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Breast Reconstruction by Pectoralis Major Muscle Transfer with Implants after Skin Sparing Partial Mastectomy (피부보존 유방절제술 후 대흉근전위술과 유방삽입물을 이용한 유방재건술)

  • Park, Jung Min;Kwon, Yong Seok;Lee, Keun Cheol;Kim, Seok Kwun;Lee, Jin Hwa;Jho, Sae Heon
    • Archives of Plastic Surgery
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    • v.32 no.5
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    • pp.573-581
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    • 2005
  • Breast cancer is the second leading cause of death in woman. Unfortunately, the frequency of breast cancer and mastectomy are increasing in Korea. This paper introduces the breast reconstruction by use of pectoralis major muscle transfer with breast implant for small size defect after skin sparing mastectomy for more satisfaction. We reviewed 24 consecutive patients who underwent breast reconstruction by pectoralis major muscle transfer with implant and only breast implant in Dong-A University from April 2002 to March 2004. The patient's age ranged between 29 and 54 years with mean of 42.3 years. We used pectorals major muscle transfer with breast implant in 12 patients and breast implant alone in 12 patients as control. The follow-up period of patients ranged from 10 months to 3 years with mean of 18.5 months. The points of comparison with control group reconstructed by breast implant alone were doctor and patient satisfaction score, operation time, duration of admission, amount of drainage, complication and satisfaction according to mass location. In conclusion, there is no difference with control group in the point of operation time, mount of drainage, duration of admission. And there is higher level of doctor's and patient's satisfaction in group reconstructed by pectoralis major muscle transfer with breast implant than implant only group. Especially, pectoralis major muscle transfer with breast implant was especially necessary for the defect in upper lateral quadrant of the breast to get more satisfaction. The advantage of pectoralis major muscle transfer with breast implant is prevention of the protruding and palpability of implant and aesthetically satisfactory result by intraoperative modification of breast shape.

Relationships of Perceived Health Status, Depression and Quality of Life of Breast Cancer Survivors (유방암 절제술을 받은 여성의 지각된 건강상태, 우울 및 삶의 질의 관계)

  • Chae, Young-Ran
    • 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.

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Spiritual Health and Fatigue of Patients with Breast Cancer according to Treatment Phases (유방암 환자의 치료단계에 따른 영적건강과 피로)

  • Tae, Young Sook;Choi, Gum Hee;Jung, Yun Kyung;Kwon, Suhye
    • Korean Journal of Adult Nursing
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    • v.24 no.6
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    • pp.659-667
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    • 2012
  • Purpose: The study was to identify the level of Spiritual Health and Fatigue in women with breast cancer according to three treatment phases (post op phase, adjuvant phase, follow up phase). Methods: The research method was a cross-sectional descriptive study. Data were collected from 161 women patients with a diagnosis of breast cancer. Both in-patient and out-patient units from two general hospitals were the source of subjects. The subjects completed two standardized instruments: the "Spiritual Health Scale" developed by Highfield and the "Fatigue Scale" developed and revised by Piper. The data were analyzed using frequency, percentage, ${\chi}^2$, ANOVA, Scheff$\acute{e}$ test, Pearson's correlation coefficients, and Multiple regression. Results: The subscale scores of Self-Esteem of spiritual health and fatigue in patients with breast cancer differed among the three treatment phases (F=3.14, p= .046; F=3.31, p= .039). Significant correlations were found between spiritual health and fatigue. The variables which explained 29% of the variance in fatigue in breast cancer patients were education, religious belief, economic status, and spiritual health. Conclusion: The study results demonstrated that spiritual health significantly explain fatigue. It is needed to develop nursing interventions to improve the spiritual health of breast cancer patients to manage fatigue according to treatment phases.

Un-met Supportive Care Needs of Iranian Breast Cancer Patients

  • Abdollahzadeh, Farahnaz;Moradi, Narges;Pakpour, Vahid;Rahmani, Azad;Zamanzadeh, Vahid;Mohammadpoorasl, Asghar;Howard, Fuchsia
    • Asian Pacific Journal of Cancer Prevention
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    • v.15 no.9
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    • pp.3933-3938
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    • 2014
  • Background: Assessment of supportive needs is the requirement to plan any supportive care program for cancer patients. There is no evidence about supportive care needs of Iranian breast cancer patients. So, the aims of present study were to investigate this question and s predictive factors. Materials and Methods: A descriptive-correlational study was conducted, followed by logistic regression analyses. The Supportive Care Needs Survey was completed by 136 breast cancer patients residing in Iran following their initial treatment. This assessed needs in five domains: psychological, health system and information, physical and daily living, patient care and support, and sexuality. Results: Patient perceived needs were highest in the health systems and information (71%), and physical and daily living (68%) domains. Logistic regression modeling revealed that younger participants have more un-met needs in all domains and those with more children reported fewer un-met needs in patient care and support domains. In addition, married women had more un-met supportive care needs related to sexuality. Conclusions: The high rate of un-met supportive care needs in all domains suggests that supportive care services are desperately required for breast cancer patients in Iran. Moreover, services that address informational needs and physical and daily living needs ought to be the priority, with particular attention paid to younger women. Further research is clearly needed to fully understand supportive care needs in this cultural context.

Identification of Germline BRCA1 Mutations among Breast Cancer Families in Northeastern Iran

  • Kooshyar, Mohammad Mahdi;Nassiri, Mohammadreza;Mahdavi, Morteza;Doosti, Mohammad;Parizadeh, Amirreza
    • Asian Pacific Journal of Cancer Prevention
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    • v.14 no.7
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    • pp.4339-4345
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    • 2013
  • Background: The purpose of this study was to evaluate the prevalence of BRCA1 (MIM: 113705) founder mutations in familial breast cancer (BC) patients with high risks in Iran. BRCA1 is among the cancer susceptibility genes best known for high penetrance mutations. BRCA1 genotyping is now used to determine patient counseling, management decisions, and prognosis of this syndrome. Materials and Method: Thirty nine patients with clinical BC and 29 high risk healthy women, related to the patients, participated in the study. DNA from blood samples was extracted and analyzed by PCR and SSCP methods in order to find 185delAG and 5382insC founder mutations. In addition, a 251bp fragment of BRCA1's exon 11 was amplified and analyzed for determination of new mutations. Results: The data indicated the presence of 185delAG and 5382insC founder mutations in both groups studied. Two out of 39 BC patients (5.1%) and one out of 29 relatives (3.4%) were suspected to be carriers of 185delAG mutations. However, we found only one patient (2.6%) to be a carrier of a 5382insC mutation. Also, 2 women (5.1%) of the patient group and 3 n (10.3%) of relatives group were identified as carriers of unclarified mutations in the 251bp fragment of the BRCA1 gene. The carriers of BRCA1 founder mutations have a high lifetime risk of breast cancer. Conclusions: Therefore, these data are useful in counseling of individuals with a significant family history of breast cancer.

Risk of Cancer with Combined Oral Contraceptive Use among Iranian Women

  • Vaisy, Afasaneh;Lotfinejad, Shirin;Zhian, Faegh
    • Asian Pacific Journal of Cancer Prevention
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    • v.15 no.14
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    • pp.5517-5522
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    • 2014
  • Oral contraceptive use is the most common type of contraception. More than 300 million women worldwide take oral contraceptives every day. However, there is a concern about the relationship with the incidence of cancer. This analytical retrospective study aimed to investigate the relationship between the incidence of cervical and breast cancers and oral contraceptive use in 128 Iranian patients with cervical cancer, 235 with breast cancer and equal numbers of controls. Data were collected through interviews with an organized set of questions. Details were also extracted from patient files. Data were analyzed using Student's t-test, chi-square and Fisher's exact tests, and Pearson's correlation analysis. The result revealed correlations between both cervical and breast cancers and history of contraceptive pills use. While cervical cancer significantly correlated with duration of use of pills, breast cancer had significant correlations with the type of oral contraceptive and age at first use. No significant relationships were found between the two types of cancer and age at discontinuation of oral contraceptives, patterns of use, and intervals from the last use. The use of oral contraceptives may triple the incidence of cervical cancer and doubles the incidence of breast cancer. Therefore, performing Pap smears every six months and breast cancer screening are warranted for long-term oral contraceptive users.

Young Women with Breast Cancer in the United States and South Korea: Comparison of Demographics, Pathology and Management

  • Son, Byung Ho;Dominici, Laura S;Aydogan, Fatih;Shulman, Lawrence N;Ahn, Sei Hyn;Cho, Ja Young;Coopey, Suzanne B;Kim, Sung Bae;Min, H Elise;Valero, Monica;Wang, Jiping;Caragacianu, Diana;Gong, Gyung-yub;Hevelone, Nathanael D;Baek, Seunghee;Golshan, Mehra
    • Asian Pacific Journal of Cancer Prevention
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    • v.16 no.6
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    • pp.2531-2535
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    • 2015
  • Background: Breast cancer diagnosed in young women may be more aggressive, with higher rates of local and distant recurrence compared to the disease in older women. Epidemiologic evidence suggests that Korean women have a lower incidence of breast cancer than women in the United States, but that they present at a younger age than their American counterparts. We sought to compare risk factors and management of young women with breast cancer in Boston, Massachusetts (US) with those in Seoul, South Korea (KR). Materials and Methods: A retrospective review was performed of consecutive patients less than 35 years old with a diagnosis of breast cancer at academic cancer centers in the US and KR from 2000-2005. Patient data were obtained by chart review. Demographic, tumor and treatment characteristics were compared utilizing Pearson's chisquare or Wilcoxon rank-sum tests where appropriate. All differences were assessed as significant at the 0.05 level. Results: 205 patients from the US and 309 from KR were analyzed. Patients in US were more likely to have hormone receptor positive breast cancer, while patients in KR had a higher rate of triple negative lesions. Patients in US had a higher mean body mass index and more often reported use of birth control pills, while those in the KR were less likely to have a sentinel node procedure performed or to receive post mastectomy radiation. Conclusions: Patients under 35 diagnosed with breast cancer in the US and KR differ with respect to demographics, tumor characteristics and management. Although rates of breast conservation and mastectomy were similar, US patients were more likely to receive post mastectomy radiation. The lower use of sentinel node biopsy is explained by the later adoption of the technique in KR. Further evaluation is necessary to evaluate recurrence rates and survival in the setting of differing disease subtypes in these patients.

Breast Cancer in Ardabil Province in the North-West of Iran: an Epidemiological Study

  • Fouladi, Nasrin;Pourfarzi, Farhad;Amani, Firooz;Ali-Mohammadi, Hossein;Lotfi, Ilshan;Mazaheri, Effat
    • Asian Pacific Journal of Cancer Prevention
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    • v.13 no.4
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    • pp.1543-1545
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    • 2012
  • Breast cancer accounts for about 26% of all newly diagnosed cancers in women aged 20 to 59 years. As part of a basic program for cancer control, the present cross sectional descriptive study was conducted with the objective of determining the epidemiology of breast cancer in Ardabil province during 2003-2010. Necessary information on 469 recorded cases of breast cancer in the registry were collected by check list from patient's files and then analyzed by statistical methods with SPSS.16 software. Some 455 of the patients (97%) were female, 329 (70.1%) residing in Ardabil. The mean age was $46.8{\pm}13.6$ and most were in the age group of 40 - 60. The most prevalent pathologic form was infiltrative ductal carcinoma with 316 cases (67.4%), the largest proportion being grade II (30.6%), but very many belonged to grades III and IV (40.5%). Breast cancer in Ardabil province appeared to slightly increase over the period studied. The results were similar to other places in Asia. With regard to this, more widespread studies are required to determine factors influencing the prevalence at low age and also how to promote early detection.

Improvement of Upper Extremity Lymphedema after Delayed Breast Reconstruction with an Extended Latissimus Dorsi Myocutaneous Flap

  • Lee, Kyeong-Tae;Lim, So-Young;Pyun, Jai-Kyung;Mun, Goo-Hyun;Oh, Kap-Sung;Bang, Sa-Ik
    • Archives of Plastic Surgery
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    • v.39 no.2
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    • pp.154-157
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    • 2012
  • Lymphedema is a common complication after mastectomy in breast cancer patients. Many treatment options are available, but no treatment results in a complete cure. We report a case of lymphedema that occurred after modified radical mastectomy in a breast cancer patient who showed objective improvement after delayed breast reconstruction with an latissimus dorsi myocutaneous flap. A 41-year-old female patient with left breast cancer had undergone modified radical mastectomy with axillary lymph node dissection and postoperative radiotherapy 12 years previously. Four years after surgery, lymphedema developed and increased in aggravation despite conservative treatment. Eight years after the first operation, the patient underwent delayed breast reconstruction using the extended latissimus dorsi myocutaneous flap method. After reconstruction, the patient's lymphedema symptoms showed dramatic improvement by subjective measures including tissue softness and feeling of lightness, and by objective measures of about 7 mL per a week, resulting in near normal ranges of volume. At a postoperative follow-up after 3 years, no recurrence was observed. Delayed breast reconstruction with extended latissimus dorsi myocutaneous flaps may be helpful to patients with lymphedema after mastectomy. This may be a good option for patients who are worried about the possibility of the occurrence or aggravation of secondary lymphedema.