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Current Understanding of Endocrine Therapy for Breast Cancer.

Journal of Korean Breast Cancer Society.2002;5(3):212-216. doi:10.4048/jkbcs.2002.5.3.212

In the treatment of breast cancer, especially in estrogen receptor (ER) positive patients, endocrine therapy has played an important role since bilateral oophorectomy, the first endocrine therapy, was performed by George Thomas Beaston in 1896. Thereafter, various therapeutic modalities such as radiation therapy to ovaries, surgical or medical adrenalectomy, or hypophysectomy, have been used for endocrine therapy in breast cancer. The discovery of ER and the development of anti-estrogens represent substantial progress, and tamoxifen, the first selective ER modulator, has become the gold standard in the endocrine therapy of breast cancer. The therapeutic effects of tamoxifen were confirmed by the 1995 Oxford overview. Recently, the 7th International Conference on Adjuvant Therapy of Primary Breast Cancer held in St. Gallen, Switzerland, recognized the increasing role played by endocrine therapy in properly selected patients groups, especially in younger patients with ER-positive tumors. In addition, recent advances in estrogen research and ER function at the molecular level have provided new strategies as well as a better understanding of endocrine therapy for breast cancer. Lately, new hormonal agents, such as the third-generation aromatase inhibitors, and ER downregulators, showed equivalent or better results in terms of therapeutic effects than tamoxifen. As a result, many clinical trials are ongoing to determine the most appropriate endocrine therapy for breast cancer. Therefore, it is important to maximize the benefits of endocrine therapy in clinical practice in terms of the patient's quality of life as well as the prolongation of patient survival. More studies are needed to determine optimal agents and the duration of therapy, combinations of agents or sequences of therapy according to prognostic and predictive factors.
Adrenalectomy ; Aromatase Inhibitors ; Breast Neoplasms* ; Breast* ; Estrogens ; Female ; Humans ; Hypophysectomy ; Ovariectomy ; Ovary ; Quality of Life ; Switzerland ; Tamoxifen

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Epidemiological Characteristics of Breast Cancer in Korea.

Keun Young YOO ; Aesun SHIN

Journal of Korean Breast Cancer Society.2002;5(3):209-211. doi:10.4048/jkbcs.2002.5.3.209

No abstract available.
Breast Neoplasms* ; Breast* ; Korea*

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Genetic Susceptibility of Breast Cancer in Korea: Molecular Epidemiological Approaches.

Dae Hee KANG ; Dong Young NOH

Journal of Korean Breast Cancer Society.2002;5(3):202-208. doi:10.4048/jkbcs.2002.5.3.202

No abstract available.
Breast Neoplasms* ; Breast* ; Genetic Predisposition to Disease* ; Korea*

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Frequency of BRCA1 and BRCA2 Germline Mutations Detected by Protein Truncation Test and Cumulative Risks of Breast and Ovarian Cancer among Mutation Carriers in Japanese Breast Cancer Families.

Noriko IKEDA ; Yasuo MIYOSHI ; Noriko IKEDA ; Kohri YONEDA ; Moritoshi KINOSHITA ; Shinzaburo NOGUCHI

Journal of Korean Breast Cancer Society.2002;5(3):194-201. doi:10.4048/jkbcs.2002.5.3.194

The purpose of this investigation is to study the frequency and penetrance of BRCA1 and BRCA2 germline mutations in Japanese familial breast cancer patients. Mutation analysis of BRCA1 and BRCA2 by protein truncation test was conducted on the 120 breast cancer patients (probands) with at least one breast cancer (site-specific breast cancer families, n=105) or one ovarian cancer (breast/ovarian cancer families, n=15) patient in their first-degree relatives. Eight BRCA1 (7.6%) and ten BRCA2 (9.5%) mutations were found in site-specific breast cancer families (n=105), and seven BRCA1 (46.7%) but no BRCA2 (0%) mutations were found in breast/ovarian cancer families (n=15). In site-specific breast cancer families, mutation frequency of BRCA1 and BRCA2 was high in families with more than three breast cancer patients (30%, 6/20), early onset (40< or = years old) breast cancer patients (41.1%, 14/34), or bilateral breast cancer patients (40%, 6/15). Cumulative incidence of breast cancer by age 70 was estimated to be 78% and 80% for BRCA1 and BRCA2 mutation carriers, respectively, and that of ovarian cancer was 40% and 0% for BRCA1 and BRCA2 mutation carriers, respectively. Family profiles are important determinants of risk for carrying a BRCA1 or BRCA2 mutation. Japanese women with BRCA1 mutation have a high risk of breast and ovarian cancer and those with BRCA2 mutation have a high risk of breast cancer but not ovarian cancer.
Asian Continental Ancestry Group* ; Breast Neoplasms* ; Breast* ; Female ; Germ-Line Mutation* ; Humans ; Incidence ; Mutation Rate ; Ovarian Neoplasms* ; Penetrance

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Surgery of Breast Cancer during the Last 5 Years: More Sophisticated and Specialized?.

Virgillio SACCHINI

Journal of Korean Breast Cancer Society.2002;5(3):189-193. doi:10.4048/jkbcs.2002.5.3.189

No abstract available.
Breast Neoplasms* ; Breast*

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A Case of Malignant Melanoma Presenting as a Breast Mass.

Tae Yun KIM ; Man Kyu CHAE ; Hyung Hwan KIM ; Sung Yong KIM ; Moo Jun BAEK ; Moon Soo LEE ; Chang Ho KIM ; Eui Han KIM ; Min Hyuk LEE ; Moo Sik CHO ; Ok Pyung SONG

Journal of Korean Breast Cancer Society.2003;6(1):35-38. doi:10.4048/jkbcs.2003.6.1.35

Malignant melanomas arising in the skin, buccal mucous membranes. and retina are encountered frequently. A malignant melanoma characteristically disseminates widely but infrequently metastasizes to the breast, and primary melanoma of the breast is even rarer. Primary melanomas can arise in the glandular tissue of the breast. We report a case of malignant melanoma either primary in the breast or metastatic from an unknown primary that presented initially as a left breast mass without a detectable cutaneous lesion.
Breast* ; Melanoma* ; Mucous Membrane ; Retina ; Skin

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The Necessity of Learning Period for Sentinel Lymphadenectomy in Breast Carcinoma.

Jin Wook CHOI ; Hy De LEE ; Byeong Woo PARK ; Woo Hee JUNG ; Ki Keun OH ; Yong Hoon RYU

Journal of Korean Breast Cancer Society.2003;6(1):29-34. doi:10.4048/jkbcs.2003.6.1.29

PURPOSE: Although an axillary lymph node dissection (ALND) has been considered as an ultimate procedure for axilla in the breast carcinoma, complications after ALND and conceptual revolution for the role of axillary nodes have made it necessary to look for an alternative. Recent studies of sentinel lymphadenectomy (SLND) have shown that SLND accurately predict axillary nodal status. However, for a satisfying outcome in SLND, a learning period would be required, as other surgical procedures do. In this study, the necessity of the learning period for SLND were examined. METHODS: From Nov. 1998 to Dec. 2001, 178 patients with invasive breast carcinoma were treated with SLND simultaneously followed by ALND. The period for the first 54 patients, Nov. 1998 to May. 1999, was set as a 'learning period'. Differences of the detection rate and the false negative rate for the 'learning period' and 'after the learning period' were compared. Also changes in the detection rate and the false negative rate with the accumulated experiences for SLND were evaluated. RESULTS: The sentinel lymph nodes were not identified in 5 patients through the whole period. Three of them occurred in the 'learning period' (5.6%, 3/54) and the rest occurred 'after the learning period' (1.6%, 2/124)(P=0.04). The false negative rate was 16.7% (4/24) in the 'learning period' and 0.0% in 'after the learning period' (P=0.00). The detection rate and the false negative rate improved with the accumulation of experiences for SLND. CONCLUSION: It is certain that 'learning period' for SLND is crucial. During this period, the improvement and stabilization of this skill is achieved.
Axilla ; Breast Neoplasms* ; Breast* ; Humans ; Learning* ; Lymph Node Excision* ; Lymph Nodes

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Decrease in Pulse Oximeter Readings Following Injection of Isosulfan Blue Dye.

Ji Kun KIM ; Soo Yong PARK ; Myung Kook LIM ; Choong Wun LEE ; Heung Dae KIM ; Koing Bo KWUN ; Soo Jung LEE

Journal of Korean Breast Cancer Society.2003;6(1):24-28. doi:10.4048/jkbcs.2003.6.1.24

PURPOSE: A sentinel lymph node mapping with blue dye has been well accepted as a common procedure in breast cancer surgery. However, it is well known that blue dye absorbed into the circulation may interfere pulse oximetery reading. The aim of this study was to evaluate the change of pulse oximetery reading by isosulfan blue dye injection during sentinel lymph node mapping. METHODS: Thirteen breast cancer patients with normal preoperative cardiopulmonary functions were studied. Four ml of isosulfan blue dye was injected subdermally when the patient became stable after induction of general anesthesia. The pulse oximetery was monitored continuously. Multiple arterial blood gas analyses (ABGA) were performed before dye injection and 10, 30, 40 minutes after dye injection. The results of oxygen saturturation by oximetery (SpO2) and the results of arterial oxygen tension (SaO2) and arterial oxygen saturation (SaO2) by ABGA were compared. RESULTS: The value of both SaO2 and PaO2 measured by ABGA has not been altered by isosulfan dye injection. However SpO2 decreased by isosulfan dye injection. SpO2 decrease started 8.2+/-1.5 (2~0) minutes after dye injection and returned to preinjection level by 85.7+/-5.6 (60~126) minutes after injection. The lowest vaule of SpO2 was 95.6+/-1.2% (93~97). Mean duration of SpO2 decrease was 77.5+/-6.2 (40~117) minutes. The duration of SpO2 decrease was longer in the aged patients, but it was not statistically significant (p=0.3). There was no siginificant difference in duration of SpO2 decrease according to injection site, operation method, and body mass index (BMI). CONCLUSION: .Isosulfan dye injection using for sentinel lymph node mapping causes no change in true ABGA results but causes a mild reversible decrease in SpO2, It is important to look for other causes when SpO2 decrease is significant and persistent.
Anesthesia, General ; Blood Gas Analysis ; Body Mass Index ; Breast Neoplasms ; Humans ; Lymph Nodes ; Oxygen ; Reading*

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Detection of Breast Mass in Mammogram Using Computer-Aided Diagnosis System.

Myung Chul CHANG ; Chan Dong KIM ; Hye Rin ROH ; Gi Bong CHAE ; Dae Hyun YANG ; Won Jin CHOI

Journal of Korean Breast Cancer Society.2003;6(1):20-23. doi:10.4048/jkbcs.2003.6.1.20

PURPOSE: Computer-aided diagnosis system was developed to improve the accuracy and the efficacy of the image interpretation. This article is to provide a possibility of computer- aided diagnosis for detection of masses in mammograms. METHODS: The craniocaudal and mediolateral images of 120 mammograms from 30 patients that were histologically proven to be malignant and 30 patients that were histologically proven to be benign were analysed using the mammography softwere. The contralateral mammograms were used as control images. Correct marks of the lesions were scored as a true positive and marks not at the location of the lesions were scored as a false negative. Any marks of the normal images were scored as a false positive and no mark of normal images were scored as a true negative. RESULTS: It took approximately 2 min to scan and 1 min to process 24 by 18-cm mammograms. There was an average of 1.4, 2.0 and 2.1 marks per image in normal, benign and malignant mammograms respectively. Mass detection rate of malignant lesion was 90.0% (27 of 30) and that of benign lesion was 63.6% (21 of 33). Mass detection rate of dense breasts was 68.8% (22 of 32) and that of fatty breasts was 83.9% (26 of 31). Mass detection rate of BI-RADS category 4, 5 and 0 was 85.7% (42 of 49) and that of category 1, 2 and 3 was 42.9% (6 of 14). The overall sensitivity was 76.2% and specificity was 28.1%. CONCLUSION: In this study, mass detection rate for malignant lesions was higher than that of benign lesions and dense breast has lower detection rate than fatty breast. According to the BI-RADS category, mass detection rate was higher in the more malignant category. Computer-aided diagnosis system for this study had limited specificity but acceptable sensitivity.
Breast* ; Diagnosis* ; Humans ; Mammography ; Sensitivity and Specificity

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A Comparison Study between Compound Imaging and Conventional Ultrasonography in Subareolar Area.

Bo Kyoung SEO ; Hae Jeong JEON ; Jeong Hee PARK ; Kyu Ran CHO ; Ji Young LEE ; Bo Kyung JE ; Eun Jeong CHOI ; June Young LEE ; Jeoung Won BAE ; Seok Jin KIM

Journal of Korean Breast Cancer Society.2003;6(1):15-19. doi:10.4048/jkbcs.2003.6.1.15

PURPOSE: The subareolar area is often difficult to evaluate ultrasonographically due to tissue shadowing, which obscures visualization of ducts and parenchymal tissue. The purpose of this study is to determine if real-time compound imaging improves evaluation of normal subareolar tissue and solid nodules in subareolar area compared to conventional ultrasonography. METHODS: 190 images of the subareolar area were obtained from 135 patients from March 2001 to July 2002. Thirty-three of 190 images showed solid nodules, extraductal nodules in 30 and intraductal nodules in three. We scanned both conventional and compound imaging with a stationary probe, to maintain an identical projection and tissue pressure. We used two compound techniques; survey mode (S) is made by 3 coplanar images and target mode (T) by 9 coplanar images. The evaluating points were 1) reduction in the density of shadowing, 2) resolution of duct wall, 3) resolution of duct lumen, 4) margin of nodule, and 5) internal echoes of nodule. In a blinded fashion, three radiologists graded the quality of images on a 5-point scale. RESULTS: For reviewer 1/2/3, S showed grade improvements in 1) reduction in the density of shadowing (0.4+/-0.6/1.1 0.6/0.5+/-0.5), 2) resolution of duct wall (0.9+/-0.2/1.5+/-0.6/1.0+/-0.5), 3) resolution of duct lumen (0.9+/-0.2/1.6 +/-0.6/0.7+/-0.6), 4) margin of nodule (1.0+/-0.3/1.5+/-0.5/1.2+/-0.5), and 5) internal echoes of nodule (1.1+/-0.3/1.5+/- 0.5/1.2+/-0.4) and T showed grade improvements in 1) reduction in the density of shadowing (0.4+/-0.6/1.2+/-0.6/0.7+/-0.7), 2) resolution of duct wall (1.0+/-0.3/1.5+/-0.6/1.1+/-0.5), 3) resolution of duct lumen (0.9+/-0.3/1.6+/-0.6/0.8+/-0.6), 4) margin of nodule (1.0+/-0.3/1.5+/-0.6/1.2+/-0.5), and 5) internal echoes of nodule (1.1+/-0.3/1.5+/-0.6/1.3+/-0.4). In all evaluating points, two modes of real-time compound imaging were superior to conventional imaging (P<0.05). There was no significant difference between two modes of compound imaging. CONCLUSION: Real-time compound imaging improves evaluation of normal subareolar tissue and subareolar solid nodules compared to conventional ultrasonography by reducing shadowing and increasing anatomic resolution of ducts.
Breast ; Humans ; Shadowing (Histology) ; Ultrasonography*

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