Tumor localization in patients receiving neoadjuvant chemotherapy (NACT) is challenging because substantial therapeutic remission of the original tumor after NACT is often noted.Currently, there is no guidance device that allows for an accurate estimation of the resection range in breast-conserving surgery after NACT. To increase the accuracy of tumor resection, we used a 3-dimensional-printed breast surgical guide based on magnetic resonance imaging (MRI) in the supine position for a breast cancer patient who underwent breast-conserving surgery after NACT. Using this device, the breast tumor with apparent therapeutic changes after NACT on imaging was successfully removed with clear resection margins by identifying the original tumor site in the affected breast. Irrespective of whether the residual tumor area after NACT is well defined, it is possible to confirm and target the tumor area on pre-NACT MRI using this device.

Tumor localization in patients receiving neoadjuvant chemotherapy (NACT) is challenging because substantial therapeutic remission of the original tumor after NACT is often noted.Currently, there is no guidance device that allows for an accurate estimation of the resection range in breast-conserving surgery after NACT. To increase the accuracy of tumor resection, we used a 3-dimensional-printed breast surgical guide based on magnetic resonance imaging (MRI) in the supine position for a breast cancer patient who underwent breast-conserving surgery after NACT. Using this device, the breast tumor with apparent therapeutic changes after NACT on imaging was successfully removed with clear resection margins by identifying the original tumor site in the affected breast. Irrespective of whether the residual tumor area after NACT is well defined, it is possible to confirm and target the tumor area on pre-NACT MRI using this device.

Objective: Self perceived health status dose not only reflects an individual's perception of their overall well-being but is also known to be influenced by various aspects of life. Rural areas tend to have relatively lower quality of life compared to urban areas. Therefore, this study aims to investigate factors related to Self perceived health status among farmers. Methods: In the subjective health status questionnaire, responses of "very healthy" and "healthy" are classified as ‘good’, whereas "average", "unhealthy" or "very unhealthy" are classified as indicative of a 'poor' subjective health status. Logistic regression analysis was conducted to calculate odds ratios(OR), aiming to investigate factors related to self perceived health status. Results: The OR for self perceived health status as poor was statistically significant for females at 2.32(95% CI 1.47-3.67), for individuals working in greenhouses at 1.43(95% CI 1.01-1.98), for current smoker at 1.50(95% CI 1.02-2.08), and for those who experienced symptoms after pesticide exposure at 1.74(95% CI 1.13-2.67). An annual income of 50 million won or more had a statistically significant OR of 0.51(95% CI 0.28-0.91), education level of high school and above had an OR of 0.45(95% CI 0.32-0.63), and engaging in physical exercise had an OR of 0.61(95% CI 0.42-0.89). Conclusions The factors related to self perceived health status were identified as sex, smoking, cultivation type, presence of symptoms after pesticide exposure, annual income, education level, and exercise status. The significance of this study lies in providing foundational data for the development of health management programs for farmers.

Tumor localization is challenging in the context of ductal carcinoma in situ (DCIS) treated with breast-conserving surgery. Conventional localization methods are generally performed under the guidance of ultrasonography or mammography and are rarely performed with magnetic resonance imaging (MRI), which is more sensitive than the aforementioned modalities in detecting DCIS. Here, we report the application of MRI-based individualized 3-dimensional (3D)-printed breast surgical guides (BSGs) for patients with breast cancer.We successfully resected indeterminate and suspicious lesions that were only detected using preoperative MRI, and the final histopathologic results confirmed DCIS with clear resection margins. MRI guidance combined with 3D-printed BSGs can be used for DCIS localization, especially for lesions easily detectable using MRI only.

Tumor localization is challenging in the context of ductal carcinoma in situ (DCIS) treated with breast-conserving surgery. Conventional localization methods are generally performed under the guidance of ultrasonography or mammography and are rarely performed with magnetic resonance imaging (MRI), which is more sensitive than the aforementioned modalities in detecting DCIS. Here, we report the application of MRI-based individualized 3-dimensional (3D)-printed breast surgical guides (BSGs) for patients with breast cancer.We successfully resected indeterminate and suspicious lesions that were only detected using preoperative MRI, and the final histopathologic results confirmed DCIS with clear resection margins. MRI guidance combined with 3D-printed BSGs can be used for DCIS localization, especially for lesions easily detectable using MRI only.

Bilateral axillary Paget's disease in men is a rare occurrence with limited reports on its diagnosis, treatment, and prognosis. Here, we report the case of a 55-year-old Korean male, who presented with a palpable mass and eczematous skin lesion on the left axilla. An incisional biopsy and histopathologic examination indicated invasive ductal carcinoma with Paget's disease arising in the accessory breast. Magnetic resonance imaging and positron emission tomography revealed no malignancy in the normal breast and other organs. The patient was subjected to a wide excision, wherein the left axillary lymph node was dissected, followed by the administration of adjuvant chemotherapy and radiation therapy. After 17 months of disease-free survival, the patient was diagnosed with Paget's disease of the contralateral accessory breast. He underwent wide excision surgery along with radiation therapy. To the best of our knowledge, this is the first report of bilateral extramammary Paget's disease in a male.

The combination of luteinizing hormone-releasing hormone analogs (LHRHa) with tamoxifen is used as a standard postoperative adjuvant therapy in patients with hormone receptor-positive/premenopausal breast cancer. Long-acting LHRHa formulations offer advantages in terms of patient convenience. However, data on the effectiveness of the 3-month (3M) acting formulation are still insufficient. This study was performed on patients who received the 3M LHRHa after surgery. The serum estradiol (E2) and follicle-stimulating hormone levels were measured before surgery, and periodically after surgery. In total, 318 patients were included in the study and analyzed. The mean E2 level before surgery was 63.7 pg/mL, while the mean E2 level during the administration of 3M LHRHa was 4.9 pg/mL.None of the patients were menstruating and had E2 values above 30.0 pg/mL. It is thought that the 3M LHRHa formulation can suppress the ovarian function effectively and be safely used to improve compliance.

Purpose: Tumescent in nipple-sparing mastectomy (NSM) has been reported to increase the risk of necrosis by impairing blood flow to the skin flap and nipple-areolar complex. At our institution, we introduced a tumescent-free robotic NSM using the da Vinci single-port system (Intuitive Surgical, Inc.). Methods: We conducted a retrospective analysis of patients who underwent tumescent-free robotic NSM between October 2020 and March 2023 at Asan Medical Center (Seoul, Korea). Clinicopathological characteristics, adverse events, and operative time were evaluated. Results: During the study period, 118 patients underwent tumescent-free robotic NSM. Thirty-one patients (26.3%) experienced an adverse event. Five patients (4.2%) were classified as grade III based on the Clavien-Dindo classification and required surgery. The mean total operative time was 467 minutes for autologous tissue reconstruction (n = 49) and 252 minutes for implants (n = 69). No correlation was found between the cumulative number of surgical cases and the breast operative time (P = 0.30, 0.52, 0.59 for surgeons A, B, C) for the 3 surgeons. However, a significant linear relationship (P < 0.001) was observed, with the operative time increasing by 13 minutes for every 100-g increase in specimen weight. Conclusion Tumescent-free robotic NSM is a safe procedure with a feasible operative time and few adverse events.