PURPOSE: Breast cancer is increasing in Korea. and it has become the second most common cancer in females. This study reviewed the history of surgery and clinical analysis with follow up result on 2,677 cases of breast cancer operated at the Gospel Hospital during the 50-year period 1951 to 2000 was performed. METHODS: We reviewed breast cancer cases by operative record datas and previous reports of our hospital during the 50-year period. RESULTS: Minimal age was 14 years old and Maximal age was 90 years old in all cases. The total count of operation was 2,677 cases during the 50-year period (1951~2000). In 1951, the hospital was opened. In 1953, 52-year old female was operated by mammary amputation. In 1958, 47-year old female was operated by radical mastectomy. In 1976, 50-year old female was operated by modified radical mastectomy. Since 1996, radical mastectomy has not been operated any more. Radical mastectomy was performed in 234 cases (8.7%), modified radical mastectomy in 2,164 cases (81.0%), simple mastectomy in 79 cases (3.0%), partial mastectomy with axillary dissection in 90 cases (3.4%), wide excision in 110 cases (4.0%) Overall 5 year survival rate was 41.5% (1970~1982), 79.0% (1983~1993), 82.3% (1994~2000). CONCLUSION: This study shows the fact that the incidence of breast cancer is increasing and the minimal age is getting younger and the maximal age is getting older. The treatment for breast cancer is changing according to the period. also it will be developing.
Adolescent ; Aged, 80 and over ; Amputation ; Breast Neoplasms* ; Breast* ; Female ; Follow-Up Studies ; Humans ; Incidence ; Korea ; Mastectomy, Modified Radical ; Mastectomy, Radical ; Mastectomy, Segmental ; Mastectomy, Simple ; Middle Aged ; Survival Rate

PURPOSE: In Korea, the incidence of breast cancer is continuously growing year after year, and it has become the second most common cancer in females following stomach cancer. This study analyzed the clinical results of 2,101 breast cancer surgeries performed in Korea. METHODS: 2,101 breast cancer surgeries were performed between Mar. 1989 and Dec. 1999 at the Breast Clinic in Asan Medical Center. RESULTS: Of 2,101 patients, 2,085 cases were female (99.2%), and 16 cases were male (0.8%). The mean age of the patients was 46 and 65% of them were under the age of 50. A radical mastectomy was performed in 1.0% of cases, a modified radical mastectomy in 75.4%, a simple mastectomy in 4.1%, breast-conserving surgery in 15.5%, and other procedures in 3.9%. Immediate breast reconstruction was performed in 136 cases (tissue expander in 61 cases, direct implant in 10 cases, transverse rectus abdominis muscle (TRAM) flap in 62 cases, and latissimus dorsi myocutaneous flap in 3 cases). The majority of reconstruction was changed to skin-sparing mastectomy (SSM) with TRAM flap. According to TNM classification, there were 156 cases (7.4%) of stage 0, 538 cases (25.6%) of stage I, 1,062 cases (50.6%) of stage II, 241 cases (11.5%) of stage III, 65 cases (3.1%) of stage IV, and 39 cases (1.9%) of an unknown stage. The axillary lymph node metastasis was present in 43.2%. The 5-year overall and disease-free survival rates were 83.1% and 76.7%, respectively. CONCLUSION: This study shows several features suggesting that the peak age of breast cancer in Korea is younger than that seen in western countries and that the types of Korean breast cancer tend to be similar to western patterns.
Breast Neoplasms* ; Breast* ; Chungcheongnam-do ; Classification ; Disease-Free Survival ; Female ; Humans ; Incidence ; Korea* ; Lymph Nodes ; Male ; Mammaplasty ; Mastectomy ; Mastectomy, Modified Radical ; Mastectomy, Radical ; Mastectomy, Segmental ; Mastectomy, Simple ; Myocutaneous Flap ; Neoplasm Metastasis ; Rectus Abdominis ; Stomach Neoplasms ; Superficial Back Muscles

PURPOSE: In Korea, the incidence of breast cancer is continuously growing year after year, and it has become the second most common cancer in females following stomach cancer. This study analyzed the clinical results of 2,101 breast cancer surgeries performed in Korea. METHODS: 2,101 breast cancer surgeries were performed between Mar. 1989 and Dec. 1999 at the Breast Clinic in Asan Medical Center. RESULTS: Of 2,101 patients, 2,085 cases were female (99.2%), and 16 cases were male (0.8%). The mean age of the patients was 46 and 65% of them were under the age of 50. A radical mastectomy was performed in 1.0% of cases, a modified radical mastectomy in 75.4%, a simple mastectomy in 4.1%, breast-conserving surgery in 15.5%, and other procedures in 3.9%. Immediate breast reconstruction was performed in 136 cases (tissue expander in 61 cases, direct implant in 10 cases, transverse rectus abdominis muscle (TRAM) flap in 62 cases, and latissimus dorsi myocutaneous flap in 3 cases). The majority of reconstruction was changed to skin-sparing mastectomy (SSM) with TRAM flap. According to TNM classification, there were 156 cases (7.4%) of stage 0, 538 cases (25.6%) of stage I, 1,062 cases (50.6%) of stage II, 241 cases (11.5%) of stage III, 65 cases (3.1%) of stage IV, and 39 cases (1.9%) of an unknown stage. The axillary lymph node metastasis was present in 43.2%. The 5-year overall and disease-free survival rates were 83.1% and 76.7%, respectively. CONCLUSION: This study shows several features suggesting that the peak age of breast cancer in Korea is younger than that seen in western countries and that the types of Korean breast cancer tend to be similar to western patterns.
Breast Neoplasms* ; Breast* ; Chungcheongnam-do ; Classification ; Disease-Free Survival ; Female ; Humans ; Incidence ; Korea* ; Lymph Nodes ; Male ; Mammaplasty ; Mastectomy ; Mastectomy, Modified Radical ; Mastectomy, Radical ; Mastectomy, Segmental ; Mastectomy, Simple ; Myocutaneous Flap ; Neoplasm Metastasis ; Rectus Abdominis ; Stomach Neoplasms ; Superficial Back Muscles

PURPOSE: In Korea, the incidence of breast cancer is continuously growing year after year, and it has become the second most common cancer in females following stomach cancer. This study analyzed the clinical results of 2,101 breast cancer surgeries performed in Korea. METHODS: 2,101 breast cancer surgeries were performed between Mar. 1989 and Dec. 1999 at the Breast Clinic in Asan Medical Center. RESULTS: Of 2,101 patients, 2,085 cases were female (99.2%), and 16 cases were male (0.8%). The mean age of the patients was 46 and 65% of them were under the age of 50. A radical mastectomy was performed in 1.0% of cases, a modified radical mastectomy in 75.4%, a simple mastectomy in 4.1%, breast-conserving surgery in 15.5%, and other procedures in 3.9%. Immediate breast reconstruction was performed in 136 cases (tissue expander in 61 cases, direct implant in 10 cases, transverse rectus abdominis muscle (TRAM) flap in 62 cases, and latissimus dorsi myocutaneous flap in 3 cases). The majority of reconstruction was changed to skin-sparing mastectomy (SSM) with TRAM flap. According to TNM classification, there were 156 cases (7.4%) of stage 0, 538 cases (25.6%) of stage I, 1,062 cases (50.6%) of stage II, 241 cases (11.5%) of stage III, 65 cases (3.1%) of stage IV, and 39 cases (1.9%) of an unknown stage. The axillary lymph node metastasis was present in 43.2%. The 5-year overall and disease-free survival rates were 83.1% and 76.7%, respectively. CONCLUSION:This study shows several features suggesting that the peak age of breast cancer in Korea is younger than that seen in western countries and that the types of Korean breast cancer tend to be similar to western patterns.
Breast Neoplasms* ; Breast* ; Chungcheongnam-do ; Classification ; Disease-Free Survival ; Female ; Humans ; Incidence ; Korea* ; Lymph Nodes ; Male ; Mammaplasty ; Mastectomy ; Mastectomy, Modified Radical ; Mastectomy, Radical ; Mastectomy, Segmental ; Mastectomy, Simple ; Myocutaneous Flap ; Neoplasm Metastasis ; Rectus Abdominis ; Stomach Neoplasms ; Superficial Back Muscles

Tamoxifen is a nonsteroidal triphenylethylene delivative that has been widely used in the treatment of breast cancer. tamoxifen is indicated for the adjuvant treatment of breast cancer in women following total mastectomy or segmental mastectomy, breast irradiation and chemotherapy. tamoxifen has been shown to have significant benificial effect in the treatment of breast cancer patient as hormonal therapy. However ,there is mounting evidence that tamoxifen may affect other hormon sensitive organs, including the uterus and ovaries. An increased risk of endometrial polyps, endometrial hyperplasia and adenocarcinoma has been reported in tamoxifen treated women. We have met cases of endometrial polyp and endocervical polyp which were associated with tamoxifen use, after modified radical mastectomy for infilterating ductal carcinoma of breast . So we report these cases with the brief review of literatures.
Adenocarcinoma ; Breast ; Breast Neoplasms ; Carcinoma, Ductal ; Drug Therapy ; Endometrial Hyperplasia ; Female ; Humans ; Mastectomy, Modified Radical ; Mastectomy, Segmental ; Mastectomy, Simple ; Ovary ; Polyps* ; Tamoxifen* ; Uterus

BACKGROUND: With no current method of prevention available, early detection of breast cancer by regular self and clinical examination in conjunction with screening mammography is emphasized. The rate of asymptomatic breast cancer detection has been increased due to the ability of mammography. METHODS: To address questions about the biology and clinical manifestation of mammographically detected breast cancer, a retrospective analysis was performed to the 31 cases of asymptomatic breast cancer treated from Jan. 1989 to Dec. 1996 at Department of Surgery, Seoul National University Hospital. RESULTS: The mean age was 50.0 with ranges from 27 to 80. The peak age was 5th decade. The most common mammographic findings of asymptomatic breast cancer was microcalcification (22 cases, 71.1%). Eighteen patients underwent modified radical mastectomy (58.1%): simple mastectomy in 4 cases (12.9%), and breast conserving surgery in 9 cases (29.0%). The histologic types were as follows: infiltrating ductal carcinoma in 17 cases (64.5%), microinvasive carcinoma in 3 cases (9.6%) and ductal carcinoma in situ in 9 cases (29.0%). Twenty one patients showed smaller than 1 cm in tumor size. Only 3 cases of invasive ductal carcinomas had axillary nodal metastasis. All cases except four cases demonstrated stage 0 (29.1%) and stage I (54.8%) according to the AJCC classification: whereas the rate of stage 0 and I in symptomatic patients during same study period was 4.1% and 19.6% respectively. CONCLUSIONS: The result of our study indicate that several benefits of mammographic screening are likely the result of detection of invasive carcinoma at an early stage and detection of noninvasive carcinoma that may later develop into or mark increased risk of invasive carcinoma. A prospective and systematic approach for evaluating efficiency of screening mammography would be necessary in Korea.
Biology ; Breast Neoplasms* ; Breast* ; Carcinoma, Ductal ; Carcinoma, Intraductal, Noninfiltrating ; Classification ; Humans ; Korea ; Mammography ; Mass Screening ; Mastectomy, Modified Radical ; Mastectomy, Segmental ; Mastectomy, Simple ; Neoplasm Metastasis ; Retrospective Studies ; Seoul

PURPOSE: Breast-conserving surgery (BCS) shows no difference in survival rates compared with total mastectomy. So, BCS is considered standard breast surgery with modified radical mastectomy. But in patients who received BCS, there is a risk of local recurrence in their long term follow up periods. Especially, BCS of young age is controversial regarding oncologic safety because of local recurrence. In this study, we struggle to confirm the oncologic safety of BCS compared with total mastectomy under the age of 35 in South Korea.METHODS: All patients who underwent surgery for breast cancer were 5,366 at Severance Hospital, Yonsei University Health System, from January 1981 to April 2008. Of them, patients younger than 35 years old were 547. We excluded patients who received chemotherapy before surgery and included only stage 1 and 2 patients who identified through the pathology after surgery. Finally, we got 367 patients; total mastectomy was performed in 245 and BCS, in 122. We compared clinicopathological characteristics and oncologic outcomes between two groups using SPSS program.RESULTS: In patients received BCS, a local recurrence rate was 7.7% at 5 years and up to 20.3% at 10 years. In patients received total mastectomy, a local recurrence rate was 1.9% over 10 years (P<0.001). However, there was no difference in 5-year and 10-year overall survival rates between two groups (P=0.689). Adjuvant chemotherapy decreased local recurrence rate in BCS patients (P=0.019).CONCLUSION: So, we concluded that BCS under the age of 35 has oncologic safety with undergoing chemotherapy.
Age Factors ; Breast Neoplasms ; Breast ; Chemotherapy, Adjuvant ; Drug Therapy ; Follow-Up Studies ; Humans ; Korea ; Mastectomy, Modified Radical ; Mastectomy, Segmental ; Mastectomy, Simple ; Neoplasm Recurrence, Local ; Pathology ; Recurrence ; Survival Rate

PURPOSE: Screening mammography is now a widely used procedure and as result, the incidence of ductal carcinoma in situ (DCIS) of the breast is increasing. The purpose of this study was to investigate the incidence and clinicopathologic features of DCIS and to evaluated the difference of clinical characteristics between breast conserving surgery and mastectomy. METHODS: We reviewed the clinical record of 112 patients with DCIS, including those with microinvasion, who were treated at the Department of Surgery, Keimyung University Hospital from January 1992 to December 2005. RESULTS: The incidence of DCIS and microinvasive carcinoma was 8.0% of all the breast cancers. The most prevalent age was in the fifth decade and the mean age was 48.8 years old. An abnormality on routine health screening exams was the most common cause of detection. Preoperatively, the diagnostic methods were fine needle aspiration biopsy in 7.6%, core needle biopsy in 19.0%, needle localization open biopsy in 33.3% and excisional biopsy in 40.0%. The surgical procedures were modified radical mastectomy or simple mastectomy in 48.2% and a breast conservation procedure in 51.8%. The final surgical margin status showed a free margin in 83.0%, a close margin in 12.8%, and an involved margin in 4.3%. The hormonal receptor positive rate was 75.3% and the c-erbB-2 positive rate was 32.9%. The patient who received mastectomy had a larger tumor size, a more common presentation of microcalcification on MMG, a more frequent comedo type lesion and a lesser expression of hormonal receptor. There was no significant difference between the two groups in terms of the c-erbB-2 expression. CONCLUSION: The widespread use of screening mammography will increase the chance to detect DCIS, and conservative surgery will be performed more frequently in a selected group of these patients.
Biopsy ; Biopsy, Fine-Needle ; Biopsy, Large-Core Needle ; Breast Neoplasms ; Breast* ; Carcinoma, Ductal* ; Carcinoma, Intraductal, Noninfiltrating* ; Humans ; Incidence ; Mammography ; Mass Screening ; Mastectomy ; Mastectomy, Modified Radical ; Mastectomy, Segmental ; Mastectomy, Simple ; Needles

PURPOSE: The combination of conservative surgery and radiotherapy is currently accepted as the preferred treatment for most patents with clinical stage I or II breast cancer. However, there is large amount of controversy concerning the optimal means of selecting patients and the details of the treatment technique. Breast cancer patients are being treated both in university hospitals and in community hospitals. Generally, the radiation therapy is not available in many community hospitals. Radiation therapy, which generally follows either a mastectomy or conservative surgery, is an important procedure. Therefore, the type of hospital facilities may influence which surgical procedures are selected. The authors conducted this study to analyse the current patterns of care for early invasive breast cancer in a hospital without a radiation therapy unit, even though the patient could receive such treatment from another affiliated hospital. METHODS: 131 cases of stage I and II breast cancer patients were reviewed between 1987 and 1997, and the types of treatments including surgery, radiation therapy and systemic therapy, were analysed retrospectively. RESULTS: The surgical procedures used were mainly a modified radical mastectomy (124/131, 94.7%), followed by breast conservation surgery (4/131, 3.1%), a total mastectomy (2/131, 1.5%) and a radical mastectomy (1/131, 0.8%). Radiation therapy was applied to 19 stage II patients (N=105), but not to any of the stage I patients (N=26). Systemic adjuvant therapy was done with chemotherapy (39/131, 29.8%), hormone therapy (17/131, 13.0%) and a combination of both modalities (67/131, 51.1%), with an exception of 8 cases. CONCLUSION: Breast conservation therapy for breast cancer patients was underutilized. The selection of the therapeutic method may be influenced by the facilities of the particular hospital. For proper treatment of early stage breast cancer, a surgeon must keep in close contact with bothe a radiologist and a radiotherapist, even in other affiliated hospitals.
Breast Neoplasms* ; Breast* ; Drug Therapy ; Hospitals, Community ; Hospitals, University ; Humans ; Mastectomy ; Mastectomy, Modified Radical ; Mastectomy, Radical ; Mastectomy, Simple ; Radiotherapy ; Retrospective Studies

PURPOSE: The combination of conservative surgery and radiotherapy is currently accepted as the preferred treatment for most patents with clinical stage I or II breast cancer. However, there is large amount of controversy concerning the optimal means of selecting patients and the details of the treatment technique. Breast cancer patients are being treated both in university hospitals and in community hospitals. Generally, the radiation therapy is not available in many community hospitals. Radiation therapy, which generally follows either a mastectomy or conservative surgery, is an important procedure. Therefore, the type of hospital facilities may influence which surgical procedures are selected. The authors conducted this study to analyse the current patterns of care for early invasive breast cancer in a hospital without a radiation therapy unit, even though the patient could receive such treatment from another affiliated hospital. METHODS: 131 cases of stage I and II breast cancer patients were reviewed between 1987 and 1997, and the types of treatments including surgery, radiation therapy and systemic therapy, were analysed retrospectively. RESULTS: The surgical procedures used were mainly a modified radical mastectomy (124/131, 94.7%), followed by breast conservation surgery (4/131, 3.1%), a total mastectomy (2/131, 1.5%) and a radical mastectomy (1/131, 0.8%). Radiation therapy was applied to 19 stage II patients (N=105), but not to any of the stage I patients (N=26). Systemic adju-vant therapy was done with chemotherapy (39/131, 29.8%), hormone therapy (17/131, 13.0%) and a combination of both modalities (67/131, 51.1%), with an exception of 8 cases. CONCLUSION:Breast c0onservation therapy for breast cancer patients was underutilized. The selection of the therapeutic method may be influenced by the facilities of the particular hospital. For proper treatment of early stage breast cancer, a surgeon must keep in close contact with bothe a radiologist and a radiotherapist, even in other affiliated hospitals.
Breast Neoplasms* ; Breast* ; Drug Therapy ; Hospitals, Community ; Hospitals, University ; Humans ; Mastectomy ; Mastectomy, Modified Radical ; Mastectomy, Radical ; Mastectomy, Simple ; Radiotherapy ; Retrospective Studies