• Archives of Plastic Surgery
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• v.46 no.5
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• pp.475-479
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• 2019

The Goldilocks technique for breast reconstruction utilizes redundant mastectomy flap tissue to construct a breast mound. This technique is suitable for women who decline, or are poor candidates for, traditional postmastectomy reconstruction. Moreover, this technique can be applied in secondary operations after the failure of initial reconstruction efforts. A 74-year-old patient underwent the Goldilocks procedure after reconstruction failure with an implant and acellular dermal matrix. At her 6-month follow-up, the cosmetic outcome of the procedure was satisfactory, and no complications were noted. Therefore, the Goldilocks procedure is a safe alternative to reconstruct breast mounds following reconstruction failure, especially in obese patients.

• The Korean Journal of Nuclear Medicine Technology
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• v.14 no.2
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• pp.186-189
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• 2010

Purpose: As many patients often showed the value of menopause although they were women of childbearing age, this study looked into their previous history. According to the findings, they were patients with a mastectomy due to breast cancer and were taking breast cancer treatment Tamoxifen (the women hormone inhibitor) after chemotherapy. This study is conducted to examine changes in FSH and E2 concentration of patients breast cancer patients of childbearing age according to Tamoxifen used to prevent recurrence of breast cancer and proliferation of mammary parenchyma. Materials and Methods: This study aims to investigate similarity in patients treated with surgery who were in their childbearing age and in values of FSH and E2 by dividing test results of FSH and E2 requested at the department of nuclear medicine among patients who visited this hospital from Jan. 2009 to Mar. 2010 into women of childbearing age (n=50), menopausal women (n=50), and patients with breast cancer surgery who take Tamoxifen (n=50) and then comparing the test results. Results: The FSH and E2 test results of 50 patients were compared and analyzed as average${\pm}$standard deviation, and the results showed that the figure of women of childbearingage (n=50) was FSH : $7.14{\pm}6.19$, E2 : $138.76{\pm}85.40$, that of menopausal women (n=50) was FSH : $52.12{\pm}24.43$, E2 : $15.06{\pm}4.43$, and that of patients with breast cancer surgery who were in their childbearing age (n=50) was FSH : $44.21{\pm}21.07$, E2 : $13.53{\pm}4.26$. When these different results of FSH and E2 were compared, the value of patients with breast cancer surgery who were in their childbearing age with Tamoxifen was somewhat similar to that of menopausal women. Conclusion: The test results of FSH and E2 have reportedly found the test values of patients with breast cancer surgery could be similar to that of menopausal women eventhough they were in their childbearing age due to the women hormone inhibitor Tamoxifen. Therefore, if a tester conducts this experiment after understanding the clinical meaning, the reliability of the tester reporting test results would be increased.

• Asian Pacific Journal of Cancer Prevention
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• v.13 no.1
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• pp.147-155
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• 2012

Aboriginal and Torres Strait Islander people comprise about 2.5% of the Australian population. Cancer registry data indicate that their breast cancer survivals are lower than for other women but the completeness and accuracy of Indigenous descriptors on registries are uncertain. We followed women receiving mammography screening in BreastScreen to determine differences in screening experiences and survivals from breast cancer by Aboriginal and Torres Strait Islander status, as recorded by BreastScreen. This status is self-reported and used in BreastScreen accreditation, and is considered to be more accurate. The study included breast cancers diagnosed during the period of screening and after leaving the screening program. Design: Least square regression models were used to compare screening experiences and outcomes adjusted for age, geographic remoteness, socio-economic disadvantage, screening period and round during 1996-2005. Survival of breast cancer patients from all causes and from breast cancer specifically was compared for the 1991-2006 diagnostic period using linked cancer-registry data. Cox proportional hazards regression was used to adjust for socio-demographic differences, screening period, and where available, tumour size, nodal status and proximity of diagnosis to time of screen. Results: After adjustment for socio-demographic differences and screening period, Aboriginal and Torres Strait Islander women participated less frequently than other women in screening and re-screening although this difference appeared to be diminishing; were less likely to attend post-screening assessment within the recommended 28 days if recalled for assessment; had an elevated ductal carcinoma in situ but not invasive cancer detection rate; had larger breast cancers; and were more likely than other women to be treated by mastectomy than complete local excision. Linked cancer registry data indicated that five-year year survivals of breast cancer cases from all causes of death were 81% for Aboriginal and Torres Strait Islander women, compared with 90% for other women, and that the former had larger breast cancers that were more likely to have nodal spread at diagnosis. After adjusting for socio-demographic factors, tumour size, nodal spread and time from last screen to diagnosis, Aboriginal and Torres Strait Islander women had approximately twice the risk of death from breast cancer as other women. Conclusions: Aboriginal and Torres Strait Islander women have less favourable screening experiences and those diagnosed with breast cancer (either during the screening period or after leaving the screening program) have lower survivals that persist after adjustment for socio-demographic differences, tumour size and nodal status.

• Korean Journal of Adult Nursing
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• v.18 no.3
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• pp.357-366
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• 2006

Purpose: The purpose of this study were to examine the incidence of lymphedema and to compare to physiological and psychosocial symptoms between breast cancer patients with lymphedema and without lymphedema. Method: Four hundreds fifty women with breast cancer receiving mastectomy were recruited from two out-patient breast clinics of A and S university hospitals in Seoul, Korea from October, 2004 to May, 2005. Lymphedema was defined by circumferential measurement. Differences greater than 2cm between the affected arm and normal arm were considered to be lymphedema. A descriptive design was used for this study and data was collected using a structured questionnaire. The data were analyzed using descriptive statistics and independent t-test. Results: Lymphedema developed in 112(24.9%) of the 450 subjects. Subjects with lymphedema reported more severe sensation change of arm and more depression and confusion than subjects without lymphedema. Range of motion of shoulder as a physical indicator and social support, however, were not significantly different between the two groups. Conclusion: Lymphedema is recognized as an unpleasant and uncomfortable consequence of breast cancer-related treatment. Therefore, more research is needed to evaluate the impact of lymphedema on quality of life in patients with lymphedema and the efficacy of nursing intervention.

• Asian Pacific Journal of Cancer Prevention
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• v.15 no.12
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• pp.4847-4849
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• 2014

A compariosn was made of survival outcomes of oncoplastic breast conserving therapy (oBCT) with nipple-areolar (NAC) preservation in women with centrally located breast cancer (CLBC) undergoing modified radical mastectomy (MRM) in China in a matched retrospective cohort study. We used a database including patients who received oBCT (n=91) or MRM (n=182) from 2003 to 2013 in our hospital. Matching was conducted according to five variables: age at diagnosis, axillary lymph node status, hormone receptor status, human epidermal growth factor-like receptor 2 status (HER-2) and tumor stage. The match ratio was 1:2. Median follow-up times for the oBCT and MRM groups were 83 and 81 months, respectively. There were no significant differences in 87-month overall, local, or distant recurrence-free survival between patients with oBCT and MRM (89%vs.90%; 93%vs.95%; 91%vs.92%;). For appropriate breast cancer patients, oBCT for CLBC is oncologically safe, oncoplastic techniques improving cosmetic outcomes.

• Asian Pacific Journal of Cancer Prevention
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• v.16 no.18
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• pp.8397-8403
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• 2016

Background: Breast cancer (BCa) is the most common malignancy in Mexican women. A set of histopathological markers has been established to guide BCa diagnosis, prognosis and treatment. Nevertheless, in only a few Mexican health services, such as that of the Secretariat of National Defense (SEDENA for its acronym in Spanish), are these markers commonly employed for assessing BCa. The aim of this study was to explore the association of Ki67, TP53, HER2/neu, estrogenic receptors (ERs) and progesterone receptors (PRs) with BCa risk factors. Materials and Methods: Clinical histories provided background patient information. Immunohistochemical (IHC) analysis was conducted on 48 tissue samples from women diagnosed with BCa and treated with radical mastectomy. The Chi square test or Fisher exact test together with the Pearson and Spearman correlation were applied. Results: On average, patients were $58{\pm}10.4$ years old. It was most common to find invasive ductal carcinoma (95.8%), histological grade 3 (45.8%), with a poor Nottingham Prognostic Index (NPI; 80.4%). ERs and PRs were associated with smoking and alcohol consumption, metastasis at diagnosis and Ki67 expression (p<0.05). PR+ was also related to urea and ER+ (p<0.05). Ki67 was associated with TP53 and elevated triglycerides (p<0.05), and HER2/neu with ER+, the number of pregnancies and tumor size (p<0.05). TP53 was also associated with a poor NPI (p<0.05) and CD34 with smoking (p<0.05). The triple negative status (ER-/PR-/HER2/neu-) was related to smoking, alcohol consumption, exposure to biomass, number of pregnancies, metastasis and a poor NPI (p<0.05). Moreover, the luminal B subty was associated with histological type (p=0.007), tumor size (p=0.03) and high cholesterol (p=0.02). Conclusions: Ki67, TP53, HER2/neu, ER and PR proved to be related to several clinical and pathological factors. Hence, it is crucial to determine this IHC profile in women at risk for BCa. Certain associations require further study to understand physiological/biochemical/molecular processes.

• Archives of Plastic Surgery
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• v.41 no.6
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• pp.702-708
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• 2014

Background Lower abdominal soft tissue transfer is the standard procedure for breast reconstruction. However, abdominal wall weakness and herniation commonly occur postoperatively at the donor site. To reduce the morbidities of the donor site, the superficial inferior epigastric artery (SIEA) flap was introduced, but inconsistent anatomy of the SIEA has reduced its utility. In the present study, the anatomy of the superficial inferior epigastric vessels in Korean women was determined with regards to breast reconstructive surgery. Methods The vascular anatomies of the SIEA and superficial inferior epigastric vein (SIEV) were evaluated on 32 breast cancer patients receiving free transverse rectus abdominis musculocutaneous flap reconstruction after mastectomy. The existence, pulsation, location, external diameter, and depth of the SIEA and SIEV were measured at the lower abdominal incision level. Results SIEA and SIEV were present in 48/64 (75.00%) and 63/64 (98.44%) hemi-abdomens, respectively. Pulsation of the SIEA was found in 44/48 (91.67%) cases. The mean locations of SIEA and SIEV were +5.79 (${\pm}12.87$) mm, and -8.14 (${\pm}15.24$) mm from the midpoint between the anterior superior iliac spine and symphysis pubis, respectively. The mean external diameters of SIEA and SIEV were 1.20 (${\pm}0.39$) mm and 1.37 (${\pm}0.33$) mm, and they were found at a mean depth of 9.75 (${\pm}2.67$) mm and 8.33 (${\pm}2.65$) mm, respectively. Conclusions The SIEA was absent in 25% of Korean women and had a relatively small caliber. Therefore, careful preoperative assessment of the lower abdominal vasculature is required to achieve successful breast reconstruction using SIEA flaps.

• Archives of Plastic Surgery
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• v.49 no.3
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• pp.339-345
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• 2022

Background Patients that undergo mastectomy for breast cancer with reconstruction may be prone to prolonged opioid use. As risk factors are not well-established, this article sought to better understand the risk factors that may be associated with this. Methods Patients that underwent breast reconstruction between 2010 and 2018 were identified in PearlDiver, a national insurance claims database. Patient demographics and comorbidities were elucidated, and various complications were then identified. Descriptive statistics as well as a multivariate analysis was used to evaluate the association of risk factors and complications. Results Breast reconstruction patients of 24,765 were identified from this database. Obesity, tobacco use, benzodiazepine use, and anticonvulsant use were all associated with prolonged opioid prescriptions greater than 90 days after both alloplastic and autologous reconstruction. Conclusion Prolonged opioid use continues to remain a topic of concern, and particularly in cancer patients that undergo breast reconstruction. Providers should be aware of potential risk factors for this to reduce this chance following breast reconstruction surgery.

• Korean Journal of Adult Nursing
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• v.17 no.1
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• pp.119-127
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• 2005

Purpose: The purpose of this study was to describe the degree of perceived health status, depression and quality of life(QOL) and to examine the relationships among these factors in breast cancer survivors. Methods: The subjects were 105 women with mastectomy after breast cancer diagnosis who were in the out-patient department of surgery at SNUH in Seoul. Data was collected using self-report instruments. The instruments included 1-item for perceived health status, Chae and Choe's QOL scale for Korean breast cancer survivors, and Beck Depression Inventory(BDI) as well as socio-demographic and medical information. Data were analyzed with SPSS WIN 10.0 program. Results: The levels of perceived health status and QOL were moderate. Mild depression was found on the BDI. QOL and depression showed a negative correlation(r= -.598), whereas QOL and perceived health status was correlated positively(r=.370). Depression, perceived health status, and time since diagnosis accounted for 47.4% of variance of the QOL. Depression was the most significant predictor of QOL in breast cancer survivors. Conclusion: Breast cancer survivors may experience depression and alteration in QOL. Future nursing research should be directed toward the implementation and evaluation of interventions that promote QOL and decrease depression in breast cancer survivors.

• Archives of Plastic Surgery
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• v.41 no.4
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• pp.414-417
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• 2014

Serratia marcescens (S. marcescens) emerged as an opportunist in the setting of immunodeficiency in the 1970s, when serious infections occurred in San Francisco hospitals after USA. Navy experiments had aerosolized the bacteria to study biologic warfare. We investigate the risks of S. marcescens in San Franciscans who undergo mastectomy with implant reconstruction. From 2007 to 2011, the senior author took breast capsule cultures for all patients at the time of tissue expander exchange/explant. Of the 142 women who had reconstruction, 23 had positive cultures. Only the two patients who were positive for S. marcescens developed clinical infections that required explantation. Both had postoperative chemotherapy with transient neutropenia, and both had close ties to San Francisco. Clinical signs of infection emerged for both patients months after initial surgery, despite having previously well healed incisions. Other patients were culture positive for Pseudomonas, Proteus, Enterococcus and MRSA and did not develop require explant. While the link between San Francisco and S. marcescens is controversial, a patient's geography is a simple screening tool when considering postoperative risks, especially in the immunocompromised. Closer monitoring for neutropenia during chemotherapy, and a lower threshold to administer S. marcescens targeted antibiotics may be warranted in these patients.