• Journal of the Korean Society of Physical Medicine
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• v.16 no.4
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• pp.45-53
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• 2021

PURPOSE: This study examined women's attitudes toward the use of physical therapy in the treatment process after breast cancer surgery and the degree of interest in this application. Path analysis was conducted to discover the approaches to improve awareness of the necessity of physical therapy intervention after breast cancer surgery. METHODS: This study was a cross-sectional survey of 230 women aged 20 years and over with no history of breast cancer. The measurement tool used in this study was a structured questionnaire, composed of 17 items in five fields: five items on the demographic characteristics, four items related to health checkups, four items involving the viewpoints on breast cancer, one item related to the interest in breast cancer, and four items related to physical therapy after surgery. RESULTS: Women's attitudes toward regular health checkups were major factors in the prevention and treatment of breast cancer. In addition, those with higher levels of interest in breast cancer showed stronger interest in using physical therapy after breast cancer surgery. CONCLUSION: Women believe that breast cancer can be prevented through the health checkups implemented by the government. Therefore, there is a need to utilize public relations to promote methods for the self-diagnosis of breast cancer in the health checkup system and the use of physical therapy after breast cancer surgery.

• Asian Pacific Journal of Cancer Prevention
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• v.16 no.17
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• pp.7467-7472
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• 2015

Background: Breast cancer is known to be one of the most prevalent cancers among women in both developing and developed countries. The incidence of breast cancer in Pakistan has increased dramatically within the last few years and is the second country after Israel in Asia to have highest proportional cases of breast cancer. However, there are limited data for breast cancer available in the literature from Pakistan. Objectives: The study was conducted to bring to light the common clinical presentation of breast cancer and to evaluate the frequency of established risk factors in breast carcinoma patients and furthermore to compare the findings between premenopausal and postmenopausal women in Pakistan. Materials and Methods: A 6 months (from July 2012 to Dec 2012) cross sectional survey was conducted in Surgical and Oncology Units of Civil Hospital, Karachi. Data were collected though a well developed questionnaire from 105 female patients diagnosed with carcinoma of breast and analyzed using SPSS version 17. Institutional ethical approval was obtained prior to data collection. Results: Out of 105 patients, 43 were premenopausal and 62 were postmenopausal, 99 being married. Mean age at diagnosis was $47.8{\pm}12.4years$. A painless lump was the most frequent symptom, notived by 77.1%(n=81). Some 55.2% (n=58) patients had a lump in the right breast and 44.8%(n=47) in the left breast. In the majority of cases, the lump was present in upper outer quadrant 41.9% (n=44). Mean period of delay from appearance of symptoms to consulting a doctor was $5.13{\pm}4.8months$, from the shortest 1 month to the longest 36 months. Long delay (> 3 months) was the most frequent figure 41.9%. Considering overall risk factors most frequent were first pregnancy after 20 years of age (41%), physical breast trauma (28.6%), lack of breast feeding(21.9%), and early menarche <11 years (19%), followed by null parity (16.2%), consumption of high fat diet (15.2%), family history of breast cancer or any other cancer in first degree relatives (9.5% and 13.3%, respectively). Some of the less common factors were late menopause >54 years (8.6%), use of oral contraceptive pills (10.5%), use of hormone replacement therapy (4.7%),smoking (4.7%) and radiation (0.96%). Significant differences (p<0.005) were observed between pre and post menopausal women regarding history of physical breast trauma, practice of breast feeding and parity. Conclusions: A painless lump was the most frequent clinical presentation noted. Overall age at first child > 20 years, physical breast trauma, lack of breast feeding, early menarche <11 were the most frequent risk factors. Physical breast trauma, lower parity, a trend for less breast feeding had more significant associations with pre-menopausal than post-menopausal onset. Increase opportunity of disease prevention can be obtained through better understanding of clinical presentation and risk factors important in the etiology of breast cancer.

• Journal of Breast Disease
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• v.6 no.2
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• pp.52-59
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• 2018

Purpose: This study aimed to determine whether clinicopathological factors are potentially associated with successful breast-conserving surgery (BCS) after neoadjuvant chemotherapy (NAC) and develop a nomogram for predicting successful BCS candidates, focusing on those who are diagnosed with hormone receptor (HR)-positive, human epidermal growth factor receptor 2 (HER2)-negative tumors during the pre-NAC period. Methods: The training cohort included 239 patients with an HR-positive, HER2-negative tumor (${\geq}3cm$), and all of these patients had received NAC. Patients were excluded if they met any of the following criteria: diffuse, suspicious, malignant microcalcification (extent >4 cm); multicentric or multifocal breast cancer; inflammatory breast cancer; distant metastases at the time of diagnosis; excisional biopsy prior to NAC; and bilateral breast cancer. Multivariate logistic regression analysis was conducted to evaluate the possible predictors of BCS eligibility after NAC, and the regression model was used to develop the predicting nomogram. This nomogram was built using the training cohort (n=239) and was later validated with an independent validation cohort (n=123). Results: Small tumor size (p<0.001) at initial diagnosis, long distance from the nipple (p=0.002), high body mass index (p=0.001), and weak positivity for progesterone receptor (p=0.037) were found to be four independent predictors of an increased probability of BCS after NAC; further, these variables were used as covariates in developing the nomogram. For the training and validation cohorts, the areas under the receiver operating characteristic curve were 0.833 and 0.786, respectively; these values demonstrate the potential predictive power of this nomogram. Conclusion: This study established a new nomogram to predict successful BCS in patients with HR-positive, HER2-negative breast cancer. Given that chemotherapy is an option with unreliable outcomes for this subtype, this nomogram may be used to select patients for NAC followed by successful BCS.

• Archives of Plastic Surgery
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• v.42 no.2
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• pp.126-130
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• 2015

Lipofilling is a reconstructive and aesthetic technique that has recently grown in popularity and is increasingly being used in breast surgery. Previous concerns had been raised regarding its safety when used for remodelling and reconstruction of the breast; however, these concerns have since been dismissed. Over the subsequent two decades, little evidence has been found to support these early theoretical concerns, and growing numbers of proponents of the procedure are confident in its safety. Many developments and refinements in the technique have taken place in recent years, and several studies have been published regarding the safety of lipofilling in the breast. We reviewed the current literature regarding the use of different lipofilling techniques as well as the current evidence regarding the oncological safety of the procedure in patients seeking aesthetic breast enhancement and in patients requiring reconstruction after treatment for breast cancer.

• Asian Pacific Journal of Cancer Prevention
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• v.16 no.6
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• pp.2203-2207
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• 2015

Background: Breast conservative surgery (BCS) followed by radiotherapy is the standard approach in management of stage I-II breast cancer. Several factors can affect cosmetic outcomes. The aim of this study was to evaluate the cosmetic results of BCS and influencing factors in the Iranian Breast Cancer Research Center. Materials and Methods: Patients who had undergone BCS were included. Photographs were taken of both breasts of the patients in three aspects and were evaluated by three specialists. The cosmetic scores were calculated based on a standard questionnaire. The data were analyzed using univariate and multivariate regression for relationships between cosmetic scores and clinical data. Results: A total number of 103 patients were included in the study. Mean age and BMI of the patients were $46.8{\pm}8.9$ and $28.1{\pm}3.9$, respectively. Breast cup sizes C and D accounted for 74.7% of the study group. The mean cosmetic score obtained from three referees was 5.72+2.06, consisting of 35.9% excellent-good, 35% moderate, and 29.1% unsatisfactory results. Patient BMI, volume of the resected tissue and breast cup size (D) showed significant correlation with the cosmetic score. On multivariate regression analysis, cosmetic score and BMI (p=0.022,) as well as breast cup size (p=0.040), remained significant. Conclusions: Immediate or delayed symmetrization of the breasts is suggested during breast conservative surgery, meanwhile performing oncoplastic techniques to improve the results significantly. Also it is suggested to discuss anticipation of less satisfactory results with patients having higher BMI and large breast cup size.

• Child Health Nursing Research
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• v.9 no.3
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• pp.272-284
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• 2003

Purpose: The purpose of this research is to provide basic informations for the encouragements of premature infants' breast feeding. Method: From August 10 to October 9, 2002, we have carried out a statical research which surveyed 148 mothers of premature infants registered in NICU. The sample had generated cluster-randomly from 25 General Hospitals, all over the Korea peninsula and being surveyed with 74 questionnaires. Result: Mean hospitalized day of premature infants was 27.9 days. The mean total feeding period was 19.1 days and continuous breast feeding period 12.4days. They were interested in breast feeding education-they answered that they would join the breast feeding education if they were given the chance 87.8％. There was significant relation between babies fed only breast milk and the body weight of birth(p<.05). The reasons why mother gave the baby her breast milk include 'for her baby's health' and 'people said breast milk is good for babies' with a portion of 99％. The main reason why mothers could not execute breast feeding was 'the deficit of breast milk volume' 50.0％ and other reason were 'because of start to support more nutritions '18.2％, 'difficulty to carry out the breast milk to hospital'13.6％. The reasen why mothers could not try breast feeding at first were 'deficit of breast milk volume'37.0％, 'not to be prepared for breast feeding because of unexpected delivery'32.6％. Conclusion: We need a program to inform importance and excellent of the breast feeding and a plan to increase the premature infants' breast feeding through the importation of fortifier.

• Asian Pacific Journal of Cancer Prevention
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• v.16 no.17
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• pp.7607-7612
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• 2015

Aims: The purpose of our study was to evaluate the diagnostic performance of breast magnetic resonance imaging (MRI) in the evaluation of contralateral breast in patients with diagnosed breast cancer. A secondary objective was to determine accuracy of breast MRI in diagnosing multi-focal and multicentric lesions in the ipsilateral breast. Materials and Methods: Using a non-probability convenience sampling technique, patients with histopathologically diagnosed breast cancer with MRI of breast performed to exclude additional lesions were included. MRI findings were correlated with histopathology. In addition, follow-up imaging with mammography and ultrasound was also assessed for establishing stability of negative findings and for the detected of benign lesions. Results: Out of 157 MRI breast conducted during the period of 2008 to 2013, 49 were performed for patients with diagnosed breast cancer. The sample comprised of all females with mean age $50.7{\pm}11.0years$. The patient follow-up imaging was available for a period of 2-5 years. The sensitivity, specificity, and positive and negative predictive values of MRI in the detection of multifocal/multicenteric lesions was 85.7%, 88.8%, 60% and 96.6% respectively and for the detection of lesions in the contralateral breast were 100%, 97%, 83.3% and 100% respectively. Conclusions: Our study highlights the diagnostic performance and the added value of MRI in the detection of multifocal/multicenteric and contralateral malignant lesions. In patients with diagnosed breast cancer having dense breast parenchyma and with infiltrating lobular carcinoma as the index lesion MRI is particularly useful with excellent negative predictive value in the exclusion of additional malignant foci in the ipsilateral and contralateral breasts.

• Asian Pacific Journal of Cancer Prevention
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• v.13 no.7
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• pp.3507-3511
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• 2012

Objective: The aim of this study was to investigate possible mechanisms of LOX gene effects on invasion and metastasis of breast cancer cells by RNA interference. Methods: LOX-RNAi-LV was designed, synthesized, and then transfected into a breast cancer cell line (MDA-MB-231). Expression of LOX, MMP-2 and MMP-9 was determined by real-time PCR, and protein expression of LOX by Western blotting. Cell migration and invasiveness were assessed with Transwell chambers. A total of 111 cases of breast cancer tissues, cancer-adjacent normal breast tissues, and 20 cases of benign lesion tissues were assessed by immunohistochemistry. Results: Expression of LOX mRNA and protein was suppressed, and the expression of MMP-2 and MMP-9 was significantly lower in the RNAi group than the control group (P<0.05), after LOX-RNAi-LV was transfection into MDA-MB-231 cells. Migration and invasion abilities were obviously inhibited. The expression of LOX protein in breast cancer, cancer-adjacent normal breast tissues and benign breast tumor were 48.6% (54/111), 26.1% (29/111), 20.0% (4/20), respectively, associations being noted with clinical stage, lymph node metastasis, tumor size and ER, PR, HER2, but not age. LOX protein was positively correlated with MMP-2 and MMP-9. Conclusion: LOX displayed an important role in invasion and metastasis of breast cancer by regulating MMP-2 and MMP-9 expression which probably exerted synergistic effects on the extracellular matrix (ECM).

• Korean Journal of Adult Nursing
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• v.12 no.4
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• pp.717-726
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• 2000

This study was undertaken to examine the degree of knowledge and compliance of breast self-examination with women. The subjects for this study were 474 women aged 35-65 receiving health examination from Yonsu-ku Public Health Service Center in Inchon. Data collection was conducted through the use of 2 questionnaires. Analysis of the data was done by used of descriptive statistics, t-test, ANOVA, and Pearson Product Moment Correlation Coefficient. The results of this study were as follows: 1. There were significant differences in the breast self-examination compliance rate according to age(F=5.82, p=.000), marital status(F=2.67, p=.047), educational level (F=5.83, p=.000) and household income (F=3.41, p=.018). 2. The correct answer rate for each items of breast self-examination knowledge scale was between 14.1% of a minimum rate and 65.0% for a maximum rate of 100. The degree of knowledge for relation of breast cancer and menopause, the time of the highest occurance of breast cancer, the best time of breast self-examination and inspection methods of breast self-examination shows relatively low understanding. 3. The average score of breast self-examination was 1.34 from a maximum score of 6. The score of breast self-examination with palpation methods was higher than with inspection methods. 4. A positive correlation was found between breast self-examination knowledge and compliance rate (r=.417, p=.001). According to the results, it is necessary to provide knowledge of the relationship of breast cancer and menopause, the time of the highest occurance of breast cancer, and the best time of breast self-examination and inspection methods of breast self-examination. Also, it is necessary to provide detail guidance for inspection methods and develop a program for promoting the compliance of breast self-examination.

• Archives of Plastic Surgery
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• v.36 no.4
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• pp.422-427
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• 2009

Purpose: Breast cancer is second most common cancer in women. Almost of patients with breast cancer treated with mastectomy undergoes breast reconstruction. Nipple reconstruction is an important step in breast reconstruction. Many surgeons have investigated of nipple reconstruction using the flap technique after breast reconstruction with the autologous tissue. The objective of this study is to evaluate the results of nipple reconstruction using the C - V flap technique after breast reconstruction with the only breast expander. Methods: From April 2006 to May 2008, the authors treated 17 patients of nipple reconstruction using C - V flap technique, who were received breast reconstruction with the only breast expander. We have predicted decrease of the size of reconstructed nipple and designed flap a little larger than wanted nipple size. Nipple splint was applied for 4 - 6 months for minimizing decrease of the size of reconstructed nipple. The diameter and height of the reconstructed nipple were measured and patient's satisfaction score was assessed. Results: Mean follow-up duration was 12.5 months. Among the 17 patients, the average absorption rate by height of nipple was 47.0%. Partial necrosis was noted in 1 case, and treated well with conservative management. There was no other significant complications noted. Patient's satisfactory score was assessed by the height, design and location of the nipple. The average of satisfaction score was 85%, 68%, 62% and total average was 83%. Conclusion: The authors experienced 17 patients of nipple reconstruction using the C - V flap technique after breast reconstruction with the only breast expander. The absorption rate of the size of the nipple, complications and patient's satisfactory score of this study were similar to those of nipple reconstruction after breast reconstruction with the autologous tissue. It is expected that nipple reconstruction after breast reconstruction with the only breast expander is safe and reliable. It is considered that a long - term study is necessary.