectioning improved the detection of micro and macro-metastases but the additional burden of serial sectioning gave low yield of micrometastases or ITC and may not be cost effective. IHC validation did not further increase sensitivity of detection. Therefore its use should only be limited to confirmation of suspicious lesions. False negative cases where SLNs were not involved could be due to skipped metastases to non-sentinel nodes or poor technique during procurement, resulting in missed detection of actual SLNs.

• Proceedings of the Korea Information Processing Society Conference
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• 2016.10a
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• pp.525-526
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• 2016

machine learning 기법 중 하나인 logistic regression을 이용하여 benign sample과 breast cancer sample을 구분할 수 있는데, 이 연구를 통해 classification의 정확도를 높이고 false positive와 false negative의 비율을 줄이려고 했다. 그래서 logistic regression의 parameter 값을 바탕으로 regression function에 영향을 많이 주는 feature 들을 선택하고, 영향력 있는 feature 들을 더한 새로운 feature를 추가했다. 그 결과 정확도와 F-score가 증가했으며, false positive, false negative의 비율이 감소했다.

• Asian Pacific Journal of Cancer Prevention
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• v.15 no.2
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• pp.569-575
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• 2014

Although mammography is the primary imaging modality for the breast, it has its limitations especially with dense breast parenchyma. Breast magnetic resonance imaging (MRI) has evolved into an important adjunctive tool as it is currently the most sensitive technique for breast cancer detection. Despite this high sensitivity, overlap in the appearances of some benign and malignant breast lesions results in additional unnecessary intervention with negative results. These false positives, in addition to high cost and limited availability, necessitate establishing proper indications for breast MRI. The literature was here reviewed for recent clinical trials, meta-analyses and review papers which have studied this important subject. PubMed; the US national library of medicine, was utilized to review the literature in the last twenty years. Using the obtained information, current uses of breast MRI are discussed in this paper to determine the indications which are relevant to clinical practice.

• Asian Pacific Journal of Cancer Prevention
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• v.14 no.3
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• pp.2137-2139
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• 2013

Breast cancer is the most common cancer among females, worldwide, accounting for 22.9% of all cancers (excluding non-melanoma skin cancer) in females. Mammography is a sensitive (77-95%) and specific (94-97%) screening method for breast cancer. Previously, females between the 40-50 years old were recommended to have mammograms every one to two years. However, based on current evidence, in 2009, USPSTF recommended that the decision to start regular, biennial screening mammography for females younger than 50 years should be an individual decision and take patient context into account, including the patient's values regarding specific benefits and harms. This decision was based on findings regarding radiation exposure, false-positive and false-negative rates, over-diagnosis, and pain and psychological responses. The goal of this paper is to focus on evidence for updating the U.S. Preventive Services Task Force (USPSTF) recommendation against routine mammography for females between 40-49 years of age.

• The Korean Journal of Nuclear Medicine
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• v.34 no.2
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• pp.119-128
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• 2000

Purpose: The aim of this study was to investigate the diagnostic role of $^{99m}Tc$-Tetrofosmin in detection of breast cancer and compared with that of $^{99m}Tc$-MIBI. Material and Methods: Forty-eight patients with a clinically palpable mass or abnormal mammographic or ultrasonographic findings had $^{99m}Tc-MIBI\;and\;^{99m}Tc$-Tetrofosmin scintimammographies after intravenous injection of 925 MBq of radiopharmaceuticals. The scintimammographs were correlated with histopathologic findings. Results: Thirty-three patients were diagnosed with breast cancer and 15 patients with benign breast diseases. The numbers of true positive, true negative, false positive, and false negative cases of $^{99m}Tc$-MIBI scintimammography were 29, 10, 5, and 4 respectively. The sensitivity, specificity, positive predictive value, and negative predictive value of $^{99m}Tc$-MIBI scintimammographies were 87.8%, 66.7%, 85.3%, and 71.4% respectively. The numbers of true positive, true negative, false positive, and false negative cases of $^{99m}Tc$-Tetrofosmin were 31,10, 5, and 2 respectively. The sensitivity, specificity, positive predictive value, negative predictive value of $^{99m}Tc$-Tetrofosmin were 93.9%, 66.7%, 86.1%, and 73.3% respectively. One patient was false negative in both $^{99m}Tc-MIBI\;and\;^{99m}Tc$-Tetrofosmin acintimammographies and its size was 0.5 cm. Conclusion: $^{99m}Tc-Tetrofosmin\;and\;^{99m}Tc-MIBI$ were non-invasive and useful in detection of breast cancer and $^{99m}Tc$-Tetrofosmin was comparable to the $^{99m}Tc$-MIBI in detection of primary breast cancer.

• The Korean Journal of Nuclear Medicine Technology
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• v.14 no.2
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• pp.60-64
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• 2010

Purpose: Until now the general study for breast cancer patient has been mammography, breast sonography for anatomic diagnostics and $^{18}F$-FDG whole body PET for functional one. But the PEM (Positron Emission Mammography) was developed to increase sensitivity, specificity and accuracy to improve the disadvantage of each study. Therefore this present study aims to describe availability of PEM for improving diagnosis of breast cancer. Materials and Methods: During 3 months from January in 2010, PEM was performed on 100 patients who had history of breast cancer. Using Naviscan's PEM Flex Solo II scanner, PEM images of breast were acquired. And then we evaluated sensitivity, specificity and accuracy of PEM data by comparing results of PEM images with postoperative pathologic finding. Results: On the 100 patients, it could reveal 89 true positive, 9 false positive, 7 false negative and 87 true negative. Thus the results of sensitivity, specificity and accuracy for PEM was evaluated 92.7%, 90.6% and 91.7%. Conclusion: The sensitivity, specificity and accuracy have been reported 83.7%, 68.5% and 77.1% in mammography, and that was 89.1%, 79.1% and 83.4% in breast sonography. However the results of PEM were more increased than others. Therefore the results of this study will be available that PEM used diagnosis with breast cancer, used preoperative operation plan and helps to discovery of a part recurrence.