A 59-year-old woman displayed multiple palpable right breast masses along with ipsilateral cervical and axillary lymphadenopathy. She had a previous history of bilateral salpingo-oopho- rectomy for serous papillary adenocarcinoma two and half years ago. She underwent mastectomy for the lesions located in the upper inner breast quadrant. A 1 cm-sized primary ductal carcinoma was present; however, the other breast lesions and the metastatic axillary lymph nodes were confirmed as showing papillary serous adenocarcinoma, which were similar to the previous ovarian tumor. After the patient underwent postoperative adjuvant chemotherapy, of 8 cycles of doxorubicin and docetaxel, she has been stable during the clinical follow-up for 10 months with decreases in size of the metastatic nodules.
Adenocarcinoma ; Adenocarcinoma, Papillary* ; Breast* ; Carcinoma, Ductal* ; Carcinoma, Ductal, Breast ; Chemotherapy, Adjuvant ; Doxorubicin ; Female ; Follow-Up Studies ; Humans ; Lymph Nodes ; Lymphatic Diseases ; Mastectomy ; Middle Aged ; Neoplasms, Multiple Primary ; Ovarian Neoplasms

PURPOSE: This study analyzed factors affecting local recurrences in AGES low risk papillary thyroid carcinomas (PTCs). METHODS: The clinical records of 89 patients who underwent thyroidectomy because of PTC were reviewed. Seventy patients had belonged to low risk PTC according to the AGES classification scheme. The clinical data of these patients concerning disease recurrence was analyzed considering age, gender, operative methods, tumor size, lymph node (LN) metastasis, postoperative radioactive iodine scan (RI scan ¹³¹I), and Synthyroid® intake. RESULTS: Of the 70 patients, 56 were female (80%). Thirtyseven patients underwent total thyroidectomy with central neck LN dissection and 33 patients underwent partial thyroidectomy with ipsilateral central neck LN dissection. Mean tumor size was 2 cm (0.4~6 cm) and 31 patients had LN metastasis. Levels were <1µg/L in all patients who underwent total thyroidectomy but were 1~10µg/L in patients who received partial thyroidectomy thyroglobulin. Local recurrencein AGES low risk papillary carcinomas was significantly associated with tumor size >2 cm (P=0.030) and partial thyroidectomy (P=0.045). There was no significant association between local recurrence and age, gender, extrathyroidal extension, LN metastasis, RI scan ¹³¹I, or Synthyroid® intake. CONCLUSION: Partial thyroidectomy and tumor size >2 cm are significantly associated with local recurrence in AGES low risk papillary thyroid carcinomas.
Carcinoma, Papillary ; Classification ; Female ; Humans ; Iodine ; Lymph Nodes ; Neck ; Neoplasm Metastasis ; Recurrence* ; Thyroglobulin ; Thyroid Gland* ; Thyroid Neoplasms* ; Thyroidectomy

PURPOSE: Axillary lymph node metastasis (ALNM) can occur even in breast cancer smaller than 2 cm in size. This study was performed to investigate the clinicopathologic factors that affect node metastasis in T1 breast cancer. METHODS: We reviewed the medical record of 206 T1 breast cancer patients and we divided them into two groups according to the presence or absence of lymph node metastasis. We analyzed the association between ALNM and various clinicopathological predictive factors such as age, tumor size (T1a, T1b, T1c), multiplicity, the histologic grade, the nuclear grade, the presence of lymphovascular invasion (LVI), the estrogen and progesterone receptor status, an HER2/neu expression, the Ki-67 labeling index and the bcl-2 expression. RESULTS: One hundred and thirty-nine were the node negative group (T1N0) and the remaining 67 cases were allotted to the node positive group (T1N1-3). On the univariate analysis, age (p=0.011), LVI (p<0.001), histologic grade (p=0.019), HER2/neu (p<0.005), Ki-67 (p=0.012) and bcl-2 (p=0.026) were the statistically significant predictive factors related to node metastasis. But on the multivariate analysis, LVI (p<0.001) and HER2/neu (p=0.009) were the statistically significant factors related to node metastasis. CONCLUSION: LVI and HER2/neu overexpression were related to the increased incidence of ALNM in T1 breast cancer patients. LVI was the most predictive factor of ALNM.
Breast ; Breast Neoplasms ; Estrogens ; Humans ; Incidence ; Lymph Nodes ; Medical Records ; Multivariate Analysis ; Neoplasm Metastasis ; Receptors, Progesterone

Background: Although myocardial thickness is an important variable for therapeutic catheter ablation of cardiac arrhythmias, quantification of wall thickness has been overlooked. We developed a software (AMBER) that measures 3D-myocardial thickness using a cardiac computed tomogram (CT) image, verified its accuracy, and tested its clinical feasibility. Methods: We generated 3D-thickness maps by calculating wall thickness (WT) from the CT images of 120 patients’ hearts and a 3D-phantom model (PhM). The initial vector field of the Laplace equation was oriented to calculate WT with the field lines derived from the 3D mesh. We demonstrate the robustness of the Laplace WT algorithm by comparing with the real thickness of 3D-PhM, echocardiographically measured left ventricular (LV) WT, and regional left atrial (LA) WT reported from previous studies. We conducted a pilot case of catheter ablation for atrial fibrillation (AF) utilizing real-time LAWT map-guided radiofrequency (RF) energy titration. Results: AMBER 3D-WT had excellent correlations with the real thickness of the PhM (R = 0.968, p < 0.001) and echocardiographically measured LVWT in 10 patients (R = 0.656, p = 0.007). AMBER 3D-LAWT (n = 120) showed a relatively good match with 12 previously reported regional LAWT. We successfully conducted pilot AF ablation utilizing AMBER 3D-LAWT map-guided real-time RF energy titration. Conclusion We developed and verified an AMBER 3D-cardiac thickness map measured by cardiac CT images for LAWT and LVWT, and tested its feasibility for RF energy titration during clinical catheter ablation.

PURPOSE: There are few reports from Asian countries about the long-term results of aromatase inhibitor adjuvant treatment for breast cancer. This observational study aimed to evaluate the long-term effects of letrozole in postmenopausal Korean women with operable breast cancer. METHODS: Self-reported quality of life (QoL) scores were serially assessed for 3 years during adjuvant letrozole treatment using the Korean version of the Functional Assessment of Cancer Therapy-Breast questionnaires (version 3). Changes in bone mineral density (BMD) and serum cholesterol levels were also examined. RESULTS: All 897 patients received the documented informed consent form and completed a baseline questionnaire before treatment. Adjuvant chemotherapy was administered to 684 (76.3%) subjects, and 410 (45.7%) and 396 (44.1%) patients had stage I and II breast cancer, respectively. Each patient completed questionnaires at 3, 6, 12, 18, 24, 30, and 36 months after enrollment. Of 897 patients, 749 (83.5%) completed the study. The dropout rate was 16.5%. The serial trial outcome index, the sum of the physical and functional well-being subscales, increased gradually and significantly from baseline during letrozole treatment (p<0.001). The mean serum cholesterol level increased significantly from 199 to 205 after 36 months (p=0.042). The mean BMD significantly decreased from −0.39 at baseline to −0.87 after 36 months (p<0.001). CONCLUSION: QoL gradually improved during letrozole treatment. BMD and serum cholesterol level changes were similar to those in Western countries, indicating that adjuvant letrozole treatment is well tolerated in Korean women, with minimal ethnic variation.
Aromatase ; Asian Continental Ancestry Group ; Bone Density ; Breast Neoplasms* ; Breast* ; Chemotherapy, Adjuvant ; Cholesterol ; Consent Forms ; Female ; Humans ; Observational Study ; Quality of Life*