• Journal of Breast Cancer
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• 제21권4호
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• pp.447-452
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• 2018

Purpose: The recent trend in breast cancer treatment is to minimize axillary dissection. However, no pattern of axillary metastasis has been precisely established. The purpose of this study was to evaluate the metastatic lymphatic pattern using near-infrared fluorescence imaging with indocyanine green (ICG) in breast cancer with cytologically proven axillary metastasis. Methods: This was a prospective single-center study. We evaluated 147 patients with breast cancer involving cytologically proven axillary metastasis, and compared physiological and nonphysiological lymphatic metastasis. Results: We performed lymphatic mapping for 64 patients who exhibited level II lymphatic flow on near-infrared fluorescence imaging with ICG, and found that all had axillary metastasis: 51 patients who did not receive neoadjuvant chemotherapy (NAC) and 13 patients post-NAC. Of patients who did not receive NAC, 32 had physiological lymphatic metastasis and 19 had nonphysiological lymphatic metastasis. The risk factors for nonphysiological lymphatic metastasis were age ${\geq}55$ years, high Ki-67 index (>20%), and perinodal extension in both univariate and multivariate analysis (p<0.05). Conclusion: Patients with identified risk factors in cytologically-proven axillary metastasis who did not receive NAC may have nonphysiological lymphatic metastasis.

• 대한영상의학회지
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• 제81권3호
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• pp.719-725
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• 2020

갑상선으로의 전이는 매우 드물며, 유방암의 갑상선으로의 전이 또한 드문 것으로 알려져 있다. 우리는 64세 유방암 환자에서 발생한 갑상선으로의 전이성 암 병변에 대한 초음파 소견과 중심부 바늘 생검의 진단적 역할에 중점을 두어 증례 보고를 하고자 한다. 초음파에서는 뚜렷한 종괴 형성은 보이지 않으면서 갑상선의 크기가 증가하였고, 저에코의 선 형태와 미세석회화가 관찰되었다. 이러한 미세석회화 부분을 조직검사의 표적으로 하여 중심부 바늘 생검을 시행하였고, 생검 결과 전이성 유방암으로 확인되었다. 최종적으로 갑상선 전절제술을 시행하여 림프선을 따라 전이한 침윤성 유관암으로 진단되었다. 저자들은 이러한 초음파 소견을 보일 경우 미세침흡인생검으로는 표적을 정하기 어려울 수 있으나, 중심부 바늘 생검을 이용하면 조직 자체를 얻어 수술 전 정확한 진단에 도움이 될 수 있다는 것을 경험하였기에 보고하고자 한다.

• 동의생리병리학회지
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• 제23권5호
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• pp.1041-1048
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• 2009

The development of skin metastasis is usually a morbid prognostic feature although they occur infrequently. Adenocarcinomas account for up to about 70% of all metastatic skin cancer. In general, adenocarcinomas are the most difficult metastatic tumor to accurately identify the primary site because they don't have distinctive histological features. For this reason, immunohistochemistry have been used to help identify the origin of metastatic adenocarcinomas. This study performed immunohistochemical staining with metastatic adenocarcinomas of the skin using a variety of antisera to find out characteristic immunohistochemical findings of them. This study was made upon the 29 cases of metastatic adenocarcinomas of the skin, which had been confirmed histopathologically in Chonbuk National University Hospital from January, 1986 to April, 2006, Paraffin blocks were colledted and homemade tissue arrays were made. We performed immunohistochemical staning using 12 antibodies (MUC1, 2, 5AC, 6, cytokeratin (CK) 7, 20, thyroid transcription factor-1 (TTF-1), estrogen receptor (ER), progesterone receptor (PR), beta-catenin, cox-2, claudin-1). The mean age at the time of diagnosis was 60.7 years and the male to female ratio was 1.2:1.0. The most common primary site was lung, followed by stomach and colorectum. MUC1 was expressed by most colorectal, breast and lung adenocarcinoma. MUC2 was expressed infrequently. MUCSAC was expressed by most gastric and colorectal cancer MUC6 was not specific of any primary site in this series. CK7+/CK20+immunophenotype was observed in gastric, lung, colorectal adenocarcinoma. CK7+/CK20- immunophenotype was observed in breast, lung, endometrial, uterine cervical, bile duct adenocarcinoma, while CK7-/CK20+ immunophenotype was observed only in colorectal adenocarcinoma. This results show the utility of TTF-1 to confirm the pulmonary origin. On the other hand ER and PR were not useful markers to assess the origin of primary tumor in this series.

• Journal of Chest Surgery
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• 제18권1호
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• pp.86-91
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• 1985

A clinical analysis was performed on 11 cases of metastatic lung cancer experienced at Department of Thoracic and Cardiovascular Surgery, Seoul National University Hospital during the 15 year period from 1970 to 1984. Of the 1lpatients of metastatic lung cancer, 4 patients were male and 7 patients were female and the age ranged from 27 years to 60 years old with the average of 38.8 years old. The sites of primary tumor were uterus and ovary in 5 patients, breast in 2, sarcoma in 2, rectum in 1 and testis in l.\ulcorner Tumor free intervals in each patients were as followed; unrecognition of primary site in 2 patients, simultaneous discovery of primary tumor and metastasis in 3, 14 months in 1, 4 years in 4 and 5 years in Twelve thoracotomies were performed in 11 patients and performed procedures were as followed; pneumonectomy in 1 patient, lobectomy in 7, wedge resection in 2, decortication and wedge resection in 1 and biopsy only in 1. Of the 11 patients, 4 patients died within one year after operation, 2 patients died within 2 years and 2 patients are alive over 5 years after operations. Other 3 patients are alive 2 months, 4 months and 9 months after operation at present.

• Asian Pacific Journal of Cancer Prevention
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• 제15권19호
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• pp.8271-8277
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• 2014

Aims: Apparent diffusion coefficient (ADC) values of nodes in diffusion-weighted imaging (DWI) are widely used in differentiating metastatic from non-metastatic lymph nodes. The purpose of this meta-analysis was to demonstrate whether DWI could contribute to the precise diagnosis of breast cancer (BC) with and without lymph node metastasis (LNM). Materials and Methods: English and Chinese electronic databases were searched for relevant studies followed by a comprehensive literature search. Two reviewers independently assessed the methodological quality of the included trials based on the quality assessment of diagnostic accuracy studies (QUADAS). Summary odds ratios (ORs) and corresponding 95% confidence intervals (95% CIs) were calculated. Results: Final analysis of 624 BC subjects (patients with LNM = 254, patients without LNM = 370) were incorporated into the current meta-analysis from 9 eligible cohort studies. Combined ORs of ADCs suggested that ADC values in BC patients without LNM were higher than in patients with LNM (OR=0.56, 95%CI: 0.11-1.01, p=0.015). Subgroup analysis stratified by country indicated a low ADC value in BC patients with LNM rather than those without LNM among Chinese (OR=1.27, 95%CI: 0.89-1.66, p<0.001), Italians (OR=0.75, 95%CI: 0.13-1.38, p=0.018), and Egyptians (OR=1.27, 95%CI: 0.71-1.84, p<0.001). The findings of subgroup analysis by MRI machine type revealed that ADC values from diffusion MRI may be potential diagnostic indicators for BC using Non-Philips 1.5T (OR=1.10, 95%CI: 0.84-1.36, p<0.001). Conclusions: The main findings of our meta-analysis demonstrated that increased signal intensity on DWI and decreased signals on ADC are helpful in diagnosis of BC patients with or without LNM. DWI could therefore be an important imaging investigation in patients suspected of BC.

• 동의생리병리학회지
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• 제20권6호
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• pp.1502-1506
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• 2006

To investigate the inhibitory effects of Citaowan (CTW) on the growth and angiogenesis of breast cancer in vivo. Orthotopic breast cancer model was established by injection of MDA-MB-231 cells into mammary fat pad of nude mice. Seven weeks after injection, CTW was orally administered at dose of 50, 100 mg/mouse every day for 40 days. Body weight, tumor volume, tumor apoptosis, microvessel density and tumor proliferation were evaluated, after the mice were sacrificed. The body weight and tumor volume were not significantly changed in CTW group compared with the control group. Tumor apoptosis, proliferation and microvessel density were significantly reduced in CTW group (100 mg/mouse) compared with the control group. These data indicate that CTW has anti-angiogenic and proapoptotic effects on breast cancer.

• 대한핵의학회지
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• 제30권3호
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• pp.332-337
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• 1996

기저막 성분인 type IV collagen을 분해하는 type IV collagenase의 농도와 종양의 전이사이에 상관관계가 있다는 동물 실험보고가 있다. 저자들은 유방암환자의 종양조직내 type IV collagenase의 농도와 골스캔상 골전이 소견과 비교하여 그 의의를 알아보고자 하였다. 원발성 및 전이성 유방암 환자의 종양조직에서 92kDa 및 72kDa type IV collagenase에 대한 면역조직화학염색을 각각 57명, 56명 환자에서 시행하여 각 효소 농도를 평가하고 골스캔상 골전이 소견을 관찰하고 등급을 부여하였다. 면역조직화학적으로 평가한 각 효소의 농도는 원발성 유방암과 전이성 유방암 환자 사이에 큰 차이가 있었으며, 골스캔 소견과 효소농도를 상호 비교한 결과 각 효소의 농도가 170이하일 경우에는 골스캔상 활동적인 골전이 소견을 볼 수 없었으나 효소의 농도가 200이상일 경우 골스캔 소견은 정상에서 골전이 소견까지 매우 다양하게 분포하였다. 결론적으로, 면역 조직화학적으로 측정한 92kDa 및 72kDa collagenase의 농도가 170이하일 때는 골스캔상 대부분 정상소견을 보여 골전이의 확률이 낮았다. 반면에 각 효소치의 농도가 200이상일 경우에는 골전이의 확진과 병소의 위치를 확인하고 추적검사를 위해서는 골스캔이 필요하다고 사료된다.

• Journal of Microbiology and Biotechnology
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• 제19권6호
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• pp.629-633
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• 2009

The present study investigated the antimetastatic property of chitosan oligosaccharides (COS) by evaluating motility, invasion, and the amount and activity of MMP-9 in MDA-MB-231 human breast carcinoma cells. Treatment of MDA-MB-231 cells with increasing concentrations of COS led to a concentration-dependent decrease in cell migration. COS significantly inhibited the invasion of MDA-MB-231 cells through a Matrigel-coated membrane. The treatment of MDA-MB-231 cells with COS reduced the amounts of secreted MMP-9. The activity and amount of MMP-9 protein in MDA-MB-231 cells were decreased by treatment with COS and occurred in a concentration-dependent manner. Our data indicated that COS can serve as a potential novel therapeutic candidate for the treatment of metastatic breast cancer.

• 대한두경부종양학회지
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• 제33권2호
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• pp.67-70
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• 2017

We present a metastatic carcinoma from the breast to the neck soft tissue around common carotid artery, with a rare finding of voice change. A 60 year-old female patient presented with voice change for 7 months. Neck ultrasound revealed a soft tissue mass between internal jugular vein and common carotid artery. Result of fine needle aspiration biopsy was a metastatic carcinoma. Computed tomography and magnetic resonance image revealed $2.5{\times}3.0cm$ sized irregular marginated soft tissue mass in right lower neck encasing common carotid artery and internal jugular vein. Surgical resection was performed and pathologic result with immunohistochemical analysis confirmed the diagnosis of a metastatic invasive ductal carcinoma originated from breast.

• Asian Pacific Journal of Cancer Prevention
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• 제17권3호
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• pp.1149-1155
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• 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.