Apocrine carcinoma is an uncommon, poorly characterized type of breast tumor. The histologic characteristics of apocrine epithelium in malignant breast lesion were first noted by Krompecher(1916), while the first detailed description of an apocrine carcinoma is credited to Ewing in 1928. The reported incidence of apocrine carcinoma is approximately 0.4% of breast cancers. Apocrine carcinoma has distinct histologic and ultrastructural features that distinguish it as a specialized form of infiltrating ductal carcinoma. The finding of a uniform pattern of apocrine differentiation with dense granularity typifying the majority of cells characterizes this variant. We experienced two cases of invasive apocrine carcinoma of the breast and report with a review of the related literature.
Breast Neoplasms ; Breast* ; Carcinoma, Ductal ; Epithelium ; Incidence

No abstract available.
Child* ; Humans ; Leprosy*

PURPOSE: Oncogen or growth factor receptor such as phospholipase C isoenzyme gamma-1 (PLC gamma-1), epidermal growth factor receptor (EGFR), and Her-2/neu which related with tyrosin kinasemay and then regulating vell proliferation may have a role as prognostic factors for breast cancer. MATERIAL AND METHODS: With assumption that expression of PLC gamma-1, EGFR and Her-2/neu oncogene has close relationship with prognosis of breast cancer, 59 breast cancer patients who were operated upon at Korea University Hospital during a period of 6 years starting June 1988 to May 1994 were selected for this study. This study was carried out by comparing between expression of PLC gamma-1, EGFR and Her-2/neu oncogene and patient's survival rate. These expression were also compared with TNM system, estrogen and progesterone receptor and at same time these expressions were compared with each other to see whether there are any relationship among these expression. RESULTS: Expression of PLC gamma-1, EGFR and Her-2/neu were present in 42% (25/59), 46% (27/59) and 20% (12/59). The expression of PLC gamma-1 was closely related with the expression of EGFR (p<0.05) and Her-2/neu (p<0.05), but there were no relationship between the expression of PLC gamma-1 and hormonal receptors and TNM stage (p>0.05). The expression of EGFR was closely related with the expression of Her-2/neu (p<0.05) and hormone receptors (p<0.05), but there were no relationship between the expression of EGFR and pathologic TNM stage (p>0.05). The expression of Her-2/neu was not closely related with hormone receptors and TNM stage except axillary lymph node metastasis. There were close relationship between overall and disease free survival and PLC gamma-1 and Her-2/neu. But EGFR had only related with disease free survival rate. CONCLUSION: In conclusion, the expression of PLC gamma-1, EGFR and Her-2/neu oncogene in human breast cancer may be useful prognostic factors independently and it may potentiated its individual value as a prognostic factors if use them together.
Breast Neoplasms* ; Breast* ; Disease-Free Survival ; Epidermal Growth Factor* ; Estrogens ; Humans* ; Korea ; Lymph Nodes ; Neoplasm Metastasis ; Oncogenes ; Phospholipases* ; Prognosis ; Receptor, Epidermal Growth Factor* ; Receptors, Progesterone ; Survival Rate ; Type C Phospholipases*

PURPOSE: The incidence of symptomatic brain metastases from breast cancerhas ranged from 10% to 16%. Brain metastases are traditionally viewed as a late complication of systemic disease, for which few effective treatment options exist. The aim of this study was to evaluate the factors that can predict brain metastases and to analyze the survival rate as compared with other systemic metastases. METHODS: Between February 1983 and October 2005, 119 patient who developed systemic metastasis during the follow up period after optimal surgical treatment at Korea University Hospital were included in this study. Twenty-nine of these 119 patients had complaints of symptoms and they were consequently diagnosed as having brain metastases. RESULTS: Estrogen receptor (-), progesterone receptor (-) and Her2 (-), and Triple negative were a significantly higher in the patients with brain metastases (p=0.04). The other clinicopathologic factors showed no difference between the patients with brain metastases and the patients without brain metastases. Lung metastases existed previously more often than the other systemic metastases (p=0.04). The overall survival of the patients with brain metastases was not significantly different from the patients with other systemic metastases. However, the disease specific survival of patients with brain metastases, as compared with other systemic metastases was poorer than that for patients with bone and lung metastases, respectively (p=0.01 and 0.03). A poor prognosis was shown for the cases with brain metastases within 1 yr after operation. CONCLUSION: Clinician should give attention to the possibility of brain metastases for the breast cancer patients with triple negative findings or the patients who have developed lung metastases as this represents a symptom of central nervous system.
Brain ; Breast ; Breast Neoplasms ; Estrogens ; Follow-Up Studies ; Humans ; Incidence ; Korea ; Lung ; Neoplasm Metastasis ; Prognosis ; Receptors, Progesterone ; Survival Rate

BACKGROUND: The major value of mammography lies in the detection of nonpalpable breast carcinomas and the mammographic appearance of clustered microcalcifications, and its predictive value in carcinomas of the breast has long been a subject of interest. Since the introduction of the fine needle localization biopsy, surgeons have performed biopsies for nonpalpable breast lesions, but there are many controversies over determining the guidelines for biopsy with only the findings of mammography. METHODS: We reviewed the correlations between the type of mammographic appearance and the histopathologic diagnosis in 74 women who had nonpalpable breast lesions that appeared only as microcalcifications on the mammograms. We subdivided the types of microcalcifications into a casting type, a crushed-stone-like type and an amorphous type. The casting type has linear and branching patterns of microcalcifications, the crushed-stone-like type has clusters of granular microcalcifications, and the amorphous type has small punctuate powdery microcalcifications arranged irregularly. RESULTS: The patients ages ranges from 25 to 82 years and 15 cases (20.3%) of breast cancer were detected among the 74 cases. Four (4) cases (28.6%) of breast carcinoma were detected in the 14 casting type cases, 8 (24.2%) in the 33 crushed-stone-like type cases, and 3 cases (11.1%) in the 27 amorphous type cases. The mean sizes of the benign and the malignant lesions were 13.11+/-11.72 mm and 12.47+/-9.46 mm, respectively, but there was no difference in size between breast carcinomas and benign lesions. CONCLUSION: We conclude that women who have microcalcifications on their mammography should undergo biopsy, especially in cases of casting type or crushed-stone-like type microcalcifications to detect breast carcinomas at an early stage.
Biopsy ; Breast Neoplasms* ; Breast* ; Diagnosis ; Female ; Humans ; Incidence* ; Mammography ; Needles

PURPOSE: Obesity has been shown to have important effects related to breast cancer. But there have been few data available on the distribution of body mass index (BMI) among Korean breast cancer patients and on the effects of this distribution on patient prognosis. Therefore we investigated the BMI distribution of Korean breast cancer patient's and its relationship with other tumor markers, in order to elucidate the relationship between BMI and patient prognosis. METHODS: We measured the BMI of 266 Korean adult women with breast carcinoma.and divided the subjects into the following subgroups according to BMI; low body weight (BMI<20), normal body weight (BMI; 20~25) and over weight (BMI>or=25). We compared this distribution with that of the general Korean women's population. and investigated the correlation with other prognostic factors and tumor markers. The 5 year overall and disease free survival rates were evaluated for both the total breast cancer patients and the adjuvant hormone treated breast cancer patients, according to BMI subgroup, using the Kaplan-Meier method. RESULTS: Mean BMI for the breast patients was 23.4+/-3.1, and did not differ from that of the general Korean adult women's population ('1994 National Nutrition Survey Report). BMI increased with increasing age and was highest in the 60~69 yr age group. BMI was correlated with tumor size and stage. The survival rates were low in the high BMI group among both total and adjuvant hormone treated breast cancer patients, but in neither was any statistical difference found between BMI subgroups. CONCLUSION: Korean breast cancer patients are not obese as the general population and their BMI increases with increasing age and menopausal status. There was a tendency for higher BMI to be associated with poorer prognosis, although not to a statistically significant degree.
Adult ; Biomarkers, Tumor ; Body Mass Index* ; Body Weight ; Breast Neoplasms* ; Breast* ; Disease-Free Survival ; Female ; Humans ; Ideal Body Weight ; Nutrition Surveys ; Obesity ; Prognosis ; Survival Rate

PURPOSE: Obesity has been shown to have important effects related to breast cancer. But there have been few data available on the distribution of body mass index (BMI) among Korean breast cancer patients and on the effects of this distribution on patient prognosis. Therefore we investigated the BMI distribution of Korean breast cancer patient's and its relationship with other tumor markers, in order to elucidate the relationship between BMI and patient prognosis. METHODS: We measured the BMI of 266 Korean adult women with breast carcinoma.and divided the subjects into the following subgroups according to BMI; low body weight (BMI<20), normal body weight (BMI; 20~25) and over weight (BMI> or25). We compared this distribution with that of the general Korean women's population. and investigated the correlation with other prognostic factors and tumor markers. The 5 year overall and disease free survival rates were evaluated for both the total breast cancer patients and the adjuvant hormone treated breast cancer patients, according to BMI subgroup, using the Kaplan-Meier method. RESULTS: Mean BMI for the breast patients was 23.4+/-3.1, and did not differ from that of the general Korean adult women's population ('1994 National Nutrition Survey Report).BMI increased with increasing age and was highest in the 60~69 yr age group. BMI was correlated with tumor size and stage. The survival rates were low in the high BMI group among both total and adjuvant hormone treated breast cancer patients, but in neither was any statistical difference found between BMI subgroups. CONCLUSION: Korean breast cancer patients are not obese as the general population and their BMI increases with increasing age and menopausal status. There was a tendency for higher BMI to be associated with poorer prognosis, although not to a statistically significant degree.
Adult ; Body Mass Index* ; Body Weight ; Breast Neoplasms* ; Breast* ; Disease-Free Survival ; Female ; Humans ; Ideal Body Weight ; Nutrition Surveys ; Obesity ; Prognosis ; Survival Rate ; Biomarkers, Tumor

Mortality associated with human breast carcinoma is almost entirely due to subsequent cancer metastasis, but the molecular basis of this metastasis is not well established. The nm23 gene was originally identified by differential hybridization between two murine melanoma cell sublines which have low and high metastatic potential, and located in chromosome 17q22. This gene has been known to be involved in the metastasis of several cancers and its down-regulation usually associated with metastasis or disease progression in breast cancer. Tumor angiogenesis, the process leading to the formation of new vessels, plays a central role in tumor progression and distant metastasis. It is implicated in the phenomenon of dormant micrometastasis. This study was designed to determine the prognostic value of expression of the nm23 protein and tumor angiogenesis in breast cancer. Also, these two factors were compared with established clinicopathological prognostic factors and hormone receptors. 118 paraffin embedded surgical specimens of breast cancer were obtained from March, 1988 to February, 1994 and were selected for study. The expression of nm23 protein was studied by using immunohistochemical staining with anti-nm23/nuclear diphosphate kinase A. Tumor angiogenesis was quantified under light microscope by counting of the tumor microvessels(MVC) which were highlighted with anti-CD31 antibodies. The patient were allocated into two groups by mean number of MVC, one group was less 42 and the other was over 42. All the patients were female. The nm23 protein expression was positive in 74(63%) cases and was negative in 44(37%) cases. There was a significant correlation between nm23 protein expression and histologic grade(p=0.023). Positive expression of nm23 protein was correlated with positive estrogen(p=0.031) and progesterone receptors(p=0.001). Also Positive expression of nm23 protein was correlated with longer disease free survival(p=0.0026) and overall survival(p=0.0048). The group of MVC<42 showed better survival in overall(p=0.0195) and disease free survival(p=0.0014) than the other group of MVC>42. But the MVC and established clinicopathological prognostic factors did not show any correlation, neither with hormone status. When the nm23 protein and angiogenesis were considered together, 50 cases of negative nm23 protein and MVC<42 showed the best survival in overall(p=0.0111) and disease free survival(p=0.0114) among the four groups of each combination. In conclusion, the expression of nm23 protein and tumor angiogenesis can be used as new prognostic factors in conjunction with established other prognostic factors.
Antibodies ; Breast Neoplasms* ; Breast* ; Disease Progression ; Down-Regulation ; Female ; Humans ; Melanoma ; Mortality ; Neoplasm Metastasis ; Neoplasm Micrometastasis ; Paraffin ; Phosphotransferases ; Progesterone

Diagnoses of pyelonephritis caused by Staphylococcus aureus should be accompanied by investigations of concomitant bladder obstruction and metastatic infections, especially to the spine or heart. Complicated pyelonephritis due to S. aureus requires more than 2 weeks of antibiotics, which is the typically recommended treatment duration for pyelonephritis. We describe a patient who was diagnosed with complicated epidural and paraspinal abscesses after insufficient evaluation and treatment of acute pyelonephritis due to S. aureus. A 62-year-old man with type 2 diabetes was admitted with fever, increased urinary frequency, and left flank pain. He was diagnosed with acute pyelonephritis caused by S. aureus. His fever and flank pain subsided after 3 days of intravenous antibiotics. Evaluation of bladder obstruction and metastatic infection were not performed, as he declined further evaluation. The patient was discharged with oral antibiotics and was requested to attend weekly appointments but was lost to follow-up. One month later, the patient presented at the outpatient clinic with similar symptoms. Computed tomography showed recurrent pyelonephritis and a distended bladder. His flank pain persisted despite administration of an opioid agent. Therefore, magnetic resonance imaging was performed, revealing epidural and paraspinal abscesses. Ultrasound-guided aspiration of the paraspinal muscle layer was performed, and blood and percutaneous aspirated fluid cultures revealed S. aureus growth. The pattern of antimicrobial sensitivity was identical to that at his first admission. Following more than 4 weeks of antibiotics, magnetic resonance imaging showed the abscesses had decreased in size. The patient was discharged without neurologic sequelae and was provided with oral antibiotics.
Abscess* ; Ambulatory Care Facilities ; Anti-Bacterial Agents ; Appointments and Schedules ; Diagnosis ; Epidural Abscess ; Fever ; Flank Pain ; Heart ; Humans ; Lost to Follow-Up ; Magnetic Resonance Imaging ; Middle Aged ; Paraspinal Muscles ; Pyelonephritis* ; Spine ; Staphylococcus aureus* ; Staphylococcus* ; Urinary Bladder ; Urinary Tract Infections

PURPOSE: This study was designed to elucidate the biology of cancer metastasis and differences in the biologic status between primary tumors and metastatic lymph nodes of invasive breast cancer by comparing the well known prognostic factors p53 gene mutation, p53 protein expression and the MIB-1 index. An additional goal was to investigate the p53 mutational pattern of breast cancer patients. METHODS: We used the PCR-SSCP method to detect p53 gene mutation and immunohistochemical staining to establish p53 protein expression and the MIB-1 labelling index in 25 primary tumors and metastatic lymph nodes from breast cancer patients. We then made a comparison the between primary tumors and the metastatic lymph nodes. RESULTS: The results indicated a correlation between histologic grade and p53 gene mutation as well as p53 protein expression, but showed no correlation to MIB-1 labelling index. The concordance rates of p53 gene mutation and p53 protein expression between the primary tumors and metastatic lymph nodes were 72% and 100%, respectively.Three cases showed a different mutated exon number between the primary tumors and the metastatic lymph nodes. Some cases showed p53 gene mutation only in the primary tumors, but while other cases only in the metastatic lymph nodes. The MIB-1 labelling index increased with tumor grade. The p53 altered group show a higher mean MIB-1 index than the non altered group's in both the primary tumors and metastatic lymph nodes. CONCLUSION: p53 gene mutation is not consistent with p53 protein expression and there are some differences in p53 gene mutation between primary tumors and metastatic lymph nodes in breast cancer. Therefore, metastatic tumor have different characteristics from those of primary tumors. In breast cancer, metastasis is regulated not only by an up- regulating mechanism but also by a down-regulating mechanism.
Biology ; Breast Neoplasms* ; Breast* ; Exons ; Genes, p53 ; Humans ; Lymph Nodes* ; Neoplasm Metastasis