• Title/Summary/Keyword: axillary lymph node

Search Result 134, Processing Time 0.021 seconds

Postoperative Radiation Therapy in High-risk Breast Cancer (고위험 유방암 환자의 수술 후 방사선치료)

  • Lee Kyung-Ja
    • Radiation Oncology Journal
    • /
    • v.19 no.4
    • /
    • pp.312-318
    • /
    • 2001
  • Purpose : To assess the locoregional recurrence rate, survival rate and prognostic factors after modified radical mastectomy and postoperative adjuvant radiation therapy with or with chemotherapy in high-risk breast cancer patients. Methods : Between $1984\~1995$, 48 patients underwent postoperative irradiation to the regional lymphatics and chest wall due to large tumor size $(\geq5\;cm)$ or small tumor size (<5 cm) with axillary lymph node involvement after modified radical mastectomy. The median age of the patients was 47 years (range, $31\~79\;years$). The clinical tumor size was <2 cm in 1 patient, $2\~5\;cm$ in 15 patients, and >5 cm in 32 patients. Thirty two patients had positive axillary lymph nodes. Forty two patients were irradiated to the chest wall and regional lymph node and 6 patients were irradiated in the chest wall only. Radiation dose to the chest wall and regional lymph node was 5040 cGy/28 fraction. The median follow-up time was 61 months. Results : Locoregional recurrence rate was $8\%$ and distant metastatic rate was $14\%$. The actuarial overall survival rate and disease-free survival rate was $53\%\;and\;62\%$ at 5 years, respectively. The median survival time was 57 months. Five-year overall survival rate by the stage is $70\%$ in IIB and $58\%$ in IIA. The significant prognostic factor for survival on multivariate analysis was the stage. Conclusion : Postoperative adjuvant radiation therapy in high-risk breast cancer can reduce the locoregional recurrence rate and increase the survival time by combined chemotherapy. The significant prognostic factor for survival rate was the stage.

  • PDF

Patients' Experiences of Sensations After Breast Cancer Surgery in Korean Women (유방암 수술 환자의 감각 변화에 대한 연구)

  • Jeong, Young-Hee;Kim, Dal-Sook
    • Asian Oncology Nursing
    • /
    • v.9 no.2
    • /
    • pp.145-154
    • /
    • 2009
  • Purpose: The purpose of this study was to obtain information about the experiences of sensations after breast cancer surgery characterized by prevalence, frequency, and severity, distresses, and disturbances in ADL using the BSAS (Breast Sensation Assessment Scale) and to develop the standardized Korean BSAS. Methods: Thirty two women from 3 to 100 days after breast cancer surgery (BCS) completed Roberta's BSAS. The 18 sensations of BSAS were translated using the references of Lee's Korean Pain Rating Scale and English-English, English-Korean dictionaries and the consultation from two native Americans, one bilingual permanent resident of the States, and one nursing professor. The Korean-translated BSAS has high reliability in test-retest. Likert type 4-point scale and 100 mm VAS were used for assessment. Results: Certain sensations remained prevalent (tender, pull, pain), frequent (numb, nag, throb), severe (throb, shoot, numb), causing distress (throb, penetrate, shoot), and influencing on ADL (throb, penetrate, nag). The most frequently experienced sensation other than BSAS was itching. There was little difference in the prevalence of symptom experiences between sentinel lymph node biopsy and axillary lymph node dissection. Conclusion: The women after BCS are suffering from neuropathic sensations. The Korean- translated BSAS could be used in effectively assessing breast sensations after BCS in Korean women.

  • PDF

Study on the Pathogenesis of Hantaan Virus with Monoclonal Antibodies (단일항체를 이용한 한국형출혈열의 병인성 연구)

  • Kim, Gum-Ryong;Kim, Tai-Gyu;Rhyu, Mun-Gan;Lim, Byung-Uk
    • The Journal of the Korean Society for Microbiology
    • /
    • v.22 no.1
    • /
    • pp.1-8
    • /
    • 1987
  • Hantaan virus(HV) 76-118 strain was inoculated into suckling ICR mice by intra-nasal route with an inoculum of $10LD_{50}$. Mortality was 65% at the 3rd week after inoculation, but declined to 35% at the 4th week. Infectivity was determined by the measuring immuno-fluorescent antibody in sera. The peak of infectivity was 80% at the 4'th week after inoculation. Viremia was reached peak level of $1.7{\times}10^4\;PFU/ml$ by day 10. Immunofluorescent antibody and neutralizing antibody appeared by 2 weeks and 15-17 days respectively, but achieved similar titer by 35 days. By using a monoclonal antibody to HV 76-118, viral antigens were initially detected in inguinal and axillary lymph node by 2 days. Viral antigens in bone marrow and lung were delayed much more than in those of lymph node. These were similar with those of intra-peritoneal and intra-muscular route. Immune complex against IgG, IgM and C3 appeared by 16 days, 14 days, and 18 days respectively. The pattern of immunofluorescence in the basement membrane of glomeruli was diffuse membranous. Spotted pattern was also observed in the tissue stained with anti-mouse C3 antibody. By 20 days, control tissue was also shown immune complex in the glomeruli.

  • PDF

A Case of Advanced Non-seminomatous Germ Cell Tumor of the Testis Cancer with Retroperitoneal Lymph Node Metastasis : Neoplastic Pain & Neoplastic Fever Treated by Sasang Constitutional Medical Treatment (고환통과 발열을 호소하는 고환암환자의 치험 1례)

  • Kim, Eun-Hee;Seo, Young-Kwang;Kim, Dal-Lae;Koh, Byung-Hee;Cheon, Seong-Ha;Eo, Wan-Kyu;Choi, Won-Cheol;Lee, Soo-Kyung
    • Journal of Sasang Constitutional Medicine
    • /
    • v.19 no.2
    • /
    • pp.179-186
    • /
    • 2007
  • 1. Objectives In this case report, We report a case of advanced non-seminomatous germ tell tumor(NSGCT) of the testis to retroperitoneal lymph node. We successfully managed with sasang medical treatment. 2. Methods We treated a man with NSGCT of testis with retroperitoneal lymph node metastasis. We evaluated pain grade by VAS(visual analogue scale). and fever grade by body temperature(by axillary thermometer) 3. Results Pain and fever were improved with the Sasang constitutional medicine. 4. Conclusions Cancer pain and fever was markedly improved by Sasang Constitutional management. Further studies are needed to evaluate the cause of the improvement.

  • PDF

A Breast Cancer Nomogram for Prediction of Non-Sentinel Node Metastasis - Validation of Fourteen Existing Models

  • Koca, Bulent;Kuru, Bekir;Ozen, Necati;Yoruker, Savas;Bek, Yuksel
    • Asian Pacific Journal of Cancer Prevention
    • /
    • v.15 no.3
    • /
    • pp.1481-1488
    • /
    • 2014
  • Background: To avoid performing axillary lymph node dissection (ALND) for non-sentinel lymph node (SLN)-negative patients with-SLN positive axilla, nomograms for predicting the status have been developed in many centers. We created a new nomogram predicting non-SLN metastasis in SLN-positive patients with invasive breast cancer and evaluated 14 existing breast cancer models in our patient group. Materials and Methods: Two hundred and thirty seven invasive breast cancer patients with SLN metastases who underwent ALND were included in the study. Based on independent predictive factors for non-SLN metastasis identified by logistic regression analysis, we developed a new nomogram. Receiver operating characteristics (ROC) curves for the models were created and the areas under the curves (AUC) were computed. Results: In a multivariate analysis, tumor size, presence of lymphovascular invasion, extranodal extension of SLN, large size of metastatic SLN, the number of negative SLNs, and multifocality were found to be independent predictive factors for non-SLN metastasis. The AUC was found to be 0.87, and calibration was good for the present Ondokuz Mayis nomogram. Among the 14 validated models, the MSKCC, Stanford, Turkish, MD Anderson, MOU (Masaryk), Ljubljana, and DEU models yielded excellent AUC values of > 0.80. Conclusions: We present a new model to predict the likelihood of non-SLN metastasis. Each clinic should determine and use the most suitable nomogram or should create their own nomograms for the prediction of non- SLN metastasis.

Effects of Bojungikkitang on the immunosuppression induced by methotrexate in rats (보중익기탕(補中益氣湯)이 Lymphocyte와 CD4+ T cell에 미치는 영향(影響))

  • Kim Mi-Ji;Kim Jang-Hyun
    • The Journal of Pediatrics of Korean Medicine
    • /
    • v.12 no.1
    • /
    • pp.211-230
    • /
    • 1998
  • Introduction The effects of Bojungikkitang on the immunosuppression induced by methotrexate in rats were investigated in this experiment. The multiple parameters of immunity assessed in. each rats includes the rate of body weight loss, weight changes in thymus, spleen and axillary lymphnode. The number of lymphocyte and CD4+ T cell count in blood, thymus, spleen and axillary lymphnode were also measured. Methodology Male Sprague-Dawley rats were chosen as an experiment object and were divided into 3 groups by a random selection. Each group consisted 6 rats. The normal group didn't receive any treatment. The control group was administered methotrexate for 4 days. The sample group was administered with both Bojungikkitang and methotrexate for 4 days. The dosage of medication was 2cc/day, 1cc given at 10AM and another 1cc given at 5PM. Results The rate of body weight loss was significantly decreased in the sample group. The weight of thymus was significantly increased in the sample group while the weight of spleen did not show much increase. Blood CD4+ T cell count, thymus lymphocyte count, thymus CD4+ T cell count, spleen lymphocyte count, spleen CD4+ T cell count and axillary lymph node CD4+ T cell count were significantly increased in the sample group while blood lymphocyte count and axillary lymphnode lymphocyte count did not show much increase. Conclusion As one can witness from the above results, administration of Bojungikkitang played potent role in increasing immune system among the rats treated with methotrexate which induces immunosuppression. Overall increase of lymphocyte count and CD4+ T cell count in the sample group with Bojungikkitang effectively proves its ability to boost the immune system.

  • PDF

Radiotherapy for initial clinically positive internal mammary nodes in breast cancer

  • Kim, Jina;Chang, Jee Suk;Choi, Seo Hee;Kim, Yong Bae;Keum, Ki Chang;Suh, Chang-Ok;Yang, Gowoon;Cho, Yeona;Kim, Jun Won;Lee, Ik Jae
    • Radiation Oncology Journal
    • /
    • v.37 no.2
    • /
    • pp.91-100
    • /
    • 2019
  • Purpose: Internal mammary lymph node (IMN) involvement is associated with poor prognosis in breast cancer. This study investigated the treatment outcomes of initial clinically IMN-positive breast cancer patients who received adjuvant radiotherapy (RT), including IMN irradiation, following primary breast surgery. Materials and Methods: We retrospectively reviewed data of 95 breast cancer patients with clinically detected IMNs at diagnosis treated with surgery and RT between June 2009 and December 2015. Patients received adjuvant RT to the whole breast/chest wall and regional lymph node (axillary, internal mammary, and supraclavicular) areas. Twelve patients received an additional boost to the IMN area. Results: The median follow-up was 43.2 months (range, 4.5 to 100.5 months). Among 77 patients who received neoadjuvant chemotherapy, 52 (67.5%) showed IMN normalization and 19 (24.6%) showed a partial response to IMN. There were 3 and 24 cases of IMN failure and any recurrence, respectively. The 5-year IMN failure-free survival, disease-free survival (DFS), and overall survival (OS) were 96%, 70%, and 84%, respectively. IMN failure-free survival was significantly affected by resection margin status (97.7% if negative, 87.5% for close or positive margins; p = 0.009). All three patients with IMN failure had initial IMN size ≥1 cm and did not receive IMN boost irradiation. The median age of the three patients was 31 years, and all had hormone receptor-negative tumors. Conclusion: RT provides excellent IMN control without the support of IMN surgery. Intensity-modulated radiotherapy, including IMN boost for breast cancer patients, is a safe and effective technique for regional lymph node irradiation.

Sentinel Node Biopsy Examination for Breast Cancer in a Routine Laboratory Practice: Results of a Pilot Study

  • Khoo, Joon-Joon;Ng, Chen-Siew;Sabaratnam, Subathra;Arulanantham, Sarojah
    • Asian Pacific Journal of Cancer Prevention
    • /
    • v.17 no.3
    • /
    • pp.1149-1155
    • /
    • 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.

Supraclavicular BCG Lymphadenitis Noted at 21 Months after BCG Vaccination Confirmed by a Molecular Method (분자생물학적 방법으로 확진한 접종 21개월 후에 발생한 BCG 쇄골상부 림프절염 1례)

  • Lee, Min Hyun;Chae, Moon-Hee;Park, Kyoung Un;Cho, Hye-Kyung
    • Pediatric Infection and Vaccine
    • /
    • v.21 no.2
    • /
    • pp.139-143
    • /
    • 2014
  • Bacille Calmette-$Gu\acute{e}rin$ (BCG) lymphadenitis is the most common complication of BCG vaccination. It commonly occurs in infants aged <6 months involving ipsilateral axillary lymph nodes. We described BCG lymphadenitis in a 22-month-old boy presenting swelling of left supraclavicular lymph node that was confirmed by real-time polymerase chain reaction (PCR) and the multiplex PCR targeting the region of difference (RD).

Erysipelas of the Upper Extremity Following Surgical Therapy for Breast Cancer (유방암 치료 후 발생한 상지의 단독)

  • Kwon, Ho;Kim, Hyung Jun;Jung, Sung No;Yim, Young Min
    • Archives of Plastic Surgery
    • /
    • v.34 no.1
    • /
    • pp.134-136
    • /
    • 2007
  • Purpose: Erysipelas is a bacterial infection of the dermis and hypodermis, mostly of streptococcal origin, and erysipelas of upper extremity following breast cancer treatment has never been reported in the Korean literature. Methods: 39-year-old female presented to our hospital complaining of fever and painful swelling of her left upper extremity. She had a history of breast cancer and was treated with breast conserving surgery with axillary lymph node dissection, chemotherapy, and radiation. On physical examination, her left upper extremity showed vesicle, bullae, local heatness and erythema with well-defined margin. With these distinctive features of a skin lesion, we gave a diagnosis of erysipelas and started treatment with intravenous antibiotics. Results: Resolution of the signs and symptoms of erysipelas occurred after 7 days of treatment. Conclusion: The diagnosis of erysipelas with distinctive feature of skin lesion is essential and we emphasize that the prevention of any trauma are very important in these patients for prophylactic measures.