No abstract available.

Immediate reconstruction of a breast after a curative mastectomy is a good alternative to a breast conserving operation and can be accomplished without altering the cancer-ablative purpose. The transversus rectus abdominis myocutaneous(TRAM) flap has proven to be the most useful autogenous tissue for restoring a breast. We evaluated 14 cases of breast cancer in which the patient underwent immediate TRAM flap reconstruction by the same surgeons who had performed the curative mastectomy. Immediate TRAM reconstruction was performed safely in all stages of breast cancer, although the majority of the patients were in stage 2. Partial necrosis of the myocutaneous flap(1 case), partial necrosis of the breast skin(1 case), hematoma(2 cases), and wound infection(1 case) developed as postoperative complications and were controlled by conservative management. Postoperative chemotherapy and chemoradiation therapy were performed in 7 cases and 4 cases, respectively, without any discernible adverse influence on the myocutaneous flap. The majority of the patients were satisfied with the reconstructed breast. Based on these results, we suggest that immediate breast reconstruction using the pedicled TRAM flap can be accomplished by the surgeon who performed the mastectomy: and will enhance cosmetic appearance without any adverse impact on curabilitly.
Breast Neoplasms ; Breast* ; Drug Therapy ; Female ; Humans ; Mammaplasty* ; Mastectomy* ; Myocutaneous Flap ; Necrosis ; Postoperative Complications ; Rectus Abdominis ; Wounds and Injuries

PURPOSE: Despite the fact that the primary factor to determine the prognosis of breast cancer is the metastatic lesion rather than the primary tumor, most studies concerning the prognostic factors related with tumoric biological behavior have focused on the primary tumors. A better understanding of changes of biological behavior in the metastatic lesions will provide a clue to more effective and rational approaches for treating metastatic breast cancer. METHODS: This study was designed to investigate the biological characteristics of metastatic cancer cells in breast cancer and to compare them to those of the primary tumors. Eighty-two breast cancer patients with metastatic axillary lymph nodes were selected for study. The evaluated tumoric biological characteristics used in this study were histologic grade, estrogen receptor, progesterone receptor, bcl-2, c- erbB2, p53, and P-glycoprotein. Evaluations were carried out with H-E and immunohistochemical stainings. The subjects were divided into positive cases and negative cases, according to extent and degree of staining. McNemar's test and Spearman's rho correlation coefficient were used for statistical analysis and cases showing a p-value of 0.05 or less were taken as being statistically significant. RESULTS: The results were as follows: 1) Metastatic nodes showed higher histologic grade than primary tumors. 2) No significant pattern was observed concerning changes in biological characteristics, including estrogen receptor, progesterone receptor, bcl-2, c-erbB2, p53, and P-glycoprotein between primary tumor and metastatic lymph nodes. 3) Neither wea any significant difference observed in biological behavior among the metastatic lymph nodes. CONCLUSION: This results indicate that the meaningful biological characteristic of metastatic lesion is higher histologic grade alone, and suggest that this change in histologic grade is the single, specific factor determineing the prognosis for metastatic breast cancer.
Breast Neoplasms* ; Breast* ; Estrogens ; Humans ; Lymph Nodes* ; P-Glycoprotein ; Population Characteristics ; Prognosis ; Receptors, Progesterone

It is deirable to identify the tumoric factors anticipating the therapeutic failure in breast cancer patients received postoperative adjuvant chemotherapy. So, we studued the tumoric topoisomerase II alpha enzyme, c-erbB-2 oncoprotein, and Pgp expression in breast cancer tissues to identify the roles of these factors as the predictors of chemotherapeutic result. The results were as follows. 1) There wee no significant differences in the average value of topoisomerase II alpha enzyme, c-erb B-2 oncoportein overexpression, and Pgp expression according to stages. 2) CAF chemotherapy was suggested to be more effective than CMF chemotherapy in more advance stages. 3) There was a possible suggestion that the breast cancer with high topoisomerase II alpha enzyme activity might indicate the failure with CMF chemotherapy. 4) C-erbB-2 oncoportein overexperession suggested the possibility of therapeutic failure with CMF chemotherapy and the selection of CAF chemotherapy might improve the survival of advanced breast cancer patients with c-erbB-2 overexpression. In conclusion, it was suggested that c-erb-2 oncopotein overexpression and high topoisomerase II alpha activity might have a meaningful role in the selection of proper chemotherapeutic regimen in setting of adjuvant chemotherapy and predict the therapeutic failure of some chemotherapeutic agents for breast cancer. An expanded study for these factors is required to reveal the clinical significance in chemotherapy for breast cancer patients.
Breast Neoplasms* ; Breast* ; Chemotherapy, Adjuvant ; DNA Topoisomerases, Type II* ; Drug Therapy* ; Humans ; P-Glycoprotein*

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: Despite the fact that the primary factor to determine the prognosis of breast cancer is the metastatic lesion rather than the primary tumor, most studies concerning the prognostic factors related with tumoric biological behavior have focused on the primary tumors. A better understanding of changes of biological behavior in the metastatic lesions will provide a clue to more effective and rational approaches for treating metastatic breast cancer. METHODS: This study was designed to investigate the biological characteristics of metastatic cancer cells in breast cancer and to compare them to those of the primary tumors. Eighty-two breast cancer patients with metastatic axillary lymph nodes were selected for study. The evaluated tumoric biological characteristics used in this study were histologic grade, estrogen receptor, progesterone receptor, bcl-2, c-erbB2, p53, and P-glycoprotein. Evaluations were carried out with H-E and immunohistochemical stainings. The subjects were divided into positive cases and negative cases, according to extent and degree of staining. McNemar's test and Spearman's rho correlation coefficient were used for statistical analysis and cases showing a p-value of 0.05 or less were taken as being statistically significant. RESULTS: The results were as follows: 1) Metastatic nodes showed higher histologic grade than primary tumors. 2) No significant pattern was observed concerning changes in biological characteristics, including estrogen receptor, progesterone receptor, bcl-2, c-erbB2, p53, and P-glycoprotein between primary tumor and metastatic lymph nodes. 3) Neither wea any significant difference observed in biological behavior among the metastatic lymph nodes. CONCLUSION: This results indicate that the meaningful biological characteristic of metastatic lesion is higher histologic grade alone, and suggest that this change in histologic grade is the single, specific factor determineing the prognosis for metastatic breast cancer.
Breast Neoplasms* ; Breast* ; Estrogens ; Humans ; Lymph Nodes* ; P-Glycoprotein ; Population Characteristics ; Prognosis ; Receptors, Progesterone

BACKGROUND: Some researchers have tried to use Tc-99m MIBI (2-methoxyisobutyl isonitril) scintigraphy to evaluate breast-cancer patients. Early reports revealed that Tc-99m MIBI breast scintigraphy was useful in distinguishing malignancies from benign masses in patients for whom mammographic evaluations were difficult. Further studies suggested that functional imaging with Tc-99m MIBI in breast cancer seemed to be correlated with the levels of P-glycoprotein (Pgp) expression and angiogenesis in cancer tissues. For that reason, we evaluated whether significant relationship actually existed between the pattern of Tc-99m MIBI uptake in tumor tissue and tumoric factors including Pgp expression and angiogenesis. METHODS: Thirty-one untreated breast-cancer patients (later pathologically proved to have had invasive ductal carcinomas) were prospectively studied by using both Tc-99m MIBI scintigraphy on and immunohistochemical analyses of angiogenesis and Pgp expression in sugically removed tumor tissues. Both lateral and anterior planar images were obtained at 10 minutes and 3 hours after intravenous injection of 740 MBq Tc-99m MIBI. The tumor-to-normal breast ratio (T/N) and the washout index (WI, early T/N minus late T/N divided by early T/N) were calculated. RESULTS: A significant correlation was found between the T/N's at early and late images (r=0.54, p=0.002 on early images; r=0.47, p=0.006 on late images). The T/N's of early images were not different among the different groups of Pgp expression (p=0.3696) while those of late images were significantly different among the groups (p=0.0276). An even more significant difference was noted in the WI's among the groups (p=0.0015). A significant negative correlation was noted between the T/N of late images and Pgp expression (p=0.0276). An even stronger correlation was found between WI and Pgp expression (r=0.668, p=0.001). CONCLUSIONS: The tumoral uptake and washout of Tc-99m MIBI can be used as a simple functional test for angiogenesis and P-glycoprotein expression in untreated breast cancer.
Breast Neoplasms* ; Breast* ; Humans ; Injections, Intravenous ; P-Glycoprotein ; Population Characteristics* ; Prospective Studies ; Radionuclide Imaging*

PURPOSE: Plasminogen Activator Inhibitor-1 (PAI-1) is the principal physiological urokinase-type plasminogen activator and is thought to regulate the overall invasive and metastatic behaviors of cancer cells. Although the occurrence of bone marrow micrometastases is an independent prognostic factor in breast cancer, its pathomechanism is not yet fully revealed until. We hypothesize that PAI-1 has a major role in the development of bone marrow micrometastases in breast cancer. Accordingly, we attempted to establish a correlation between PAI-1 activity in tumor tissues and bone marrow micrometastases in breast cancer. Additionally, we studied the relationship between PAI-1 level and selected clinicopathological characteristics such as tumor size, lymph node metastases, and steroid receptor positivity. METHODS: we used the RT-PCR targeting mRNA of cytokeratin 19 to detect bone marrow micrometastases and an ELISA kit to estimate PAI-1 activity in frozen tumor tissues. RESULTS: (1) The median PAI-1 level was 13.55 ng/ml+/- 16.38 in the cases with bone marrow metastases, and 6.02 ng/ml+/-10.85 in the cases without bone marrow micrometastases. The difference was statistically significant (p-value= 0.0165). (2) PAI-1 levels did not show any significant differ-ences according to lymph node status, variation of tumor size or the expression status of the steroid receptors. CONCLUSION: PAI-1 is considered to have a role to hematogenous metastases of breast cancer cells. However, further study is recommended to reveal its significance as an independent prognstic factor for breast cancer.
Bone Marrow* ; Breast Neoplasms* ; Breast* ; Enzyme-Linked Immunosorbent Assay ; Keratin-19 ; Lymph Nodes ; Neoplasm Metastasis ; Neoplasm Micrometastasis ; Plasminogen Activator Inhibitor 1 ; Plasminogen Activators ; Plasminogen* ; Receptors, Steroid ; RNA, Messenger ; Urokinase-Type Plasminogen Activator

No abstract available.
Humans ; Lymphocytes* ; Siblings* ; Sister Chromatid Exchange* ; Thyroid Gland* ; Thyroid Neoplasms*

PURPOSE: As neoplasia is the result of unbalanced cell growth and cell death, alternations in the growth control pathway including the immunity within the individual host-tumor relationship has been attributed to the development of breast cancer. Interferon(IFN)-gamma based immunity was recently reported to have an antitumor effect and some new methods to assess the state of interferon-gamma based immunity have been introduced. Interferon regulatory factor(IRF)-1 and interferon regulatory factor(IRF)-2 are transcriptional factors that mediate the effects of Interferon-gamma. It was suggested that the loss of IRF-1 expression is associated with the loss of tumor suppression and the development of IRF-2 expression is associated with oncogenic activation. Thus, we studied the significances of the IRF-1 and IRF-2 expressions as they are related with some clinicopathological parameters to determine the biological behavior of breast cancer including the menopausal status, tumor size, lymph node status, histologic grade, the expression of steroid receptors, the expression of c-erb B2 oncoprotein and the expression of p53 protein. METHODS: Formalin-fixed paraffin embedded specimens from 82 patients with invasive ductal carcinoma were used to evaluate the expression of IRF-1 and IRF-2 by performing immunohistochemical staining with using an avidin-biotin-peroxidase complex technique. RESULTS: The expression of IRF-1 was observed in 80.5 % of the study group. However, the expression of IRF-1 did not show any correlation with menopausal status, tumor size, histologic grade, the expression of steroid receptors, the expression of c-erb B2 oncoprotein and the p53 expression. Only lymph node metastasis showed a decreasing tendency of IRF-1 expression, but this was without statistical significance (p=0.075). The expression of IRF-2 was observed in 58.5% of the study group and it did not show any significant relationship with any of the above mentioned clinicopathological parameters. CONCLUSION: This study suggests that the expression of IRF-1 and IRF-2 does not affect the previously established parameters for determining such biological behaviors of breast cancer as the tumor size, lymph node metastasis, the histologic grade, the expression of steroid receptors, the expression of c-erb B2 and the expression of p53. In spite of these results, We'd like to recommend that another study be done to evaluate the role of IRF-1 and IRF-2 for the proper selection of the patients who are suitable for immunotherapy.
Breast Neoplasms* ; Breast* ; Carcinoma, Ductal ; Cell Death ; Humans ; Immunotherapy ; Interferon Regulatory Factors* ; Interferon-gamma ; Interferons* ; Lymph Nodes ; Neoplasm Metastasis ; Paraffin ; Receptors, Steroid