One hundred and fifty two patients presenting with palpable primary breast cancer were studied to evaluate accuracy of clinical assessment, mammography, and ultrasonography in measuring tumor size. The clinical, mammographic, and ultasonographic diameter of tumor size was compared to histological diameters. The histological diameter of tumors was 27.9+/-12.7mm. The average diameter of tumor on clinical assessment was 33.8+/-13.1mm and its correlation coefficient to the histological size was 0.73. The average size on the mammography was 21.4+/-9.0m and its correlation coefficient to the histological size is 0.71. The tumor size on the ultrasonography in 22 patients was is 22.3+/-10.4mm. The sonographic measurement dimonstrated the highest correlation coefficient (0.83). The clinical assessment overstimated the tumor size, but the mammogaphic and sonographic measurement understimated it compared with histological size. The combined measurement with clinical and ultrasonography could be useful method to estimate tumor size preoperatively. And when it is combined with clinical assessment, it is the most reliable and accurate technique.
Breast Neoplasms* ; Breast* ; Humans ; Mammography ; Ultrasonography

By using (99m)Tc-Pertechnetate, we evaluated the thyroid function of 136 persons with uptake slopeindex(U.S.I.) which was calculated by computerized dynamic flow study. Also, we compared our results of U.S.I.with those of established ¹³¹I-24 hr uptake % in given materials by comparative analysis of their correlation with the hormonal values of T3, T4, Free T4. The results wre as follows: 1. The U.S.I. of euthyroidismal group and hyperthyrodismal group were 4.87±2.26, 27.67±9.56 respectively. The ¹³¹I-24 hr uptake % of above groups were29.22±10.23, and 71.45±15.51. So the differentiation of the two groups could be done more easily by using (99m)Tc-Pertenchnetate U.S.I. than by using ¹³¹I-24 hr uptake %. 2. The correlation rates between (99m)Tc-Pertechnetate U.S.I. and other laboratory hormon levels, T3, T4, Free T4, ar almost parallel with thosebetweeen ¹³¹I-24 hr uptake % and the values of T3, T4, Free T4. Also the direct correlation rate between (99m)Tc-Pertechnetate U.S.I. and ¹³¹I-24 hr uptake % was 0.898. So, the method of thyroidal function evaluation by (99m)Tc-Pettechnetate U.S.I. is very reliable. 3. The (99m)Tc-Pertechnetate U.S.I. is very helpful to evaulate thefunctions of each lobe respectively incases of having obviously different radioactivity between both lobes. 4. (99m)Tc-Pertechnetate used dynamic thyroid function study and scan can be performed during the short time without preparation and especially helpful in debilitating patient and patients under antithyroid drug therapy, who need repetitive follow-up examination.
Drug Therapy ; Follow-Up Studies ; Humans ; Methods ; Radioactivity ; Thyroid Gland

PURPOSE: This study was prospectively carried out to determine the concordance between the immunohistochemical assay (IHC) and the enzyme immunoassay (EIA) assessing estrogen receptor (ER) and progesteron receptor (PR) in breast cancer tissues. MATERIALS AND METHODS: Breast carcinoma tissues were obtained from 36 patients. Hormonal receptors were determined by IHC assay using polyclonal antimouse antibody and by EIA. The concordance between two methods and the concordance according to in age, tumor size, stage, and lymph node metastasis of breast cancer patient were analyzed. RESULTS: The concordant rate of ER status was 88.9% between IHC and EIA. ER-IHC(+)/EIA(-) were 3 cases and ER-IHC(-)/EIA(+) was 1 cases. ER-positive was 63.9% in IHC and 53.8% in EIA. The concordant rate of PR status was 86.1% between IHC an EIA. PR-IHC(+)/EIA(-) were 4 cases and PR-IHC(-)/EIA(+) was 1 cases. PR-positive was 61.1% in IHC and 52.8% in EIA. There was high concordance (76.2-100%) in age, tumor size, stage, and lymph node metastasis. CONCLUSIONS: There was high concordance between immunohistochemical assay and enzymeimmunoassay determining estrogen and progesteron receptors in the breast cancer. The IHC assay appears to be a resonable substitute for the EIA to determine hormonal receptors.
Breast Neoplasms* ; Breast* ; Estrogens ; Humans ; Immunoenzyme Techniques ; Lymph Nodes ; Neoplasm Metastasis ; Prospective Studies

PURPOSE: The development of publicized screening methods for breast carcinoma detection has led to a marked increase in the discovery of ductal carcinoma in situ (DCIS) or DCIS with microinvasion (DCIS-MI). Axillary lymph node status has been believed to be not only an indicator of prognosis, but also a direction of adjuvant therapy. But the incidence of axillary metastasis in DCIS or DCIS-MI has diversely found in from 0% to 20%. This study was performed to analyze the incidence of axillary metastasis and the predictive factors associated with axillary lymph node metastasis in DCIS or DCIS-MI. METHODS: Patients with DCIS or DCIS-MI and axillary lymph node dissection from 1987 to 2004 were selected from Korea University Medical Center. We reviewed their medical records for age, palpability and size of the tumor, histolgic subtype, nuclear grade, hormone receptor status, and pathologic slides. RESULTS: Fifty two patients in DCIS and Thirty eight patients in DCIS-MI were included in the study. Axillary lymph node metastases were identified in 2 patients (3.8%) in DCIS and 4 patients (10.5%) in DCIS-MI. Tumor size and nuclear grade in DCIS had a borderline significance in association with microinvasion. We could not be able to find any predictive factor associated with axillary lymph node metastasis in DCIS and DCIS-MI. CONCLUSION: Axillary lymph node metastasis in DCIS or DCIS-MI appeared to be not low and there was no predictive factor associated with axillary lymph node metastasis in DCIS and DCIS-MI. But DCIS patients with large tumor size and poor nuclear grade have the high possibility associated with microinvasion, therefore, in that cases, there is a need to consider the possibility of axillary metastasis.
Academic Medical Centers ; Breast ; Breast Neoplasms ; Carcinoma, Ductal* ; Carcinoma, Intraductal, Noninfiltrating* ; Humans ; Incidence ; Korea ; Lymph Node Excision ; Lymph Nodes* ; Mass Screening ; Medical Records ; Neoplasm Metastasis* ; Prognosis

BACKGROUND: Popular immunohistochemical techniques for assay of estrogen receptor(ER) allow the localization of positive cells in specific cell populations. Some of breast carcinomas composed of discrete populations of cells were negative for ER, while neighboring populations of cells were positive for ER. Such heterogeneity might be due to biological or artifactual causes. METHODS: We studied 67 tissue blocks for geographic heterogeneity within the level of ER and cytokeratin(CK) by staining ER and CK. Positive distribution of ER and CK was manually assessed. RESULTS: The immunohistochemical expression revealed 50 cases for ER-positive and 17 cases for ER-negative. In 50 ER-positive cancers, homogeneity was 38 cases, heterogeneity was 11 case, and artifactural change was developed in and one case. excluded in the analysis. The rate of heterogeneity of the ER-positive cancers was 22.4%(11/49). Comparisons of homogeneity and heterogeneity according to clinicopathologic risk factors in ER-positive breast cancer demonstrated that the heterogeneity of ER was significantly higher in each subgroups; relatively younger ages(< or =50yr), premenopausal status, early menarche(< or =15yr), early stage(< or =I b), DCIS in pathology, and lower positive expression rate of ER(<50%). CONCLUSION: Clinicopathologic risk factoes would be required to discover the heterogeneity of ER-positive breast cancer. Also a long-term follow-up study on risk factors, including disease free survival, response to anti-estrogen therapy, and survival according to heterogeneity of ER would be need.
Breast Neoplasms* ; Breast* ; Carcinoma, Intraductal, Noninfiltrating ; Disease-Free Survival ; Estrogens* ; Immunohistochemistry ; Pathology ; Population Characteristics* ; Risk Factors ; Staining and Labeling

Eosinophilic gastroenteritis is an unusual disease characterized by eosinophilic infiltration of gastrointestinal tract, peripheral eosinophilia, and gastrointestinal symptoms. There are mucosal, muscular, and subserosal types, of which the subserosal type is the rarest. We experienced a 32-year old male patient with the subserosal type of eosinophilic gastroe-nteritis, who was presented with abdominal distension. The ascitic fluid revealed increased eosinophil count. With oral prednisolone, diarrhea and ascites rapidly disappeared and eosinophils in peripheral blood returned to normal. We report this case with a review of relevant literature.
Adult ; Ascites* ; Ascitic Fluid ; Diarrhea ; Eosinophilia ; Eosinophils* ; Gastroenteritis* ; Gastrointestinal Tract ; Humans ; Male ; Prednisolone

PURPOSE: Since fine needle localization biopsy has been introduced, surgeons can have performed biopsies for nonpalpable microcalcified breast lesions, but there are many controversies in determining the disease characteristics and guideline for biopsy with only the findings on mammography. This study was designed to determine the breast cancers according to microcalcification type. MATERIALS AND METHODS: We reviewed 91 cases with only microcalcifications on mammography and with performing localization biopsies from January 1995 to June 1998 at department of surgery, Korea University Hospitals. We subdivided the type of microcalcifications into casting-type, crushed stone like-type and amorphous-type. RESULTS: The mean age was 49 years old (25-82 years). 16 patients (17.6%) among the 91 patients were diagnosed as the breast cancer. Four (22.2%) of 18 patients with casting type, eight (21.6%) of 37 patients with crushed stone-like type, and four (11.1%) of 36 patients with amorphous type microcalcifications were detected in the breast cancer. The incidence of breast cancers by mammographic microcalcificated breast lesions was more prevalent in casting and crushed stone-like types than amorphous types. The mean size of the benign and malignant lesions was 13.11+/-10.89mm, 13.13+/-.51mm, and there was no difference in the size of microcalcifiations between benign and malignant lesions. CONCLUSIONS: Patients who have had clustered microcalcifications of more than 5 within 1 cm circle in diameter on mammography should be undergone biopsies especially in case of casting or crushed stone-like type to detect early breast cancers.
Biopsy ; Breast Neoplasms* ; Breast* ; Classification* ; Hospitals, University ; Humans ; Incidence* ; Korea ; Mammography* ; Middle Aged ; Needles

BACKGROUND: The estrogen receptor (ER) in breast cancer specimens has traditionally been assessed using a biochemical ligand binding assay (LBA). Recently, the application of an immunohistochemical method (IHC) for formalin-fixed breast carcinoma tissue has greatly increased. Controversy exists over the accuracy of IHC compared with that of LBA in determining ER. METHODS: Breast-carcinoma tissues were obtained from 247 patients. ER was determined within 1 week or at 4 weeks after surgery by using the traditional LBA and by using IHC with monoclonal antibodies. The ER status was assessed with respect to age, size of tumor, and stage according to the two methods. RESULTS: The concordant rate of ER status was 75% between IHC and LBA. IHC-negative/LBA- positive results occurred in 31 cases (13%) and IHC-positive/LBA-negative were observed in 30 cases (12%). ER-positive cases were more common in older patients. The disconcordant rate was much higher in premenopausal females. There was a significantly lower ER positivity in tumors of larger than 5 cm. ER positivity was significantly lower at 4 weeks compared to within 1 week in both methods, but this did not change the concordance rate between the two methods. CONCLUSIONS: The ER-IHC method appears to be a reasonable substitute for a biochemical ligand binding assay. This is based on a 75% concordance of the method as well as on the findings in the disconcordant cases. The appropriate measured time for ER was within 1 week after the cancer tissues were obtained.
Antibodies, Monoclonal ; Biochemistry ; Breast Neoplasms* ; Breast* ; Estrogens* ; Female ; Humans ; Immunohistochemistry

PURPOSE: In breast cancer patients, information of the axillary nodal status is essential for staging, determining the necessity of systemic therapy, and predicting the prognosis. The necessity of an axillary lymph node dissection in small breast cancers is controversial. The aim of this study is to identify the factors associated with axillary lymph node metastases and to determine the necessity of axillary lymph node dissections in T1 invasive ductal carcinomas of the breast. METHODS: From the June 1991 to the March 2004, of a total 919 cases who underwent surgery for breast cancer in Korea University Hospital, 230 cases of T1 invasive ductal carcinomas were reviewed retrospectively. All subjects were classified as T1a, T1b, or T1c. The rate of axillary lymph node metastasis was calculated for each group and the factors that have a statistically significant correlations with axillary lymph nodes metastases were investigated. RESULTS: Of the 230 cases of T1 invasive ductal carcinomas, 22 cases were T1a, 27 cases were T1b, and 181 cases were T1c. Axillary lymph node metastases were encountered in 4 T1a case (18%), 5 T1b cases (18.5%), and 67 T1c cases (30.3%). The overall rate of axillary lymph node metastases rate in T1 was 33% (76/230). The T stage had a statistically significant correlation (p=0.043) with the axillary lymph node metastases. Lymphovascular invasion of the tumor had a significant correlations with an axillary lymph node metastases (p=0.032). The MIB-1 labeling index was increased according to the tumor size, and correlated with the presence of an axillary lymph node metastasis (p=0.032, p=0.18). However age, hormone receptors, p53, HER2/neu , and nm23 were not associated with an axillary lymphnodes metastasis. CONCLUSIONS: The tumor size and the lymphovascular invasion could be significantly prognostic factors suggesting an axillary lymph node metastasis in T1 invasive ductal carcinomas. The MIB-1 immunostain was higher in the T1c cases. Therefore, a combination of the tumor size and MIB-1 immunostain would be an indicator for an axillary lymph node dissection. A sentinel lymph node biopsy may be of more benefit in T1a invasive ductal carcinomas of the breast.
Breast Neoplasms ; Breast* ; Carcinoma, Ductal* ; Humans ; Korea ; Lymph Node Excision ; Lymph Nodes* ; Neoplasm Metastasis* ; Prognosis ; Retrospective Studies ; Sentinel Lymph Node Biopsy

PURPOSE: In breast cancer patients, information of the axillary nodal status is essential for staging, determining the necessity of systemic therapy, and predicting the prognosis. The necessity of an axillary lymph node dissection in small breast cancers is controversial. The aim of this study is to identify the factors associated with axillary lymph node metastases and to determine the necessity of axillary lymph node dissections in T1 invasive ductal carcinomas of the breast. METHODS: From the June 1991 to the March 2004, of a total 919 cases who underwent surgery for breast cancer in Korea University Hospital, 230 cases of T1 invasive ductal carcinomas were reviewed retrospectively. All subjects were classified as T1a, T1b, or T1c. The rate of axillary lymph node metastasis was calculated for each group and the factors that have a statistically significant correlations with axillary lymph nodes metastases were investigated. RESULTS: Of the 230 cases of T1 invasive ductal carcinomas, 22 cases were T1a, 27 cases were T1b, and 181 cases were T1c. Axillary lymph node metastases were encountered in 4 T1a case (18%), 5 T1b cases (18.5%), and 67 T1c cases (30.3%). The overall rate of axillary lymph node metastases rate in T1 was 33% (76/230). The T stage had a statistically significant correlation (p=0.043) with the axillary lymph node metastases. Lymphovascular invasion of the tumor had a significant correlations with an axillary lymph node metastases (p=0.032). The MIB-1 labeling index was increased according to the tumor size, and correlated with the presence of an axillary lymph node metastasis (p=0.032, p=0.18). However age, hormone receptors, p53, HER2/neu , and nm23 were not associated with an axillary lymphnodes metastasis. CONCLUSIONS: The tumor size and the lymphovascular invasion could be significantly prognostic factors suggesting an axillary lymph node metastasis in T1 invasive ductal carcinomas. The MIB-1 immunostain was higher in the T1c cases. Therefore, a combination of the tumor size and MIB-1 immunostain would be an indicator for an axillary lymph node dissection. A sentinel lymph node biopsy may be of more benefit in T1a invasive ductal carcinomas of the breast.
Breast Neoplasms ; Breast* ; Carcinoma, Ductal* ; Humans ; Korea ; Lymph Node Excision ; Lymph Nodes* ; Neoplasm Metastasis* ; Prognosis ; Retrospective Studies ; Sentinel Lymph Node Biopsy