• Nuclear Engineering and Technology
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• v.56 no.1
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• pp.241-246
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• 2024

The study was carried out by numerical integration based on the diffraction properties and elemental composition. The elemental compositions of breast tissues in the literature were tested. The photon attenuation coefficients calculated using the recent elemental composition were found within 0.2-16% for adipose tissue and within 0.04-17% for glandular tissue with the experimental reference data. The attenuation coefficients of cancerous breast tissue calculated according to the elemental content previously measured in breast cancer patients were found within 0-17% with experimental data in the literature. The attenuation coefficients are of great interest to medical research. To calculate realistic attenuation coefficients, the characteristic coherent scatter, which is most intense at small angles, must be considered. For this reason, experimentally measured form factor data were reviewed, and the most compatible one with the theoretical form factor data produced in this study was used at low momentum transfer x (0 < x ≤ 8 nm^-1). The differential linear coherent scattering distributions were calculated for an energy value of 17.44 keV and compared with their experimental counterparts.

• Asian Pacific Journal of Cancer Prevention
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• v.13 no.4
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• pp.1675-1682
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• 2012

Aim: The study aim was to determine the frequency with which women decline clinicians' treatment recommendations and variations in this frequency by age, cancer and service descriptors. Design: The study included 36,775 women diagnosed with early invasive breast cancer in 1998-2005 and attending Australian and New Zealand breast surgeons. Rate ratios for declining treatment were examined by descriptor, using bilateral and multiple logistic regression analyses. Proportional hazards regression was used in exploratory analyses of associations with breast cancer death. Results: 3.4% of women declined a recommended treatment of some type, ranging from 2.6% for women under 40 years to 5.8% for those aged 80 years or more, and with parallel increases by age presenting for declining radiotherapy (p<0.001) and axillary surgery (p=0.006). Multiple regression confirmed that common predictors of declining various treatments included low surgeon case load, treatment outside major city centres, and older age. Histological features suggesting a favourable prognosis were often predictive of declining various treatments, although reverse findings also applied with women with positive nodal status being more likely to decline a mastectomy and those with larger tumours more likely to decline chemotherapy. While survival analyses lacked statistical power due to small numbers, higher risks of breast cancer death were suggested, after adjusting for age and conventional clinical risk factors, (1) for women not receiving breast surgery for unstated reasons (RR=2.29; p<0.001); and (2) although not approaching statistical significance $p{\geq}0.200$), for women declining radiotherapy (RR=1.22), a systemic therapy (RR1.11), and more specifically, chemotherapy (RR=1.41). Conclusions: Women have the right to choose their treatments but reasons for declining recommendations require further study to ensure that choices are well informed and clinical outcomes are optimized.

• Asian Pacific Journal of Cancer Prevention
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• v.17 no.7
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• pp.3325-3328
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• 2016

Background: There are limited studies on oncoplastic breast conserving surgery in Asian women. We aimed to determine the applicability and safety of oncoplastic surgery, highlighting the specific circumstances when it will be most useful and compare our preferred technique with the worldwide practice of oncoplastic approaches. Materials and Methods: Breast cancer patients who underwent oncoplastic breast conserving surgery at a single institution from 1st May 2014-31st March 2015 were included. Data on patient demographics, tumor characteristics and the type of oncoplastic surgery performed were collected. Results: Nineteen breast cancer patients were identified. 42.1% of patients had grade I ptosis. The indications for surgery included a large tumor to breast size ratio (52.6%), multifocal/multicentric lesions (36.8%) and asymmetric breasts (10.6%), averting a mastectomy in 89.4%. Round block was the commonest technique in 63% of patients, in contrast to the inverted T pattern most frequently used in renowned institutions in the West. Mean and median tumor size and weight of specimen were 29.4/25mm (11 - 75mm) and 77g/64g (10 - 246g) respectively. Re-excision rate was 10.5%. Complete mastectomy was performed for one patient. One patient developed wound dehiscence which was treated conservatively. Cosmetic outcome was rated as excellent/good by 94.7% of patients. The patients remained clinically well after a median 16 months follow up. Conclusions: Oncoplastic breast conserving surgery is useful in a specific subgroup of Asian patients with a relatively small breast volume and minimal ptosis. Round block was the commonest technique in our series, in contrast to the worldwide utility of oncoplastic techniques. It is oncologically safe and has good cosmetic outcomes.

• Journal of the Korean Society of Radiology
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• v.82 no.3
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• pp.737-742
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• 2021

Primary neuroendocrine carcinomas of the breast are a rare, distinct category of breast carcinomas that require immunohistochemical staining for diagnosis. Currently, there is not enough evidence on the clinical pattern, prognosis, and proper management of the disease. Only few case series have described the imaging findings of neuroendocrine carcinomas of the breast. We herein present a case of a primary neuroendocrine carcinoma of the breast (small cell) presenting as a locally aggressive tumor with metastatic disease, and describe the radiologic findings.

• Asian Pacific Journal of Cancer Prevention
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• v.13 no.11
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• pp.5829-5834
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• 2012

Background: Breast cancer is the most common cancer in women worldwide. Although different metabolic factors have been implicated in breast cancer development, the relationship between hypertension and breast cancer has not been elucidated. Aim: To evaluate hypertension as a risk factor for breast cancer in Chilean women of low and middle socio-economic status. Methods: We conducted an age-matched (1:1) case-control study in 3 hospitals in Santiago, Chile. Breast cancer cases (n=170) were histopathologically confirmed. Controls had been classified as Breast Imaging Reporting and Data System I (negative) or II (benign findings) within 6 months of recruitment. Blood pressure was measured using a mercury sphygmomanometer and standardized procedures. We used 2 hypertension cut-off points: blood pressures of ${\geq}140/90$ mmHg and ${\geq}130/85$ mmHg. Fasting insulin and glucose levels were assessed, and anthropometric, sociodemographic, and behavioral information were collected. Odds ratios and 95% confidence intervals were estimated for the entire sample and restricted to postmenopausal women using multivariable conditional logistic regression models. Results: Hypertension (${\geq}140/90$ mmHg) was significantly higher in cases (37.1%) than controls (17.1%) for the entire sample and in postmenopausal pairs (44.0% compared to 23.8%). In crude and adjusted models, hypertensive women had a 4-fold increased risk of breast cancer (adjusted odds ratio: 4.2; 95% confidence interval: 1.8; 9.6) compared to non-hypertensive women in the entire sample. We found a similar association in the postmenopausal group (adjusted odds ratio: 2.8; 95% confidence interval: 1.1; 7.4). A significant effect was also observed when hypertension was defined as blood pressure of ${\geq}130/85$ mmHg. Conclusion: A significant association was found between hypertension and breast cancer over the entire sample and when restricted to postmenopausal women. Hypertension is highly prevalent in Latin America and may be a modifiable risk factor for breast cancer; therefore, a small association between hypertension and breast cancer may have broad implications.

• 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.34 no.1
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• pp.93-98
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• 2007

Purpose: Many options are available for the incision and pocket selection in breast augmentation. Each method has its advantages and disadvantages. To leave an invisible operation scar and to achieve easier pocket dissection by the central location of the incision on the breast, we made a transareolar-perinipple incision. To overcome the disadvantages of the transareolar incision, originally advocated by Pitanguy in 1973, we modified the direction of incision line and dissection plane. Methods: To avoid the injury of 4th intercostal nerve responsible for nipple sensation, we made perinipple incision on the medial side of the nipple instead of trans-nipple incision and made the transareolar incision as 11-5 o'clock on the left side and 1-7 o'clock on the right side instead of 3-9 o'clock on both sides. To avoid the possible infection and breast feeding problem caused by the injury to the lactiferous duct, and the possible implant hernia caused by the incisions lying on a same plane of pocket dissection, we made a subcutaneous dissection just above the breast tissue medially down to the bottom of breast tissue and made a subglandular or subfascial pocket, which may avoid the injury of lactiferous duct and create different planes for skin incision and pocket dissection. Other advantages of the transareolar-perinipple incision include easier pocket dissection, less chance of hematoma, and as a result less postoperative pain because of the central location of the approach which allow finger dissection and meticulous bleeding control with direct vision, without any specialized instrument such as an endoscope or long mammary dissectors. As for pocket selection, we made dual pockets. We prefer subglandular or subfascial pocket. Also, we made a subpectoral pocket in the upper 1/4 of the pocket to add more volume on the upper part of the augmented breast, which can make aesthetically more desirable breasts in thin Asian women with small breasts. Possible disadvantages of our method are subclinical infection and scar widening, which could be overcome by meticulous operation techniques, antibiotic therapy, and intradermal tattooing. Results: From September, 2003 to August, 2005, 12 patients underwent breast augmentation using round smooth surface saline implants by our method. During the mean follow-up period of 13 months, there were no complications such as infection, hematoma, capsular contracture, and sensory change of nipple, and results were satisfactory. Conclusion: We suggest breast augmentation via transareolar-perinipple incision and dual pockets(subpectoral-subglandular or subfascial) as a valuable method in thin oriental women with small breasts.

• Asian Pacific Journal of Cancer Prevention
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• v.16 no.17
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• pp.7809-7812
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• 2015

Background: In non-small cell lung cancer (NSCLC) patients with preoperative high serum carcinoembryonic antigen (CEA) level, patients with a persistently high serum CEA level after surgery have been reported to have a poor prognosis. In addition, in other cancers, the post/preoperative serum CEA ratio has been reported as a useful parameter. Materials and Methods: We enrolled 123 NSCLC patients with preoperative high CEA levels (${\geq}5ng/mL$) who underwent curative surgery between 2004 and 2011. Prognostic significance of postoperative serum CEA level and the CEA ratio was examined. Results: The 5-year survival of patients with persistently high serum CEA level after surgery was poor. On the other hand, patients with normal postoperative serum CEA levels had significant favorable prognosis. The patients with CEA ratio>1 had poor prognosis, however the number was only 7 (5.7%). The 5-year survival rates of patients with other subgroup based on the CEA ratio ($0.5{\geq}CEA$ ratio and $0.5{\leq}CEA$ $ratio{\leq}1$) was similar. Multivariate analysis revealed prognostic significance for the postoperative serum CEA level but not the CEA ratio. Conclusions: For NSCLC patients with preoperative high serum CEA level, their postoperative serum CEA levels is a more significant prognostic factor than the post/preoperative serum CEA ratio.

• Journal of Haehwa Medicine
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• v.10 no.1
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• pp.67-78
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• 2001

From the study of acupuncture and external diseases on mammary diseases, the following conclusions are obtained. 1. Point Shanzhong, Shaoze and Rugen are often used for galactostasis in acupuncture. 2. Often used vessels for galactostasis in acupuncture are Stomach Meridian, Conception Vessel, Small Intestine Meridian, Bladder Meridian, Liver Meridian and Large Intestine Meridian in order. 3. The direct stimulations are used in external treatment for galactostasis, often accompanied by internal medical treatment, to promote the circulation of Qi and Blood. 4. Point Zuimup, Guangming of Gall bladder Meridian and Zusanli of Stomach Meridian is used for lactation pain in acupuncture. 5. Point Jianjing, Zusanli and Shanzhong are most often used for acuremastitis and breast cancer in acupuncture. 6. Often used vessels for acuremastitis and breast cancer in acupuncture are Stomach Meridian, Gall bladder Meridian, Conception Vessel, Small Intestine Meridian, Bladder Meridian, Pericardium Meridian in order. 7. The external treatment used for acuremastitis and breast cancer can be classed into its pathological period. When lactation is interrupted, Kumhwang Powder, Okro Powder, Robongbang, Allii Radix, Pinelliae Rhizoma, garlic moxibustion and Arusaenatus Rgizoma powder are used. When pus is piled up, Chunghwa Extracts, Dioscoreae Rhizoma, Leonuri Herba, Typa Latifolia, Taraxacum platycarpum, Phaseolus angularis, Manchong, Crvi Cornus latex, and Aucklandiae Radix are used. When pus flows down, Salviae Miltiorrhizae Radix Extract, nine-one pellet, Yongboo extract, eight-dampness extract, Tissue-regeneration Powder, Toad-net treatment, Kitten-hair, Hongseung pellet are used. 8. Stomach Meridian, Conception Vessel, Small Intestine Meridian, Gall Bladder Meridian, Bladder Meridian are most often used vessels for mammary diseases. From the conclusions above, It appears that the medical effect could be maximized by further studying and developing of the acupuncture and external treatment for mammary diseases according to the its nature, while accompanying internal medicine appropriately at the same time.

• Archives of Plastic Surgery
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• v.46 no.5
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• pp.433-440
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• 2019

Background Mastectomy in male transgender patients is an important (and often the first) step toward physical manhood. At our department, mastectomies in transgender patients have been performed for several decades. Methods Recorded data were collected and analyzed for all male transgender patients undergoing mastectomy over a period of 24 years at our department. Results In total, 268 gender-reassigning mastectomies were performed. Several different mastectomy techniques (areolar incision, n=172; sub-mammary incision, n=96) were used according to patients' habitus and breast features. Corresponding to algorithms presented in the current literature, certain breast qualities were matched with a particular mastectomy technique. Overall, small breasts with marginal ptosis and good skin elasticity allowed small areolar incisions as a method of access for glandular removal. In contrast, large breasts and those with heavy ptosis or poor skin elasticity often required larger incisions for breast amputation. The secondary correction rate (38%) was high for gender reassignment mastectomy, as is also reflected by data in the current literature. Secondary correction frequently involved revision of chest wall recontouring, suggesting inadequate removal of the mammary tissue, as well as scar revision, which may reflect intense traction during wound healing (36%). Secondary corrections were performed more often after using small areolar incision techniques (48%) than after using large sub-mammary incisions (21%). Conclusions Choosing the suitable mastectomy technique for each patient requires careful individual evaluation of breast features such as size, degree of ptosis, and skin elasticity in order to maximize patient satisfaction and minimize secondary revisions.