breast cancer (CBC) and ipsilateral breast tumor recurrence (IBTR) and investigated the predictive factors for CBC and IBTR in breast cancer patients with BRCA mutations and non-carriers at high-risk of hereditary breast and ovarian cancer (HBOC).METHODS: We analyzed prospectively collected clinical data of patients with unilateral breast cancer who were at high-risk for HBOC and were tested for the BRCA mutation between 2003 and 2013.RESULTS: The cohort comprised 540 patients with 45 BRCA1 carriers, 50 BRCA2 carriers, and 445 non-carriers. The median follow-up was 84.5 months. Overall, 61 patients (11.3%) developed CBC (24.4% for BRCA1 carriers, 20% for BRCA2 carriers, and 9% for non-carriers). The 10-year cumulative risk for CBC was 23.8% for BRCA1 carriers, 19.1% for BRCA2 carriers, and 9.8% for non-carriers (p = 0.174). Among the 277 patients who underwent breast-conserving surgery, 29 (10.5%) developed IBTR (9.1% for BRCA1 carriers, 16.7% for BRCA2 carriers, and 10.2% for non-carriers). The 10-year cumulative risk for IBTR for BRCA1 carriers, BRCA2 carriers, and non-carriers was 8.7%, 14.1%, and 20%, respectively (p = 0.577). BRCA1 (hazard ratio [HR], 2.94; 95% confidence interval [CI], 1.20–7.20; p = 0.019) and BRCA2 (HR, 2.88; 95% CI, 1.13–7.35; p = 0.027) mutations and negative estrogen receptor status (HR, 4.02; 95% CI, 1.60–10.08; p = 0.003) were the significant predictive factors for CBC, while tumor size ≥ 2 cm was predictive of IBTR (HR, 6.11; 95% CI, 2.03–18.33; p = 0.001).CONCLUSION: While BRCA1/2 mutation carriers had a higher risk of developing CBC compared to non-carriers at high-risk of HBOC, the risk of IBTR was similarly high across breast cancer patients irrespective of the BRCA mutation. Further preventive strategies to reduce CBC and IBTR for all patients at high-risk of HBOC should be investigated.]]>
Breast Neoplasms ; Breast ; Cohort Studies ; Estrogens ; Follow-Up Studies ; Genes, BRCA1 ; Genes, BRCA2 ; Hereditary Breast and Ovarian Cancer Syndrome ; Humans ; Mastectomy, Segmental ; Ovarian Neoplasms ; Prospective Studies ; Recurrence ; Risk Factors ; Unilateral Breast Neoplasms

Breast carcinomas are an uncommon neoplastic condition in men, accounting for only 1% of all breast cancers, and less than 1% of all malignancies in men. A 70-year-old man who presented a right breast mass was found to have infiltrating ductal carcinoma. We herein report the case with a review of the literature.
Aged ; Breast Neoplasms ; Breast* ; Carcinoma, Ductal* ; Humans ; Male*

This study is aimed at preparing basic data required for establishment of a cancer screening program by examining the status of cancer screenings performed by residents in a community and the factors that have an effect on determination for a cancer screening by residents. Cervix, breast and stomach cancers were chosen as target cancers of the study due to the fact that merits of screening for these cancers have been proved by studies done in different countries. In order to find out the status of cancer screening and the factors having an effect on the determination for a cancer screening, 10 Dongs and a total of 1988 people were selected as study area and subjects by a random cluster sampling method, and the subjects were questioned on different aspects by questionnaires. Additionally, in order to find out how cancer screening is performed at medical facilities and how cancer screening is recommended by doctors, medical facilities doing cancer screening were also questioned. The results of the study are as follows: 1. In the case of the screening of the stomach cancer, 16.1% of male subjects and 25.6% of female subjects turned out to have had one or more screening for the cancer. In the cases of the breast and the cervical cancers, 21.6% and 62.6% of the subjects turned out to have had one or more screenings respectively. 2. As to the screening for the stomach cancer, there was a tendency that more of the subjects with lower level education, excepting those without education, had themselves screened for the cancer. Higher screening rates were shown by the subjects in higher ages, those who visited doctors regularly. 3. As to the screening rate by education levels, a high rate of screening was shown by the subjects with above-university education level and there was not a big difference between the screenings done for high school graduates and for those with lower education levels. Regarding the rates of screening by age groups the screening rate turned out to be higher with the higher ages. Screening rates, checked on the basis of the income levels, did not show a big differences between income levels. 4. The highest rate of screening for the breast cancer was shown by the subjects with postgraduate level of education and regarding the rate by income level, a slightly higher level was shown by the subjects with the monthly income of the 2,010,000 won, but the difference between the rates of screening by subjects at different income levels was overall not significant. 5. The rates for selecting the health screening facilities were higher in orders of the reasons that 1) they were close: 2) service was excellent and 3) equipment and facilities were good. Based on the above-mentioned results obtained by the study, it is anticipated that this study will play a vital role as basic data for the development and execution of cancer screening program for a community, and the analysis, done on the basis of the status of the cancer screening, of the factors related to the determination for the cancer screening showed that for the development of a cancer screening program, factors like income levels, education levels, whether people consult doctors regularly and the local government' care for health in a community should be considered, and in addition to which active participation of doctors in the program is also requested.
Breast ; Breast Neoplasms ; Early Detection of Cancer* ; Education ; Female ; Humans ; Male ; Mass Screening ; Stomach Neoplasms ; Uterine Cervical Neoplasms ; Surveys and Questionnaires

PURPOSE: To perform a medical audit of screening mammography for breast cancer and to determine the benefit of this procedure for the early detection of this condition. MATERIALS AND METHODS:We reviewed the results of 43,329 instances of mammography in 36,802 women [18-86 (mean, 46) years old] who underwent the procedure at our health promotion center between January 1995 and December 1998. After reviewing the mammographic reports, we selected ACR BI-RADS assessment cate-gories 0, 4, 5, and then reviewed the follow-up studies and the pathologic results thus obtained. By comparison with the total number of patients diagnosed with breast cancer during the same period, false negative cases were confirmed, and from these data a medical audit was performed. RESULTS: The percentage of women undergoing mammographic examination has increased in recent years (from 64.5% in 1995 to 97.4% in 1998), and cases of breast cancer among those aged 30 to 69 has tended to increase. A total of 1,879 cases were assessed as BI-RADS categories 0, 4, 5, and of these, 155 were recommended for biopsy or surgery. A confirmatory pathologic diagnosis was obtained in 106 cases, and in 43 of these, breast cancer was pathologically proven. The recall rate was 5.1%, and the cancer detection rate was 1.2/1000 population. Positive predictive value 1(PPV1) was found in 2.3% of cases, PPV2 in 27.7%, and PPV3 in 40.6%. The most common mammographic finding was microcalcification (40.5%), and a pathological finding of invasive ductal carcinoma was found in 66.7% of cases. Patients diagnosed with breast cancer totalled 47 (four cases were false negative); the estimated sensitivity was 91.5%, with a specificity of 95.0%. The percentage of minimal cancers found was 48.8, while that of axillary node-positive invasive cancers was 33.3. The total rate of axillary nodal metastasis was 22.0%, and the rate of stages 0 and I was 73.2%. CONCLUSION: When appropriate interpretation and follow-up monitoring of screening mammography is per-formed, the procedure is effective for the early detection of breast cancer.
Biopsy ; Breast Neoplasms ; Carcinoma, Ductal ; Diagnosis ; Early Detection of Cancer ; Female ; Follow-Up Studies ; Health Promotion ; Humans ; Mammography* ; Mass Screening* ; Medical Audit ; Neoplasm Metastasis ; Sensitivity and Specificity

Breast carcinoma in men is very rare but a potentially serious neoplasm. We report herein a case of male breast carcinoma presented with a mobile asymptomatic nodule on the chest in a 73-year-old man. Histopathologic diagnosis was invasive ductal carcinoma of a male breast.
Aged ; Breast ; Breast Neoplasms ; Breast Neoplasms, Male* ; Carcinoma, Ductal ; Diagnosis ; Humans ; Male ; Male* ; Multiple Endocrine Neoplasia Type 1 ; Thorax*

PURPOSE: This study was undertaken to examine the impact of screening and race on breast cancer outcomes in Singapore. METHODS: An institutional database was reviewed, and invasive ductal carcinoma (IDC) and ductal carcinoma in situ (DCIS) data were analyzed separately. Overall survival (OS), disease-free survival (DFS), and cancer-specific survival (CSS) were assessed. RESULTS: The study included 6,180 IDC and 1,031 DCIS patients. The median follow-up time was 4.1 years. Among IDC patients, Malay women were the youngest when first diagnosed, and were more likely to present with advanced stage disease. Malay women also had the highest proportion of T3 and T4 tumors at 14.2%, compared with Chinese women at 8.7% and Indian women at 9.6% (p<0.001). Malay women had a higher incidence of node-positive disease at 58.3% compared with Chinese women at 46.4% and Indian women at 54.9% (p<0.001). Malay subjects also had higher-grade tumors; 61.8% had grade 3 tumors compared with 45.8% of Chinese women and 52% of Indian women (p<0.001). Furthermore, tumors in Malay subjects were less endocrine-sensitive and more human epidermal growth factor receptor 2 enriched. Malay women had the lowest 5- and 10-year OS, DFS, and CSS rates (p<0.001). After separating clinically and screen-detected tumors, multivariate analysis showed that race was still significant for outcomes. For screen-detected tumors, the OS hazard ratio (HR) for Malay women compared to Chinese women was 5.78 (95% confidence interval [CI], 2.64–12.64), the DFS HR was 2.18 (95% CI, 1.19–3.99), and the CSS HR was 5.93 (95% CI, 2.15–16.39). For DCIS, there were no statistically significant differences in the tumor size, grade, histology subtypes, or hormone sensitivity. CONCLUSION: Malay race is a poor prognostic factor in both clinically and screen-detected IDC. Special attention should be given to the detection and follow-up of breast cancer in this group.
Asian Continental Ancestry Group ; Breast Neoplasms* ; Breast* ; Carcinoma, Ductal ; Carcinoma, Intraductal, Noninfiltrating ; Continental Population Groups ; Disease-Free Survival ; Early Detection of Cancer ; Ethnic Groups ; Female ; Follow-Up Studies ; Humans ; Incidence ; Mass Screening* ; Multivariate Analysis ; Prognosis ; Receptor, Epidermal Growth Factor ; Singapore

Breast Neoplasms ; diagnosis ; genetics ; pathology ; Carcinoma, Ductal, Breast ; diagnosis ; genetics ; pathology ; Centromere ; genetics ; Chromosomes, Human, Pair 17 ; genetics ; Early Detection of Cancer ; methods ; Female ; Gene Amplification ; Gene Dosage ; Genes, erbB-2 ; Humans ; Immunohistochemistry ; In Situ Hybridization ; standards ; Receptor, ErbB-2 ; genetics

PURPOSE: The Korean National Cancer Screening Survey (KNCSS) is a nationwide survey conducted annually, since 2004. This study was conducted in order to report on trends in rates of cancer screening for five major cancers-stomach, liver, colorectal, breast, and cervix uteri in Korea. MATERIALS AND METHODS: Data collected by the KNCSS between 2004 and 2011 were used in this study. The eligible study population included cancer-free men who were 40 years old and over, and women who were 30 years old and over. Lifetime screening rate, screening rate with recommendation, and changes in annual rates were calculated. RESULTS: Both lifetime screening rates and screening rates with recommendation have increased since 2004. On average, screening rates with recommendation have shown an annual increase of 4.2% (95% CI, 3.3 to 5.2%) for stomach cancer, 1.1% (95% CI, -0.5 to 2.7%) for liver cancer, 2.2% (95% CI, 0.8 to 3.6%) for colorectal cancer, 4.0% (95% CI, 3.0 to 4.9%) for breast cancer, and 0.2% (95% CI, -0.9 to 1.3%) for cervical cancer. Increases in rates of cancer screening, with the exception of liver and cervical cancers, were significant, and screening rates for stomach and breast cancer in particular showed a marked increase. CONCLUSION: Cancer screening rates among Koreans showed a consistent increase from 2004 to 2011 and rates of screening for gastric, breast, and cervical cancer are approaching 70%.
Breast ; Breast Neoplasms ; Cervix Uteri ; Colorectal Neoplasms ; Early Detection of Cancer ; Female ; Humans ; Liver ; Liver Neoplasms ; Male ; Mass Screening ; Stomach ; Stomach Neoplasms ; Uterine Cervical Neoplasms

PURPOSE: The National Cancer Screening Program (NCSP) in Korea supports cancer screening for stomach, liver, colorectal, breast, and cervical cancer. This study was conducted to assess trends in participation rates among Korean men and women invited to undergo screening via the NCSP as part of an effort to guide future implementation of the program in Korea. MATERIALS AND METHODS: Data from the NCSP for 2002 to 2012 were used to calculate annual participation rates with 95% confidence intervals (CI) by sex, insurance status, and age group for stomach, liver, colorectal, breast, and cervical cancer screening. RESULTS: In 2012, participation rates for stomach, liver, colorectal, breast, and cervical cancer screening were 47.3%, 25.0%, 39.5%, 51.9%, and 40.9%, respectively. The participation rates increased annually by 4.3% (95% CI, 4.0 to 4.6) for stomach cancer, 3.3% (95% CI, 2.5 to 4.1) for liver cancer, 4.1% (95% CI, 3.2 to 5.0) for colorectal cancer, 4.6% (95% CI, 4.1 to 5.0) for breast cancer, and 0.9% (95% CI, –0.7 to 2.5) for cervical cancer from 2002 to 2012. CONCLUSION: Participant rates for the NCSP for the five above-mentioned cancers increased annually from 2002 to 2012.
Breast ; Breast Neoplasms ; Colorectal Neoplasms ; Early Detection of Cancer* ; Female ; Humans ; Insurance Coverage ; Korea* ; Liver ; Liver Neoplasms ; Male ; Mass Screening ; Stomach ; Stomach Neoplasms ; Uterine Cervical Neoplasms

PURPOSE: The National Cancer Screening Program (NCSP) in Korea supports cancer screening for stomach, liver, colorectal, breast, and cervical cancer. This study was conducted to assess trends in participation rates among Korean men and women invited to undergo screening via the NCSP as part of an effort to guide future implementation of the program in Korea. MATERIALS AND METHODS: Data from the NCSP for 2002 to 2012 were used to calculate annual participation rates with 95% confidence intervals (CI) by sex, insurance status, and age group for stomach, liver, colorectal, breast, and cervical cancer screening. RESULTS: In 2012, participation rates for stomach, liver, colorectal, breast, and cervical cancer screening were 47.3%, 25.0%, 39.5%, 51.9%, and 40.9%, respectively. The participation rates increased annually by 4.3% (95% CI, 4.0 to 4.6) for stomach cancer, 3.3% (95% CI, 2.5 to 4.1) for liver cancer, 4.1% (95% CI, 3.2 to 5.0) for colorectal cancer, 4.6% (95% CI, 4.1 to 5.0) for breast cancer, and 0.9% (95% CI, –0.7 to 2.5) for cervical cancer from 2002 to 2012. CONCLUSION: Participant rates for the NCSP for the five above-mentioned cancers increased annually from 2002 to 2012.
Breast ; Breast Neoplasms ; Colorectal Neoplasms ; Early Detection of Cancer* ; Female ; Humans ; Insurance Coverage ; Korea* ; Liver ; Liver Neoplasms ; Male ; Mass Screening ; Stomach ; Stomach Neoplasms ; Uterine Cervical Neoplasms