• Journal of Korean Physical Therapy Science
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• v.7 no.2
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• pp.439-457
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• 2000

The causes, risk factors and sequelae of mastectomy were studied, and the physical therapy approaches on post-mastectomy was discussed in this study. It was found that the patients taken mastectomy have experienced pins and needles in muscle, weakening of muscle, pains, deterioration of motion in joint region and activities of daily living, psychiatric sequelae, and etc even after the conservertive therapies like the chemical therapy, radiotherapy, immunotherapy, and hormone therapy. However, few study on the physical therapy approaches for patients with breast cancer has been carried in Korea at present. The followings were proposed as the physical therapy approaches. 1. Shoulder joint motion approach to relax the limit of range of motion 2. Control of breathing exercise for dealing with removal of the pectorailis muscle 3. Method to reduce the edema of arms for tackling the cut of lymph node 4. Method to reduce pains, pins and needles 5. Support home exercise program after discharging from hospital, sexual life and pregnancy, and activities of daily living training method.

• Asian Oncology Nursing
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• v.9 no.2
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• pp.129-135
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• 2009

Purpose: This study was to explore the psychosocial adjustment, marital intimacy and family support of post-mastectomy patients. Methods: The subjects were 90 post-mastectomy patients (stage I or II) who were eligible and agreed to participate in the study. The data collection period was from March to May, 2008. Subjects completed a survey including demographics, psychosocial adjustment scale by Lee (a 4-point Likert scale), marital intimacy scale by Kim (a 4-point Likert scale), and family support by Shim (a 5-point Likert scale). Data were analyzed using SAS (ver 9.0) program and frequency, mean (SD), t-test, ANOVA and Pearson correlation coefficients were used. Results: The mean scores of the psychosocial adjustment and marital intimacy were 2.8 (${\pm}0.4$) and 2.5 (${\pm}0.5$). Also, the mean score of the family support was 3.6 (${\pm}0.7$). Regarding the correlation between the psychosocial adjustment, marital intimacy and family support, there was a positive correlation. Conclusion: These results showed that subjects who had higher marital intimacy and family support showed better in psychosocial adjustment. To improve psychosocial adjustment of post-mastectomy patients for breast cancer more effectively, there is an necessity to provide various strategic supports and intervention for effective communication with spouse and family.

• Asian Pacific Journal of Cancer Prevention
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• v.15 no.6
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• pp.2505-2510
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• 2014

Background: The standard radiotherapy (RT) fractionation practiced in India and worldwide is 50Gy in 25 fractions over 5 weeks to the chest wall or whole breast followed by tumour bed boost in case of breast conservation (BCS). A body of validated data exists regarding hypofractionation in breast cancer. We here report initial results for 135 patients treated at our center with the START-B type of fractionation. Materials and Methods: From May 2011 till July 2012, women with all stages of breast cancer (excluding metastatic), who had undergone BCS or mastectomy were planned for 40Gy in 15 fractions over 3weeks to chest wall/whole breast and supraclavicular fossa (where indicated) followed by tumour bed boost in BCS patients. Planning was done using Casebow's technique. The primary end point was to assess the acute toxicity and the cosmetic outcomes. Using cosmetic scales; patients were assessed during radiotherapy and at subsequent follow up visits with the radiation oncologist. Results: Of the 135 patients, 62 had undergone BCS and 73 mastectomy. Median age of the population was 52 years. Some 80% were T1&T2 tumours in BCS whereas most patients in mastectomy group were T3&T4 tumours (60%). 45% were node negative in BCS group whilst it was 23% in the mastectomy group. Average NPI scores were 3.9 and 4.9, respectively. Most frequently reported histopathology report was infiltrating ductal carcinoma (87%), grade III being most common (58%), and 69% were ER positive tumours, and 30% were Her 2 Neu positive. Triple negative tumours accounted for 13% and their mean age was young (43 yrs.) The maximum acute skin toxicity at the end of treatment was Grade 1 in 94% of the mastectomy grouppatients and 71% in BCS patients. Grade 2 toxicity was 6% in mast group and 23% in BCS group. Grade 3 was 6% in BCS group, no grade 3 toxicity in mastectomy patients and there was no grade 4 skin toxicity in any case. Post RT at 1 month; 39% of BCS patients had persisting Grade I skin reaction which was only 2% in mastectomy patients. At 3 months post RT, 18% patients had persisting hyperpigmentation. At 6 months 8% patients had persisting erythema in the BCS group only. Some 3% BCS and 8% mastectomy patients had lymph edema till the date of evaluation. Cosmetic outcome in BCS patients remained good to excellent 6 months post surgery and radiotherapy. 1 patient of BCS and 3 patients of mast had developed metastatic disease at the time of evaluation. Conclusions: Hypofractionated RT is well tolerated in Indian population with reduced acute skin toxicity and good cosmetic outcome. Regimens such as these should be encouraged in other centers to increase machine output time. The study is on-going to assess long term results.

• Korean Journal of Radiology
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• v.22 no.7
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• pp.1005-1020
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• 2021

Breast augmentation is becoming more common, be it for cosmetic reasons or post-mastectomy. Multiple articles in the literature describe the imaging findings of various types of cosmetic breast augmentation. Some articles describe imaging findings for different types of post-mastectomy reconstructions. This essay aims to serve as a comprehensive reference for the multimodality imaging of various types of breast augmentations in native breast and post-mastectomy reconstructions. Familiarity with these findings will facilitate the detection of complications and new or recurrent breast malignancies in patients. With the extensive illustrations provided in this essay on normal and abnormal imaging findings of augmented breasts, readers will receive exposure that will facilitate effective practice.

• Archives of Plastic Surgery
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• v.39 no.3
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• pp.222-226
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• 2012

Background : Immediate breast reconstruction after mastectomy and delayed breast reconstruction with post-supplementary treatment are the two types of breast reconstruction currently performed when treating breast cancer. Post-mastectomy radiation therapy (PMRT) not only reduces local recurrence but also improves overall survival. However, the complications and survival rates associated with PMRT need to be clear when determining the timing of breast reconstruction. Accordingly, we investigated the optimal timing of breast reconstruction by observing patients who underwent mastectomy followed by PMRT, based on their overall health and aesthetic satisfaction. Methods : We retrospectively reviewed 21 patients who underwent breast reconstruction with PMRT between November 2004 and November 2010. We collected data regarding the various methods of mastectomy, and the modality of adjuvant therapy, such as chemotherapy, hormone therapy, and radiotherapy. Telephone interviews were conducted to study the general and aesthetic satisfaction. Results : Patients who received PMRT after breast reconstruction showed a greater complication rate than those undergoing breast reconstruction after PMRT (P=0.02). Aesthetic satisfaction was significantly higher in the groups undergoing breast reconstruction after PMRT (P=0.03). Patients who underwent breast reconstruction before PMRT developed complications more frequently, but they expressed greater aesthetic satisfaction with the treatment. Conclusions : It is recommended that the complication rates and aesthetic satisfaction after breast reconstruction be carefully considered when determining the optimal timing for radiotherapy.

• Journal of muscle and joint health
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• v.19 no.3
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• pp.319-328
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• 2012

Purpose: The purpose of this study was to explore effects of a Cancer-overcome BeHaS exercise program that consists of exercise, education, and cognitive supports to improve shoulder external rotation, cancer coping, group cohesion in mastectomy patients. Methods: A one group pre-post test design was used. Thirty mastectomy patients from C Hospital participated in the supervised exercise program once a week for 8 weeks. Data were collected from May to July 2011 using self-administered questionnaires and physical measurement. SPSS/WIN 19.0 was used for the data analysis. Results: The mean age of participants was 53.7 and the mean postoperative period after the surgery was 12.93 months. There were significant differences in the shoulder external rotation, cancer coping, group cohesion between pre and post program. Conclusion: The results showed that cancer-overcome BeHaS exercise program was an effective nursing intervention for improving breast cancer patient's shoulder external rotation, cancer coping and group cohesion.

• Journal of Society of Preventive Korean Medicine
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• v.14 no.3
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• pp.37-49
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• 2010

Objective : Qigong has been reported as an effective for post-mastectomy women. It consists of a series of postures combined with slow, smooth, graceful movements, and is considered a low intensity exercise. In this study, a specialist of Qigong developed a Qigong program for post-mastectomy women in a community. The object of this research is to evaluate the effect of Qigong on a subjective symptom scale, on the grade of discomfort and pain in everyday life, BMI, fat(%), muscular strength, shoulder joint movement, in post-mastectomy women. Methods : The study used a non-equivalent control group non-synchronized design. The experimental group received a Qigong 3 times a week for 12 weeks from September 7th to December 28th in 2009. The subjects were 40 patients are divided into 25 persons in experimental groups and 15 persons in contrastive group. The data were analyzed with descriptive statistics, chi-square test, t-test, Mann-Whitney U test. A P-value less than .05 was considered significant by 2-tailed test. All statistical analyses were performed with SPSS win(ver 12.0). Results : The results were as follows : The score in the subjective symptom(p=.040), and score of anxiety (p=.024), fat(%)(p=.007) were significantly decreased after Qigong program. The values for shoulder flexibility (left : p=.010, right : p=.008), and Muscular strength(grip power)(left : p=.021, right : p=.029) significantly increased after Qigong program. And Flexion(left ; p=.029), Extension(left : p=.001, right : p=.038), Adduction(left ; p=.001, right ; p<0.001) were also significantly increased after Qigong Conclusions : The Qigong is an effective health promotion program for post-mastectomy women.

• Korean Journal of Social Welfare
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• v.59 no.3
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• pp.99-124
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• 2007

The purpose of this study is to research psychosocial experience in post-mastectomy women, who participated in self-help group, using in-depth interviews and participant observations. Until recently, studies on post-mastectomy women in psychological perspectives had been maily done by nurses, and there are only few literatures in social welfare studies. Therefore, based on phenomenological theory, the meaning and essence of "the breast" and the lived experience of post-mastectomy women, i.e. emotional distress, and as a result has been explored, it has confirmed six clusters and explained them in detail. As a result, from the subjects' experience, the essence of 'A crossroad of life and death', 'sexual-identity crisis', 'feeling mortified due to double binded messages of others', 'conflict between physical and psychological disabilities', 'feelings of gratitude or wishfulness', and 'their realistic suggestions and wishes' has been shown. It has been founded that the subjects experienced not only self-identity crisis as women but also unending internal turmoil because of their passion to live. It has been hoped that this study will help to shape government policy and social welfare services on post-mastectomy patients.

• Asian Oncology Nursing
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• v.1 no.2
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• pp.204-216
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• 2001

The purpose of this study was to test the effects of foot reflexology on pain and mood in patients who have just had a mastectomy. The research design was a nonequivalent control group, non-synchronized design. The participants for this study were 28 patients with breast cancer on first or second day after mastectomy surgery. The first 12 patients were assigned to the control group and the second 16 to the experimental group. The study was conducted from October 28, 2001 to December 22, 2001 on a surgical unit of Y Medical Center in Seoul, Korea. Pain intensity, blood pressure, pulse rate and mood were measured as dependent variables. The instrument used for pain intensity and mood was a 10 cm visual analogue scale. Cronbach alpha for this study was .70. For the experimental group pre and post tests were done immediately before and 15 minutes after completion of foot reflexology. Foot reflexology was performed once for 20 minutes. After the pretest, patients in the control group were instructed to have a quiet time for a 35 minute period and then the post-test was done. The number of participants was small so the data were analyzed by Mann-Whitney U test, and Wilcoxon signed ranks test. The results of this study are as follow : 1. In the experimental group there were significant decreases between the pre and post tests for pain intensity (z=-3.47, p<.001), diastolic blood pressure (z=-2.67, p<.01) and pulse rate (z=-3.44, p<.001) but there was no difference between the two groups on the post test. 2. The systolic blood pressure, diastolic blood pressure and pulse rate were also not significantly different between the experimental group and the control group on the post test. 3. The mood score was significantly improved after foot reflexology(z=-3.52, p=.000) and the difference between the two groups was also significant (u=49.0, p=.03). In conclusion, there was a statistically significant difference in mood between the two groups, but no difference for pain intensity, blood pressure, or pulse rate. However, there were significant differences between the pretest and post-test for pain intensity, diastolic blood pressure and pulse rate in the experimental group. On the basis of the above findings, this study suggests that foot reflexology can be an effective method of relieving pain and improving mood in clinical practice in women who have had mastectomy surgery.

• Korean Journal of Adult Nursing
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• v.13 no.1
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• pp.82-95
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• 2001

The purpose of this study was to examine the relationship among perceived health status, self-esteem, self-efficacy and health promoting behavior, and to determine the predictors of health promoting behavior in post-mastectomy patients. The study, a descriptive correlational study, was done with structural questionnaires. A total of 51 post-mastectomy subjects from C university hospital in Kwang-ju, South Korea completed mail-in self-reporting questionnaires during a three month period from March to June, 1999. The data were collected using Lawstone's(1982) perceived health status scale, Rosenberg's(1965) self-esteem scale, the modified self-efficacy scale(Shere et al, 1982), and the modified health promoting lifestyle profile (Walker et al, 1987). The data obtained were analyzed according to percentage, mean and standard deviation, principal component analysis, varimax rotation, t-test, ANOVA, Pearson's correlation, and stepwise multiple regression. The results were as follows: 1. The health promoting behavior measurement resulted in six factors. Each factor was labelled as follows: self-actualization, nutrition, stress management, exercise, health responsibility and interpersonal support. The total percent of variance explained by the six factors was 58.4%. 2. The mean score of health promoting behavior was 85.92(range 58~117). The scores of six factor were nutrition 3.20, self-actualization 2.59, stress management 2.58, interpersonal support 2.58, health responsibility 2.49, and exercise 2.34 on a four point scale. 3. When the score of health promoting behavior factors were compared by general characteristics. Factor I: self-actualization, differed significantly by the frequency of pregnancy (F=3.06, p=.037). Factor II: nutrition differed significantly by drinking experience(t=-2.26, p=.028) and the pre- or post stage of menopause(F=2.69, p=078). FactorIII: stress management differed significantly depending on regularity of mensturation(t=-2.12, p= .042). FactorIV: exercise differed significantly by type of religion (F=2.49, p=.072), marital status(F=5.03, p=.010), and feeding type (F=2.64, p=.036). Factor V: health responsibility differed significantly by regularity of mensturation(t=2.18, p=.037). 4. The total health promoting behavior score was significantly related to self-esteem and perceived health status(r=.610, p.006; r= .378, p=.006). The score of selfactualization also corresponded with selfesteem and perceived health status(r=.556, p=.001; r=.343, p=.013). 5. The predictor to explain the score of health promoting behavior was self-esteem, which accounted for 37.1% of the total variance. The predictor to explain the score of self-actualization was self-esteem, which accounted for 30.9% of the total variance. The score of nutrition was primarily affected by both premenopause and drinking experience, which accounted for 13.1% and 9.5% respectively. Finally, the score of exercise was dictated by marriage, Buddhism, no experience of breast feeding, which accounted for 17%, 9.8%, & 5.2% respectively. In conclusion, self-esteem is the main predictor for health promoting behavior in post-mastectomy women. These findings suggest a need for nursing strategies which promote self-esteem in such patients.