PURPOSE: Real-time compound imaging obtains multiple coplanar tomographic ultrasound images and combines them into a single compound image, reducing acoustic artifacts and noise. The purpose of this study is to determine if real-time compound imaging improves evaluation of breast cancer compared to conventional sonography. METHODS: From May 2000 to July 2001, we scanned the same axial plane with conventional sonography and real-time compound imaging in 520 patients with solid breast nodules. Twenty-eight cancers in 25 patients which were confirmed pathologically were included in this study. Twenty-five of 28 cases were invasive ductal carcinoma and the remaining three were ductal carcinoma in situ. Each image pair consisted of a conventional ultrasound and a real-time compound image with a stationary probe, to maintain an identical projection. The evaluating points were 1) contrast between cancer and normal breast tissue, 2) depiction of margin, 3) clarity of internal echotexture, 4) clarity of posterior echo pattern, and 5) clarity of internal microcalcifi-cation. Two radiologists graded for quality of images on a 5-point scale and in a blinded fashion and Wilcoxon rank test was used for comparison between conventional and real-time compound images. RESULTS: For reviewer 1/reviewer 2, compound image showed grade improvements in 1) contrast (1.4?0.5/1.4?0.7), 2) margin (1.4?0.5/1.8?0.4), 3) internal echotexture (1.0?0.5/1.4?0.7), 4) posterior echo pattern (?0.9?0.7/?0.8?0.7), and 5) internal microcalcification (1.8?0.5/1.8?0.5). In all evaluating points, there was statistically significant difference between conventional and compound images (P<0.05). CONCLUSION: Real-time compound imaging improves contrast, depiction of margin, and clarity of internal echotexture and internal microcalcification of the breast cancer. But compound image is not effective to evaluate posterior echo pattern of the breast cancer.
Acoustics ; Artifacts ; Breast Neoplasms* ; Breast* ; Carcinoma, Ductal ; Carcinoma, Intraductal, Noninfiltrating ; Humans ; Noise ; Ultrasonography

PURPOSE: The incidence of breast cancer is continuously increasing in Korea, and the age of the initially detected breast cancer is younger than western people. The purpose of this study was to compare radiological, pathological, and clinical findings of breast cancers according to age and then contribute to the basis of screening program of breast cancer. METHODS: Retrospectively, the 325 patients who had pathologically confirmed breast cancer were included in this study. The patients were classified into 6 groups according to age, 20~29, 30~39, 40~49, 50~59, 60~69, and more than 70 years. We evaluated the radiological findings of 325 cases of mammography and 144 cases of breast ultrasonography, classified as four types; mass, microcalcification, others, and non-detected lesion, and then analyzed radiological findings according to age. We evaluated pathological and clinical findings according to age and compared with radiological findings. We used Mantel-Haenszel's chi 2 test and trend test for comparison according to age. RESULTS: The incidence of breast cancer was 61 cases (19%) in 30~39 years, 122 (38%) in 40~49 years, 92 (28%) in 50~59 years. Most of breast cancer was invasive ductal carcinoma, 258 (79%) and in situ carcinoma was 32 (10%). Most of in situ carcinoma was detected in 20~59 years, 31/32 (97%). Mammography showed mass in 237 (73%), microcalcification in 45 (14%), other finding in 13 (4%), and non-detected lesion in 30 (9%). Twenty-one (47%) of 45 cases with microcalcification were in situ carcinoma and most of in situ carcinoma was presented as microcalcification on mammography, 21/32 (66%). In twenty-eight of 30 cases (93%) with non-detected lesion on mammography, breast cancer was detected on ultrasonography. In terms of clinical findings, there was no symptom in 12/32 (38%) with in situ carcinoma and 57/258 (22%) with invasive ductal carcinoma. CONCLUSION: The incidence of breast cancer is abruptly increasing from 4th decades and there is no significant difference in radiological and clinical findings according to age. But, most of in situ carcinoma was detected in 20~59 years and presented as microcalcification on mammography. Thus, Screening mammography should be considered from 4th decades.
Breast Neoplasms* ; Breast* ; Carcinoma, Ductal ; Diagnosis ; Female ; Humans ; Incidence ; Korea ; Mammography ; Mass Screening ; Retrospective Studies ; Ultrasonography ; Ultrasonography, Mammary

PURPOSE: Cells of mammary gland as well as breast cancer uptake iodide through sodium/iodide symporter (NIS). The pathophysiologic importance of NIS is not evaluated well. The purpose of this study is to find relationships between the expression of NIS and other findings of breast cancer including ER, PR, C-erbB2, topoisomerase IIa, p53, and histologic grade of breast cancer. METHODS: Fresh frozen specimens from 21 female breast cancer patients (mean age 50 13 years) with breast cancer were examined by RT-PCR for NIS mRNA. Immunohistochemical staining for ER, PR, C-erb B2, topoisomerase IIa and p53. Staging and degree of differentiation of cancer cells were also performed to evaluate the biological behavior of breast cancer. RESULTS: NIS mRNA was expressed in 90% of the evaluated breast cancer tissues. The mean semiquantitative value of NIS mRNA in PR positive group was 2.02+/-0.35, which was higher than that of PR negative group (1.11+/-0.18; P=0.001). ER positive group showed higher value of NIS mRNA (2.02+/-0.35) than ER negative group (1.19+/-0.63; P=0.002). In addition, NIS mRNA values was significantly different according to differentiation of cancer cells (well differentiated type, 2.20+/-0.37 vs. less differentiated type, 1.39+/-0.63, P=0.01). However, there was no significant association between NIS mRNA levels and the other biologic characteriscs such as C-erb B2, topoisomerase IIa, and p53. CONCLUSION: The results showed that the expression of NIS in breast cancer may be associated with the presence of PR and ER as well as the degree of differentiation of breast cancer cells.
Breast Neoplasms* ; Breast* ; Female ; Humans ; Ion Transport* ; Mammary Glands, Human ; RNA, Messenger*

PURPOSE: Estrogen signal transduction plays very important roles in both normal mammary development and neoplastic progression. Since the discovery of estrogen receptor-beta (ER-beta) there have been many controversial reports on the role of ER-beta in breast carcinogenesis and progression, and prognostic implications. ER-beta mRNA levels were investigated in various mammary tissues in order to verify the role of ER-beta expression in breast carcinogenesis. METHODS: Using messenger RNA (mRNA) in situ hybridization, we examined ER-beta expression in 60 paired normal and cancer tissues, 11 paired normal and benign breast tumor tissues, and 10 metastatic lymph nodes. We determined the intensity and extent (proportion of cells with positive hybridization) of the mRNA hybridization signals and gave scores 0 to 3; no hybridization (0), minimal (1), moderate (2), and strong (3) by the hybridization intensity and no hybridization (0), hybridization in less than 10% of cells (1), 10~50% (2), and more than 50% of cells (3) by the proportion of positively hybridized cells. Chi-square test, independent t-test or one-way ANOVA test was used for the statistical analysis and differences were considered to be significant with a p-value of less than 0.05. RESULTS: There was no statistically difference in ER-beta expression between normal and benign mammary tissues. ERbeta expression was significantly decreased in breast cancer and metastatic lymph node tissues compared with normal mammary and benign breast tumor tissues (P<0.01). The intensity and extent of ER beta expression were also significantly lower in breast cancer and metastatic lymph node tissues than in the normal mammary and benign breast tumor tissues (P<0.01). In cases of positive hybridization, the sum of scores of intensity and area were also significantly higher in normal and fibroadenoma tissues than in cancer or metastatic lymph nodes (P<0.01). CONCLUSION: ER beta transcription decreases in the process of breast cancer development, which suggests a protective role of ER beta in breast carcinogenesis.
Breast ; Breast Neoplasms ; Carcinogenesis ; Estrogen Receptor beta ; Estrogens* ; Fibroadenoma ; In Situ Hybridization ; Lymph Nodes ; RNA, Messenger* ; Signal Transduction

PURPOSE: Apoptosis is known to be induced either by direct oxidative damage from oxygen free radicals or hydrogen peroxide, or from their generation in cells by injurious agents. Peroxiredoxin plays an important role in eliminating peroxides generated during metabolism. The aim of this study is to elucidate the role of Prx (peroxiredoxin) enzymes during the cellular response to oxidative stress. METHODS: The presence of Prx isoforms was demonstrated by immunoblot analysis using Prx isoforms-specific antibodies, and RT-PCR using Prx isozyme coding sequences. Annexin V-FITO apoptosis detection method was used to measure the cell death following exposure to H2O2. RESULTS: Treatment of MCF7 cell lines with H2O2 resulted in the dose-dependent expression of Prx I and II. Observed decreases in the mRNA expressions of Prx I and II, analyzed by RT-PCR, correlated well with the results of immunoblot analysis. The treatment of normal breast cell line, MCF10A, with H2O2 resulted in rapid cell death, while the breast cancer cell line, MCF7, was resistant. In addition, we confirmed that Prx I and II transfected MCF10A cells were more prone to cell death than MCF10A transfected with vector alone, after H2O2 treatment. CONCLUSION: These findings suggest that Prx I and II have an important function as inhibitors of cell death during the cellular response to oxidative stress.
Antibodies ; Apoptosis* ; Breast ; Breast Neoplasms ; Cell Death ; Cell Line ; Clinical Coding ; Free Radicals ; Hydrogen Peroxide ; MCF-7 Cells* ; Metabolism ; Oxidative Stress ; Oxygen ; Peroxides ; Peroxiredoxins ; Protein Isoforms ; RNA, Messenger

PURPOSE: The aim of this study was to classify breast carcinomas based on variations in gene expression patterns derived from cDNA microarrays and to correlate tumor characteristics to clinical outcome. METHODS: A total of 7 pairs of breast tumors and control tissues were taken at the time of primary surgery for array analysis. Then, performed microarray experiments in breast cancer tissues with the cDNA microarray spotted 3,063 clones of genes, were analyzed by hierachical clustering. RESULTS: Thirteen genes were over expressed in tumor samples regardless of their histopathological features and ER status, those were including, vitamin A responsive gene, proliferating cell nuclear antigen (PCNA), and signal transducer and activator of transcription 1 (STAT1). Twenty-four genes were down-regulated in tumor sites, those were including, discoidin domain receptor family mamber 2, crystallin alpha B, and myosin light polypeptide kinase. We also identified the differentially expressed genes between ER positive and negative tumors. PCNA, FLJ20500, STAT1, signal recognition particle 9 kD, and proteasome activator subunit 2 were more predominantly expressed in ER negatives. Serine protease 23, vitamin responsive gene, fibronectin 1, and SERPINA1 genes were more highly expressed in ER positive tumors. We further classified the patients according to their gene expression patterns with Cluster program. Clustering results divided patients into two distinct groups, the first group consists of only estrogen receptor (ER) negative tumors and they showed more higher gene expression levels of cell replication and cycle, invasion and metastasis, those considered poor prognosis signature. The other group mostly consists of ER positive tumors. CONCLUSION: These results support the feasibility and usefulness of this systematic approach to studying variation in gene expression patterns in human cancers as a means to dissect and classify solid tumors. We believe, this gene expression profile will outperform all currently available clinical parameters in predicting disease outcome.
Breast Neoplasms* ; Breast* ; Clone Cells ; Crystallins ; DNA, Complementary* ; Estrogens ; Fibronectins ; Gene Expression* ; Humans* ; Myosins ; Neoplasm Metastasis ; Oligonucleotide Array Sequence Analysis ; Phosphotransferases ; Prognosis ; Proliferating Cell Nuclear Antigen ; Proteasome Endopeptidase Complex ; Serine Proteases ; Signal Recognition Particle ; STAT1 Transcription Factor ; Transcriptome* ; Vitamin A ; Vitamins

Hereditary predisposition to breast and ovarian cancer and responsible for autosomal-dominant transmission, most commonly due to germline mutations in BRCA1 and BRCA2 has been recognized for many years. Hereditary breast cancer is characterized by early age at onset, bilaterality, vertical transmission through both maternal and paternal lines, and familial association with tumors of other organs, particularly the ovary and prostate gland. Most of the BRCA1 and BRCA2 mutations are predicted to produce a truncated protein product, supporting the hypothesis that they are tumor suppressor genes. Progress in determining the function of BRCA1 and BRCA2 suggests that they are involved in two fundamental cellular processes, DNA damage repair and transcriptional regulation. Several series have examined the prevalence of germline BRCA mutations in population or hospital based samples of breast cancer patients mainly European ancestry and studies have demonstrated BRCA1/2 mutation between 5% and 10% with early-onset breast cancer. The assessments of familial cancer risk are extremely varied, including families from different ethnic backgrounds with greater or less numbers of affective relatives at varying ages. And estimates of penetrance for BRCA1 and BRCA2 mutations range from 36% to 85% for breast cancer, and 16% to 60% for ovarian cancer. For molecular correlations, BRCA1 cancers were shown to be more often estrogen receptor negative, more high grade tumors and more frequent mutations in p53 than nonhereditary cancers. The phenotype for BRCA2-related tumor sappears to be more heterogeneous. The prognosis of BRCA related tumor is elusive, despite of a significantly increased risk of contralateral breast cancer. Surveillance recommendations for women with germline BRCA mutations are necessary and women are encouraged to learn and practice breast self-examination beginning at age 18 and to begin annual mammogram screening at age 25. A number of women with BRCA mutations may consider undergoing surgical procedures (mastectomy and salpingooophorectomy) in attempt to reduce their risk. Nonsurgical options (tamoxifen medication) for the prevention of hereditary breast cancer are currently limited. The choice of whether to undergo genetic testing is difficult one and should be made only after extensive consultation with a professional who is well versed in the counselling and management of families at hereditary risk. And psychological consequences of testing and the potential impact on family dynamics are important considerations that must be individually addressed. Most of above mentioned data are based on studies of European ancestry. To apply these results to Korean patients with breast cancer, we have to collect a lot of data specific to Korean patients. Therefore, it is needed to study many aspects of Korean breast cancer including age specific mutation prevalence, penetrance, molecular correlation, pathology, prognosis, surveillance and prevention options for women with BRCA mutations.
Breast Neoplasms* ; Breast Self-Examination ; Breast* ; DNA Damage ; Estrogens ; Female ; Genes, BRCA1* ; Genes, Tumor Suppressor ; Genetic Testing ; Germ-Line Mutation ; Humans ; Mass Screening ; Midazolam ; Ovarian Neoplasms ; Ovary ; Pathology ; Penetrance ; Phenotype ; Prevalence ; Prognosis ; Prostate

The role of steroid receptor has been widely studied and well established in the field of breast cancer. In contrast of breast cancer, the clinicopathological roles of steroid receptors in benign breast diseases were not established clearly until now. Authors evaluated steroid receptor expressions of benign breast diseases using the immuno-histochemical staining and analyzed their relationship with pathologic types and the correlation between the positivity of steroid receptor expression and the proliferative activity of ductal epithelial cells. The results were follows; 1) The assayed tissue specimens were 93 cases which consisted with fibrocystic disease, 39 cases and fibroadenoma, 54 cases. 2) The positivity rate of steroid receptor expression in fibroadenoma (ER: 59.2%, PR: 75.9%) seemed to be more higher than in fibrecystic diseases (ER: 46.1%, PR: 55.5%) without a statistical significance. 3) The positivity rate of ER expression of fibrocystic diseases developed in premenopausal women (54.8%) was significantly higher than in postmenopausal women (2.5%). 4) Any significant correlation was not noted between the positivity of steroid receptor expression in the tissue and ductal epithelial proliferative activity. In conclusion, fibrocystic disease and fibroadenomas possessed a significant amount of steroid receptor positive cells in their tissues. However, the positivity of steroid receptor expression in the tissues seemed to have few correlation with the ductal epithelial cellular proliferation.
Breast Diseases* ; Breast Neoplasms ; Breast* ; Cell Proliferation ; Epithelial Cells ; Female ; Fibroadenoma ; Humans ; Receptors, Steroid*

PURPOSE: The axillary lymph node status is the most important prognostic factor in breast cancer. The axillary node dissection is done are usually performed in infiltrating breast cancer for the information of therapeutic decision and prediction of prognosis. But this procedure results in lymphedema of affected upper extremity nearly about 25%, increased axillary drainage, sensory abnormality and pain. Many researches are focussed to find the patients group who do not need axillary dissection according to the status of tumor size, patient age, hormonal receptor and histologic grade. MATERIAL AND METHODS: We evaluated the axillary lymph node status related with tumor size less then 2 cm in and the correlation of other prognostic factor. We reviewed 127 women with histologically diagnosed infiltrating ductal carcinoma of breast who were treated by one surgeon at YongDong Severance Hospital, Yonsei University College of medicine between 1991 and 1996. RESULTS: Five patients (3.9%) had T1a lesion (< 5 mm), 24 patients (18.9%) had T1b tumors (6-10 mm), and 98 cases (77.2%) had T1c lesion (11-20 mm). The average numbers of dissected axillary lymph nodes were 14.2 We found that small tumor size, good histologic grade, estrogen receptor positivity, old age (over 50 years) showed tendency of decreased axillary node metastasis but without statistical significance. CONCLUSIONS: There are possibility of finding subset with low risk of axillary lymph node metastasis in small size tumor with addition of good prognostic indicators such as good histologic grade, hormonal receptors and old age.
Breast Neoplasms* ; Breast* ; Carcinoma, Ductal ; Drainage ; Estrogens ; Female ; Humans ; Lymph Nodes* ; Lymphedema ; Neoplasm Metastasis* ; Prognosis ; Upper Extremity

Mouse monoclonal antibody was used for this study. This study was undertaken to define the prognostic value of the expression of Cathepsin-D in 121 breast cancer patients. The results were as follows: 1) Overall, 53.7% of patients were positive for Cathepsin-D 2) Positive staining did not correlate with age, estrogen receptor status,tumor size, axillary nodal status, tumor stage, menopausal status, pathologic grade, DNA ploidy and S-phase fraction.
Animals ; Breast Neoplasms* ; Breast* ; DNA ; Estrogens ; Humans ; Mice ; Ploidies