• 대한영상의학회지
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• 제79권5호
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• pp.259-263
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• 2018

52세 남자 환자가 우측 유방의 바깥부위에서 무통의 단단한 종괴를 호소하였다. 흉부 CT에서 3.3 cm 크기의 원형의 미세소엽상 경계의 조영증강되는 종괴가 확인되었고, 초음파에서는 미세소엽상 경계를 보이는 저에코성 종괴로, 종괴의 내부에는 석회화와 혈류가 보였다. 중심부바늘생검에서 종괴는 양성 과립세포종양(granular cell tumor; 이하 GCT)으로 확진되었다. 환자는 타병원으로 전원되어 병변의 수술적 제거를 시행하였다. 과립세포종양은 슈반세포(schwann cell)에 유래하는 종양으로, 유방에서는 드물고 대부분은 양성이다. 과립세포종양의 임상적 및 방사선학적 특징은 악성 종양과 유사한 소견을 보여 감별이 어려운 경우가 있으며, CT 영상은 거의 보고된 바가 없다. 본 증례를 통해 임상의와 방사선 전문의가 드물지만 양성종양인 GCT의 영상의학적 특징을 알고, 이를 악성종양과 감별하여 과도한 치료를 피해야 할것이다.

• 대한임상검사과학회지
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• 제56권1호
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• pp.73-84
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• 2024

펄스 전자기장(pulsed electromagnetic field, PEMF)은 여러 항암제의 항암 효과를 향상시키는 것으로 알려져 있고 독소루비신(doxorubicin, DOX)은 유방암을 포함한 다양한 종류의 악성 종양을 치료하는 데 사용되는 항암제이다. 본 연구는 PEMF가 MCF-7 유방암 세포에 대한 DOX의 항암 효과 증진 여부를 조사하고 관련기전을 규명하기 위해 진행되었다. 본 연구팀은 DOX와 PEMF를 동시에 처리하면 DOX 단독 처리에 비해 MCF-7 유방암 세포의 생존율 감소가 더 커지는 것을 확인하였다. PEMF는 cyclin-dependent kinase 2의 인산화와 p53, p21, 사이클린 E2 및 polo like kinase 1의 단백질 발현에 영향을 주어 DOX 처리에 의한 G1 세포주기 정지를 더욱 증가시켰다. 또한, PEMF는 DOX 처리에 의한 Fas와 Bcl-2-associated X의 증가, myeloid leukemia 1과 survivin의 감소, 카스파제(caspase)-8/9/7의 활성 및 poly (adenosine diphosphate-ribose) polymerase 절단을 더욱 증가시켰다. 이러한 연구결과를 바탕으로, 본 연구팀은 PEMF는 DOX 처리에 의한 G1 세포주기 정지와 카스파제 의존적 세포자멸사를 더욱 증가시켜 DOX 처리에 의한 MCF-7 세포의 생존율 감소를 더욱 증진시킴을 확인할 수 있었다.

• Asian Pacific Journal of Cancer Prevention
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• 제16권4호
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• pp.1455-1461
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• 2015

Background: Young onset breast cancer (BC) has a worse outcome as compared to in the elderly. However, some studies have shown that BC in the elderly, despite indolent features, does also cause increase in mortality. In an attempt to compare clinic-pathological characteristics, BC subtypes and survival in patients with BC presenting at extremes of age, we performed a retrospective study. Materials and Methods: Patients were either ${\leq}40$ or ${\geq}70$ years old. Subtypes were defined using immunohistochemistry and histological grade. Chi-Square test was used for evaluation of categorical variables, and Kaplan-meier and log-rank for disease-specific survival (DSS) and disease free survival (DFS). Results: We analyzed 256 patients ${\leq}40$ and 366 patients ${\geq}70$. Younger patients presented with more aggressive disease, with less luminal A but more luminal B and triple negative (TN) subtype. With a median follow-up of 57.5 months, DFS at 5 years in younger patients was 72.3% vs 84.6% in the elderly (p=0.007). Luminal A and B disease presented with worse DFS in younger patients. The opposite was seen in the TN subgroup. Although we found no significant differences in DSS, older patients with TN tumors died of BC more frequently. This group also received less chemotherapy. Conclusions: Young patients present with more aggressive disease, this translating into worse DFS. However, elderly patients with TN disease represent a particular subpopulation with worse DFS and DSS, suggesting that chemotherapy should not be withheld only because of age.

• 대한골대사학회지
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• 제25권4호
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• pp.251-266
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• 2018

Background: The causal networks among genes that are commonly expressed in osteoblasts and during bone metastasis (BM) of breast cancer (BC) are not well understood. Here, we developed a machine learning method to obtain a plausible causal network of genes that are commonly expressed during BM and in osteoblasts in BC. Methods: We selected BC genes that are commonly expressed during BM and in osteoblasts from the Gene Expression Omnibus database. Bayesian Network Inference with Java Objects (Banjo) was used to obtain the Bayesian network. Genes registered as BC related genes were included as candidate genes in the implementation of Banjo. Next, we obtained the Bayesian structure and assessed the prediction rate for BM, conditional independence among nodes, and causality among nodes. Furthermore, we reported the maximum relative risks (RRs) of combined gene expression of the genes in the model. Results: We mechanistically identified 33 significantly related and plausibly involved genes in the development of BC BM. Further model evaluations showed that 16 genes were enough for a model to be statistically significant in terms of maximum likelihood of the causal Bayesian networks (CBNs) and for correct prediction of BM of BC. Maximum RRs of combined gene expression patterns showed that the expression levels of UBIAD1, HEBP1, BTNL8, TSPO, PSAT1, and ZFP36L2 significantly affected development of BM from BC. Conclusions: The CBN structure can be used as a reasonable inference network for accurately predicting BM in BC.

• 한국간담췌외과학회지
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• 제27권4호
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• pp.415-422
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• 2023

Backgrounds/Aims: Although cancer survivors are at higher risk of developing second primary malignancies, cancer surveillance strategies for them have not yet been established. This study aimed to identify first primary cancers that had high risks of developing second primary exocrine pancreatic cancer (EPC). Methods: Data on individuals diagnosed with primary cancers between 1993 and 2017 were obtained from the Korea Central Cancer Registry. The standardized incidence ratios (SIRs) of second primary EPCs were analyzed according to the primary tumor sites and follow-up periods. Results: Among the 3,205,840 eligible individuals, 4,836 (0.15%) had second primary EPCs, which accounted for 5.8% of the total EPC patients in Korea. Between 1 and 5 years after the diagnosis of first primary cancers, SIRs of second primary EPCs were increased in patients whose first primary cancers were in the bile duct (males 2.99; females 5.03) in both sexes, and in the small intestine (3.43), gallbladder (3.21), and breast (1.26) in females. Among those who survived 5 or more years after the diagnosis of first primary cancers, SIRs of second primary EPCs were elevated in patients whose first primary cancers were in the bile duct (males 2.61; females 2.33), gallbladder (males 2.29; females 2.22), and kidney (males 1.39; females 1.73) in both sexes, and ovary (1.66) and breast (1.38) in females. Conclusions: Survivors of first primary bile duct, gallbladder, kidney, ovary, and female breast cancer should be closely monitored for the occurrence of second primary EPCs, even after 5 years of follow-up.

• 대한한방부인과학회지
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• 제33권2호
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• pp.77-89
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• 2020

Objectives: The purpose of this study is to analyse current status and treatment of the Korean medicine hospital after chemotherapy in patients with breast cancer. Methods: We investigated the medical records of 21 patients who admitted to Korean medicine hospital after chemotherapy in patients with breast cacner from March 1, 2017 to December 31, 2019. We searched medical records retrospectively and analyzed current status and treatment of Korean medicine hospital. Results: The average age of 21 participants was 52.81±8.38 years and 40s and 50s accounted for 85.6% of the total. After receiving chemotherapy, the average time to hospitalization was 1.87±3.13days and average hospital stay was 9.78±4.14 days. The subjects were classified as 28.6% of stage I, 52.4% of stage II, 9.5% of stage III, and 9.5% of stage IV. The analysis according to the presence of metastasis was 57.1% without metastasis, 33.3% with axillary lymph node metastasis, and 9.5% with distant metastasis. The main symptoms complained when hospitalized by 21 subjects were nausea (54.2%), fatigue (54.2%), and anorexia (50.8%) in over 50%, pantalgia (47.5%), and insomnia (47.5%), dizziness (44.1%), cold sweating (42.4%), lower extremity pain (40.7%), 37.5~37.9℃ fever (39.0%), headache (37.3%), hot flush (37.3%), pruritus (30.5%) are 30% or more. Korean medicine treatment was performed in 87.4% of all hospitalizations and Gwakhyangjunggi-san-gami was the most administered prescription. Extracts of Korean medicine was performed in 100.0% of all patients and Eunkyo-san was most administered extracts medicine. Acupuncture, moxibustion, and cupping treatments were performed in all 21 study subjects. Other treatments was performed at a frequency of hyperthermia (90.5%), lymph massage (23.8%), air compression therapy (23.8%), and Interference current therapy (19.0%) Conclusion: Korean traditional medicine can be used as a countermeasure for side effects after chemotherapy in breast cancer patients.

• Investigative Magnetic Resonance Imaging
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• 제12권2호
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• pp.161-169
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• 2008

목적 : 유방 절제 생검 후 유방암이 진단된 환자에서 잔류종양과 추가 병변을 진단하는데 있어 자기공명영상의 유용성을 알아보고자 하였다. 대상 및 방법 : 2005년 3월부터 2007년 8월까지 유방 절제 생검으로 유방암이 진단되고 수술 전 자기공명영상을 시행한 16명의 환자를 대상으로 하였다. 생검 후 생긴 공동 주위로 두껍고 불규칙한 조영증강 테두리를 보이거나 공동에 연하여 조영증강되는 종괴가 있는 경우를 잔류종양이 있다고 보았다. 또한 공동과 분리된 다초점성, 다발성, 혹은 반대측 유방 병변 등의 추가 병변을 확인하였다. 수술 후 조직학적 소견을 비교하여 자기공명영상의 정확성을 평가하였고 자기 공명영상소견에 따라 향후 치료에 변화가 있었는지를 알아보았다. 결과 : 공동주위 조영증강 소견으로 잔류종양을 평가하는 자기공명영상의 민감도와 특이도는 각각 85.7%(6/7)와 55.6%(5/9)이었다. 자기공명영상으로 6명의 환자에서 다초점성(multifocal), 다발성(multicentric), 혹은 반대측 유방에 추가 병변을 발견하였다. 자기공명 영상의 결과에 따라 7명의 환자에서 치료 범위가 변화되었다. 결론 : 절제 생검 후 자기공명영상에서 보인 소견 중 공동주위 조영증강 소견만으로 잔류종양 유무를 감별하기 어렵다. 그러나 유방 자기공명영상은 다초점성 및 다발성 혹은 반대측 병변을 포함한 추가병변을 발견하는 데 도움을 주어 수술적 치료에도 유용한 정보를 제공한다.

• Asian Pacific Journal of Cancer Prevention
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• 제16권3호
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• pp.1041-1045
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• 2015

Background: Paget's disease (PD) is a rare form of intraepithelial adenocarcinoma that involves breast and extramammarian tissues. It is often associated with ductal carcinoma in situ and/or invasive ductal cancer. Molecular pathways that play a role in development of Paget's disease are stil unclear. Expression patterns of Cox-2 and bcl-2 were therefore assessed. Materials and Methods: Patients with a histopathological diagnosis of Paget's disease were included in this study. Patient files were analysed retrospectively. Results: Invasive cancer was diagnosed in 35 (76.1%) of the patients, 7 (15.2%) had ductal carcinoma in situ and 4 (8.7%) patients had no associated neoplasm. Twenty four (52.2%) patients showed COX-2 expression in Paget cells whereas no expression was seen in 22 (47.8%) patients. No relation was found between COX-2 expression and the lesion underlying Paget's disease (p=0.518). Bcl-2 expression in Paget cells was found positive in 12 (26.1%) and negative in 27 (58,7%) cases. There was no relation between Bcl-2 expression and the lesion accompanying Paget's disease (p=0.412). No relation was observed between COX-2 expression and Bcl-2 expression (p=0.389). Conclusions: In breast cancer, COX-2 expression is associated with poor prognostic factors. As COX-2 expression increases the tendency to metastasize also increases. In our study we found a significantly high COX-2 expression in Paget's disease of the breast. We suggest that COX-2 expression and inflammatory processes may play a role in pathogenesis of the Paget's disease of the breast.

• Asian Pacific Journal of Cancer Prevention
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• 제16권3호
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• pp.903-907
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• 2015

Background: Among human epidermal growth factor receptor 2 (HER2)-positive breast cancer, more than half are also hormone receptor (HR)-positive. Although HR is a predictive factor for the efficacy of hormone therapy, there are still some uncertainties in regard to the effects on patients with HR-positive and HER2-positive metastatic breast cancers due to the potential resistance to hormone therapy caused by co-expression of HR and HER2. There are no clinical trials directly comparing the efficacy of hormonal therapy with chemotherapy. Materials and Methods: To examine the real-world effect of hormone therapy on patients with HR-positive and HER2-positive metastatic breast cancers, a cross-sectional study of a representative sample of the Chinese population was conducted. The study included 113 patients who received first-line and second-line palliative treatment between 2005 and 2010 in the Cancer Institute and Hospital, Chinese Academy of Medical Science. The effect of hormone therapy on overall survival (OS) was studied. Results: The patients who received hormone therapy (n=51) had better overall survival in contrast to those who received chemotherapy with anti-HER2 therapy (n=62) in first- or second-line treatment. The difference was of borderline statistical significance (51.8m vs 31.9m, p=0.065). In addition, the effect of hormone therapy did not differ significantly with other prognostic factors, including age (${\leq}50$ years or >50 years), disease free survival (${\geq}2$ years or < 2 years) and site of metastasis (visceral or bone/soft tissue). On multivariate analysis, administration of hormone therapy was associated with a trend toward a favorable prognosis (p=0.148, HR=0.693, 95%CI 0.422-1.139). Age more than 50 years was the sole independent harmful prognostic factor (p<0.001, HR=2.797, 95%CI 1.676-4.668). Conclusions: Our data suggest that hormonel therapy may improve outcomes of the patients with ER-positive and HER2-positive metastatic breast cancer.

• 대한영상의학회지
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• 제81권1호
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• pp.157-165
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• 2020

목적 S-Shearwave를 이용하여 유방 병변을 감별하는데 있어 최적의 cut-off 값과 종괴 내 위치를 알아보고 진단적 가치를 평가하고자 한다. 대상과 방법 연구 기간 동안 197명의 여성에서 225개의 유방 병변을 평가하였다. S-Shearwave 값은 초음파 기기에서 자동적으로 생성된 사각형의 region-of-interest로 측정하였다. 병변 내 서로 다른 네 군데에서 각각 세 번 측정하였으며 세 개의 중위 값 중 최대 값을 이용해 각각의 위치에서 최적의 cut-off 값을 계산하였다. 진단적 가치는 area under the receiving operator characteristics curve (이하 AUC)를 통해 평가하였다. 결과 총 225개의 유방 병변 중 156개(69.3%)는 양성, 69개(30.7%)는 악성이었다. 평균 SShearwave 값은 악성 병변이 양성 병변에 비해 유의미하게 높았다(108.0 ± 70.0 kPa vs. 43.4 ± 38.3 kPa, p < 0.001). 하지만 병변 내 위치에 따른 값의 유의미한 차이는 없었다. Cut-off 값을 41.9 kPa로 사용했을 때, 민감도 85.7%, 특이도 63.9%, 정확도 70.7%, 양성예측도 51.7% 및 음성예측도 90.8%였다. 초음파와 S-Shearwave 간의 AUC는 유의미한 차이를 보이지 않았다(p = 0.179). 결론 S-Shearwave는 유방 병변의 감별진단을 하는데 grayscale 초음파에 필적하는 진단적 가치를 가진다.