Vascular tumors of the breast are a highly infrequent finding. Hemangiomas are benign vascular tumors that are rarely present in the breast, and they are usually found incidentally on microscopy of biopsy material when checking for other diseases. Cavernous hemangioma also can develop at many anatomic sites, but there are only a few recorded examples of this lesion arising primarily in the breast. We report here on a case of cavernous hemangioma of the breast.
Biopsy ; Breast* ; Hemangioma* ; Hemangioma, Cavernous ; Microscopy

Mastitis is a disease common in the puerperal period and it only has a rare coincidence with breast cancer in nonpuerperal women. The characteristics of mastitis can masquerade as those of coincident breast cancer on the physical examination, mammography and breast ultrasono-graphy. Fine needle aspiration cytology might show cancer cells, but this not always possible. Therefore the detection of breast cancer coincident with mastitis is very difficult. Various researches have been conducted to see if mastitis is a risk factor for breast cancer. At present, there is no evidence to support a relationship between breast cancer and mastitis. The coincidence of breast cancer, and especially noninflammatory early breast cancer and mastitis is very rare, but the effect on the patient could be great. Attention should be paid to the nonpuerperal women with mastitis for the differential diagnosis or for a coincidental finding of breast cancer.
Biopsy, Fine-Needle ; Breast ; Breast Neoplasms ; Carcinoma, Ductal* ; Diagnosis, Differential ; Female ; Humans ; Mammography ; Mastitis* ; Physical Examination ; Risk Factors

Sentinel Node Biopsy (SNB) is beneficial for reducing axillary functional impairment and lymphedema due to extended lymph node dissection. We used the Indigo Carmine dye instead of radioisotope, since it can simplify the complicated multistep identifying procedures and has economic benefit because it requires no radioisotope detection equipment. The operation for small breast cancer is continuously changing from a modified radical mastectomy to various type of breast conserving operations. Among these we performed a partial mastectomy with rotation flap using remnant breast tissue (RFB). This method needs small operation field, so we could reduce trauma to the patient, shorten the operation time, and use natural blood supplies and tissues without destructing other organ structures. The cosmetic effect is desirable to Korean women considering their relatively small breast size as to that of western people. In SNB, 5cc indigocarmine was injected intradermally just around main lesion. Sentinel node was able to be identified easily if a proper dose was used. Its approach was achieved in 15 to 20 minutes. Partial mastectomy (quadrantectomy) was done with cancer free margins. Rotation flap which is covering the defect included as much breast tissue as possible sparing the nipple areolar complex. Sentinel node biopsy and rotation flap brought out both satisfactory cosmetic result and cost effective outcome, so this breast conserving method is recommendable to small breast cancers.
Biopsy ; Breast Neoplasms* ; Breast* ; Equipment and Supplies ; Female ; Humans ; Indigo Carmine ; Lymph Node Excision ; Lymphedema ; Mastectomy, Modified Radical ; Mastectomy, Segmental ; Nipples

PURPOSE: This study was designed to investigate the validity of the WHOQOL-BREF (Brief form of the World Health Organization Quality of Life Assessment Instrument) and explore the quality of life (QOL) of breast cancer patients who survived after an operation, using the Korean version of the WHOQOL-BREF. METHODS: Fifty (50) breast cancer patients after their operations and obtaining their informed consent were recruited. Hospital staff members served as the controls. The 100 item-WHOQOL instrument was employed for testing all the subjects. The scores of the WHOQOL-BREF, which is a short version (26 questions) of the WHOQOL, includes four domains (physical, psychological, social, and environmental), were compared with those of the WHOQOL. RESULTS: The scores of the WHOQOL-BREF were significantly correlated with those of the WHOQOL in all domains. The physical, psychological, and environmental domains were associated with a worse quality of life in patients with breast cancer. CONCLUSION: The WHOQOL-BREF is a valid and useful instrument for evaluating the quality of life in patients with breast cancer.
Breast Neoplasms* ; Breast* ; Humans ; Informed Consent ; Quality of Life* ; World Health Organization

PURPOSE: The number of people who visit outpatient departments for a self-examination, health examination or an examination about breast disease has recently been increasing. Among these peoples, some of them have abnormal finding for their breasts, and several diagnostic methods are presently being used for the accurate diagnosis of these patients. In this study, we wished to increase the diagnosis rate of breast disease and we wanted to create the opportunity for obtaining accurate diagnosis by using mammography, ultrasonography and fine needle aspiration biopsy. METHODS: From January 2000 to December 2002, 127 patients among all the patients who visited department of surgery, were clinically assessed with using ultrasonography, mammography, fine needle aspiration biopsy and postoperative histopathology after they had first undergone excisional biopsy. We had calculated the sensitivity, specificity, the positive predictive value, the negative predictive value and the diagnostic accuracy of each diagnostic method. We assigned points for the diagnostic result and we then calculated the sensitivity and specificity via these points. RESULTS: The sensitivity of ultrasonography, mammography and fine needle aspiration biopsy was 94.9%, 82.1% and 94.9%, respectively, and the specificity was 62.5%, 90.9% and 93.2%, respectively. The positive predictive value was 52.9%, 80% and 86.0%, and the negative predictive value was 96.5%, 92% and 97.6%, and the diagnostic accuracy was 72.4%, 88.2% and 93.7%, respectively. We divided the results by the benign and malignant nature of the findings with using points, and on this triple test, the sensitivity was 97.4%, the specificity was 97.7%, the positive predictive value was 95%, the negative predictive value was 98.9% and the diagnostic accuracy was 97.6%. CONCLUSION: When diagnosing breast disease, the modified triple test showed that it reduce the rate of performing unnecessary surgical operations. Good skilled technique when performing fine needle aspiration biopsy can help to future reduce this rate even more.
Biopsy ; Biopsy, Fine-Needle ; Breast Diseases* ; Breast* ; Diagnosis* ; Humans ; Mammography ; Outpatients ; Self-Examination ; Sensitivity and Specificity ; Ultrasonography

PURPOSE: The clinical use of the zoledronic acid has been increasing recently, and especially for the treatment of bone metastases. The synergistic effects of zoledronic acid with other chemotherapeutic agents have been shown. However it is not known whether a similar synergistic apoptotic effects exist for a combination therapy of zoledronic acid with radiation. METHODS: The MCF-7 human breast cancer cell lines were treated with 10 micrometer, 50 micrometer or 100 micrometer of zoledronic acid, irradiated with 5 Gy, and they were also treated with a combination of both treatments. The results of the synergistic effect on apoptosis were identified by performing XTT assay, DNA fragmentation assay, FACS analysis and western blot analysis at 24, 48, 72 hours after treatment. RESULTS: Zoledronic acid afftects anti-proliferative and apoptotic effects on MCF-7 breast cancer cell line in a dose-dependent manner. The synergistic cytotoxic effect of zoledronic acid and radiation was noted. The western blot analysis suggested that this synergistic effect has a relationship with the intracellular signal pathway especially with Ras, eventhough Bcl-2 and BAX expressions showed no difference in a zoledronic acid and combination treatment group compared to a control group significantly, CONCLUSION: The combined use of zoledronic acid and radiotherapy shows enhanced in vitro cytotoxicity for the MCF-7 human breast cancer cell line. And in vivo study is under way to elucidate the effect of this combination therapy.
Apoptosis ; Blotting, Western ; Breast Neoplasms* ; Breast* ; Cell Line* ; DNA Fragmentation ; Humans* ; Neoplasm Metastasis ; Radiotherapy ; Signal Transduction

PURPOSE: A skin-sparing mastectomy (SSM), followed by immediate reconstruction, which has aesthetic advantages, is being increasingly used to treat many early breast carcinomas; however, there are few data regarding the outcome and safety of this procedure. The objective of this study was to evaluate the safety of utilizing a SSM with immediate reconstruction compared with the outcome of a conventional mastectomy. METHODS: A retrospective review was performed on 169 patients who underwent a SSM with immediate reconstruction, and 2102 patients who received a conventional mastectomy between January 1996 and December 2002, at the Asan Medical Center. The patient and tumor characteristics, as well as the types of reconstruction, incidences of recurrence and survival rates were examined. RESULTS: The mean age of the SSM group was younger (39 vs. 47 years, p < 0.001), and the mean tumor size smaller than those of the mastectomy group (2.6 vs. 3.2cm, p = 0.002). Lymph node involvement was present in 39.6% and 48.4% of the SSM and mastectomy groups, respectively (p = 0.24). The proportion at early stages (0 and 1) in the SSM group was higher than those in the mastectomy group (50.9 vs. 30.7%, p < 0.001). In the high-risk patients, postoperative radiation was administered to 24.1 and 54.9% of the SSM and mastectomy group, respectively (p = 0.002). With a median follow-up of 41 months, the recurrence rates for the SSM and mastectomy groups were 11.8 (20 of 169 patients) and 14.4% (303 of 2102 patients), respectively (p = 0.22). There were no differences in the locoregional and distant recurrences between the two groups. The 5-year disease free survivals for the SSM and mastectomy groups were 81.9 and 81.7%, respectively (p = 0.71). The 5-year overall survivals for the SSM and mastectomy groups were 91.7 and 88,8%, respectively (p = 0.13). In a univariate analysis, the factors associated with a recurrence and the survival rates were the tumor stage and a lymph node positive state. CONCLUSION: No significant differences were found in the recurrence and survival rates of the SSM group, with immediate reconstruction, compared to those of the mastectomy only group. A skin-sparing mastectomy, with immediate reconstruction, which has greater aesthetic benefits, appeared to be an oncologically safe treatment option for breast carcinomas.
Breast Neoplasms ; Chungcheongnam-do ; Follow-Up Studies ; Humans ; Incidence ; Lymph Nodes ; Mastectomy* ; Recurrence* ; Retrospective Studies ; Survival Analysis* ; Survival Rate

PURPOSE: Although the overexpression of c-erbB-2 has been reported to be associated with a poor clinical outcome in breast cancer, its prognostic value remains controversial. The overexpression of c-erbB-2 can be detected using immunohistochemical analysis which is cost-effective, but not ideal due to variations in tissue fixation and processing, different testing methods with variable sensitivity and the subjectivity in grading. The purpose of this study was to evaluate the grade of c-erbB-2 expression and compare the grading with the patient's prognosis. The grading was performed via immunohistochemical staining of the protein in the tissue obtained from breast cancer patients. METHODS: Between January 2000 and March 2004, 253 patients with breast cancer were studied. Immunoperoxidase staining for c-erbB-2 on paraffin blocks was interpreted as either negative or positive; the presence of circumferential membranous staining (+2 and +3) in tumor cells was interpreted as "positive" and the absence of staining, with the only the presence of cytoplasmic staining (without membranous staining) was interpreted as "negative"(0 and +1). RESULTS: Of the 253 breast cancer samples, c-erbB-2 expression was negative in 138 cases (54.5%) and positive in 115 cases (45.4%). The c-erbB-2 tissue assay grading results were G0: 62 (24.5%), G1+: 76 (30%), G2+: 53 (20.9%) and G3+: 62 (24.5%) cases. Of the prognostic factors, the histological grade (p = 0.010), P53 (p = 0.000) and the absence of estrogen receptors (p = 0.028) displayed a significant relationship (p < 0.05) with an increase in the c-erbB-2 expression grading, but the tumor size, lymph node metastasis, tumor stage, lymphovascular invasion and progesterone receptor state showed no significant differences with respect to the expression grading. CONCLUSION: The c-erbB-2 expression grading was found to be positively correlated with the histological grade, ER status and p53 but not with the tumor size, lymph node metastasis, lymphovascular invasion, tumor stage or PR status. In this study c-erbB-2 immunohistochemical staining result were insufficient to recommened the use of prognostic factor.
Breast Neoplasms* ; Breast* ; Cytoplasm ; Humans ; Lymph Nodes ; Neoplasm Metastasis ; Paraffin ; Prognosis ; Receptors, Estrogen ; Receptors, Progesterone ; Tissue Fixation

PURPOSE: The mitotic index (MI) and Ki-67 labeling index have been used as cell proliferative markers in the various tumors. Topoisomerase II alpha (Topo II alpha) is also expressed in proliferating cells. The aim of this study was to evaluate the correlations between the MI, Ki-67, and Topo II alpha expression as proliferative markers of breast cancer. METHODS: The cell proliferative activity of 181 breast cancers was measured using MI, Ki-67 labeling index and Topo II alpha expression. The correlation between the measured markers was also analyzed. RESULTS: The MI, Ki-67, and Topo II alpha were significantly correlated with each other(p < 0.000). The MI and Ki-67 labeling index were associated with high histological grade, and absence of hormone receptor (p < 0.000). Topo II alpha expression was correlated with high histological grade (p < 0.000), absence of hormone receptor and HER-2/neu overexpression (p < 0.043). The MI, Ki-67, and Topo II alpha were not associated with any other clinical variables, such as age, tumor size, and lymph node status. CONCLUSION: The three proliferative indices were significantly associated with aggressive features of breast cancer, and significantly correlated with each other.
Breast Neoplasms* ; Breast* ; DNA Topoisomerases, Type II ; Lymph Nodes ; Mitotic Index

PURPOSE: The E-cadherin gene, located on chromosome 16q22, may play principal roles in cell adhesion with the loss of E-cadherin expression leading to a propensity for a great number of malignant properties. The loss of heterozygosity (LOH) on 16q22 has rarely been studied in invasive ductal carcinomas. Our objectives were to evaluate the LOH of E-cadherin and the protein expression in invasive ductal carcinomas and their correlation with various clinicopathological factors. METHODS: The LOH analysis was performed using polymerase chain reactions with three polymorphic microsatellite markers (D16S419, D16S3106 and D16S498) in 50 surgically resected tumors and their non-tumorous counterparts. The E-cadherin protein expression was studied using immunohistochemistry. RESULTS: The LOH and loss of protein expression were detected in 54% and 46% of the tumors, respectively. There was no LOH or protein loss detected in the non-tumor lesions. The LOH results were well correlated with the tumor size and lymph node metastasis. The protein loss results were well correlated with tumor histological grade. No correlation was found between LOH and protein loss. CONCLUSION: These results suggest that the LOH of E-cadherin may be associated with tumor metastasis and tumor progression and E-cadherin protein loss may be related with the dedifferentiation in some portions of invasive ductal carcinomas. We propose the LOH of E-cadherin and protein loss may contribute to tumor progression by independent mechanism.
Cadherins* ; Carcinoma, Ductal* ; Cell Adhesion ; Immunohistochemistry ; Loss of Heterozygosity* ; Lymph Nodes ; Microsatellite Repeats ; Neoplasm Metastasis ; Polymerase Chain Reaction