1.Association of Breast Tissue Composition on Preoperative Automated Breast Ultrasound With Accuracy of Cancer Multiplicity Evaluation and Recurrence-Free Survival in Patients With Early-Stage Breast Cancer
Myoung Kyoung KIM ; Haejung KIM ; Sun-Young BAEK ; Eun Young KO ; Boo-Kyung HAN ; Eun Sook KO ; Jeongmin LEE ; Nami CHOI ; Jin CHUNG ; Ji Soo CHOI
Korean Journal of Radiology 2026;27(2):97-110
Objective:
To investigate whether breast tissue composition on preoperative automated breast ultrasound (ABUS) is associated with the accuracy of cancer multiplicity evaluation and postoperative recurrence-free survival (RFS) in patients with early-stage breast cancer.
Materials and Methods:
This retrospective analysis included women with early-stage breast cancer (clinical Tis, T1–2/N0) who underwent ABUS and digital mammography (DM) between October 2019 and April 2021. Tissue composition on ABUS was assessed using the Breast Imaging Reporting and Data System background echotexture (BE) (homogeneous-fat, homogeneous-fibroglandular, or heterogeneous). In a subgroup of patients with mammographically dense breasts, the glandular tissue component (GTC) on ABUS were further stratified into high (moderate or marked) or low (minimal or mild).Multivariable logistic and Cox regression analyses were used to identify factors associated with accurate cancer multiplicity categorization (unifocal, multifocal/multicentric, or bilateral) using ABUS + DM, and with RFS, respectively.
Results:
Among 409 women (mean age ± standard deviation, 50.2 ± 8.7 years), ABUS combined with DM yielded accurate cancer multiplicity categorization in 368 patients (90.0%). Neither BE nor GTC on ABUS affected the accuracy of categorization when ABUS was combined with DM. Over a median postoperative follow-up of 3.5 years, 11 recurrences occurred. Heterogeneous BE on ABUS (hazard ratio [HR] 11.24 [95% confidence interval [CI]: 2.82–44.92]; P = 0.001), BRCA mutation (HR 15.94 [2.47–102.97]; P = 0.004), and pathologic index cancer size (HR per 1-cm increase 1.91 [1.13–3.23];P = 0.02) was independently associated with RFS. In patients with dense breasts, heterogeneous BE (HR 14.17 [95% CI:2.69–74.60]; P = 0.002) and high GTC (HR 10.32 [2.35–45.28]; P = 0.002) on ABUS, BRCA mutation (HR 24.34 [2.75– 215.06]; P = 0.004), and pathologic cancer size (HR per 1-cm increase 2.62 [1.50–4.59]; P = 0.001) was independently associated with RFS.
Conclusion
In patients with early-stage breast cancer, heterogeneous BE and high GTC on preoperative ABUS, along with larger cancer size and BRCA mutation, was associated with worse RFS. However, BE and GTC did not affect cancer multiplicity evaluation when ABUS was used in combination with DM.
2.Impact of including weekend days on dietary intake patterns in Korean adults with metabolic syndrome: a secondary data analysis
Journal of Korean Biological Nursing Science 2026;28(1):133-146
This study examined the impact of including weekend days in 24-hour dietary recalls on dietary intake patterns and investigated associations between dietary intake—analyzed using nutrient- and food-group–based categories—and cardiovascular risk factors in adults with metabolic syndrome (MetS). Methods: A cross-sectional study analyzed data from 185 adults aged 40-69 years with metabolic syndrome (MetS), who had either a history of cardiovascular disease or an intermediate-to-high 10-year cardiovascular disease risk. Dietary intake was assessed over three days using 24-hour dietary recalls and analyzed with CAN-Pro 4.0. Results: Overall dietary intake did not differ significantly according to the number of weekend days included, except food-group–based protein intake (p = .030). In the no-weekend group, most nutrients and food groups demonstrated relatively consistent correlations between the 3-day average intake and single-day intake (r ≥ .61). In contrast, correlation coefficients varied widely among groups that included weekend days (r = −.08 to .97). Further analyses stratified by specific weekend days (saturdays, sundays, and national holidays) revealed significant differences in nutrient-based protein intake (F = 3.38, p = .011). Both nutrient- and food-group–based dietary intakes were significantly associated with cardiovascular risk factors. Conclusion: The number of weekend days included in dietary assessment may influence estimated dietary intake. The observed variability across specific weekend days suggests that using multiple 24-hour dietary assessments and developing nutritional interventions that explicitly account for weekend schedules would improve the accuracy of dietary pattern assessment and the effectiveness of interventions in individuals with MetS.
3.Impact of adding preoperative magnetic resonance imaging to ultrasonography on male breast cancer survival: a matched analysis with female breast cancer
Jeongmin LEE ; Ka Eun KIM ; Myoung Kyoung KIM ; Haejung KIM ; Eun Sook KO ; Eun Young KO ; Boo-Kyung HAN ; Ji Soo CHOI
Ultrasonography 2025;44(1):72-82
Purpose:
The study investigated whether incorporating magnetic resonance imaging (MRI) alongside ultrasonography (US) in the preoperative evaluation is associated with differing survival outcomes between male and female breast cancer patients in a matched analysis. Additionally, clinicopathological prognostic factors were analyzed.
Methods:
Between January 2005 and December 2020, 93 male and 28,191 female patients who underwent breast surgery were screened. Exact matching analysis was conducted for age, pathologic T and N stages, and molecular subtypes. The clinicopathological characteristics and preoperative imaging methods of the matched cohorts were reviewed. Disease-free survival (DFS) and overall survival (OS) were assessed using Kaplan-Meier analysis, and Cox proportional hazards regression analysis was used to identify prognostic factors.
Results:
A total of 328 breast cancer patients (61 men and 267 women) were included in the matched analysis. Male patients had worse DFS (10-year DFS, 70.6% vs. 89.2%; P=0.001) and OS (10-year OS, 64.4% vs. 96.3%; P<0.001) than female patients. The pathologic index cancer size (hazard ratio [HR], 2.013; 95% confidence interval [CI], 1.063 to 3.810; P=0.032) was associated with worse DFS, whereas there were no significant factors associated with OS. Adding MRI to US for preoperative evaluation was not associated with DFS (HR, 1.117; 95% CI, 0.223 to 5.583; P=0.893) or OS (HR, 1.529; 95% CI, 0.300 to 7.781; P=0.609) in male patients.
Conclusion
Adding breast MRI to US in the preoperative evaluation was not associated with survival outcomes in male breast cancer patients, and the pathologic index cancer size was associated with worse DFS.
4.Impact of adding preoperative magnetic resonance imaging to ultrasonography on male breast cancer survival: a matched analysis with female breast cancer
Jeongmin LEE ; Ka Eun KIM ; Myoung Kyoung KIM ; Haejung KIM ; Eun Sook KO ; Eun Young KO ; Boo-Kyung HAN ; Ji Soo CHOI
Ultrasonography 2025;44(1):72-82
Purpose:
The study investigated whether incorporating magnetic resonance imaging (MRI) alongside ultrasonography (US) in the preoperative evaluation is associated with differing survival outcomes between male and female breast cancer patients in a matched analysis. Additionally, clinicopathological prognostic factors were analyzed.
Methods:
Between January 2005 and December 2020, 93 male and 28,191 female patients who underwent breast surgery were screened. Exact matching analysis was conducted for age, pathologic T and N stages, and molecular subtypes. The clinicopathological characteristics and preoperative imaging methods of the matched cohorts were reviewed. Disease-free survival (DFS) and overall survival (OS) were assessed using Kaplan-Meier analysis, and Cox proportional hazards regression analysis was used to identify prognostic factors.
Results:
A total of 328 breast cancer patients (61 men and 267 women) were included in the matched analysis. Male patients had worse DFS (10-year DFS, 70.6% vs. 89.2%; P=0.001) and OS (10-year OS, 64.4% vs. 96.3%; P<0.001) than female patients. The pathologic index cancer size (hazard ratio [HR], 2.013; 95% confidence interval [CI], 1.063 to 3.810; P=0.032) was associated with worse DFS, whereas there were no significant factors associated with OS. Adding MRI to US for preoperative evaluation was not associated with DFS (HR, 1.117; 95% CI, 0.223 to 5.583; P=0.893) or OS (HR, 1.529; 95% CI, 0.300 to 7.781; P=0.609) in male patients.
Conclusion
Adding breast MRI to US in the preoperative evaluation was not associated with survival outcomes in male breast cancer patients, and the pathologic index cancer size was associated with worse DFS.
5.Impact of adding preoperative magnetic resonance imaging to ultrasonography on male breast cancer survival: a matched analysis with female breast cancer
Jeongmin LEE ; Ka Eun KIM ; Myoung Kyoung KIM ; Haejung KIM ; Eun Sook KO ; Eun Young KO ; Boo-Kyung HAN ; Ji Soo CHOI
Ultrasonography 2025;44(1):72-82
Purpose:
The study investigated whether incorporating magnetic resonance imaging (MRI) alongside ultrasonography (US) in the preoperative evaluation is associated with differing survival outcomes between male and female breast cancer patients in a matched analysis. Additionally, clinicopathological prognostic factors were analyzed.
Methods:
Between January 2005 and December 2020, 93 male and 28,191 female patients who underwent breast surgery were screened. Exact matching analysis was conducted for age, pathologic T and N stages, and molecular subtypes. The clinicopathological characteristics and preoperative imaging methods of the matched cohorts were reviewed. Disease-free survival (DFS) and overall survival (OS) were assessed using Kaplan-Meier analysis, and Cox proportional hazards regression analysis was used to identify prognostic factors.
Results:
A total of 328 breast cancer patients (61 men and 267 women) were included in the matched analysis. Male patients had worse DFS (10-year DFS, 70.6% vs. 89.2%; P=0.001) and OS (10-year OS, 64.4% vs. 96.3%; P<0.001) than female patients. The pathologic index cancer size (hazard ratio [HR], 2.013; 95% confidence interval [CI], 1.063 to 3.810; P=0.032) was associated with worse DFS, whereas there were no significant factors associated with OS. Adding MRI to US for preoperative evaluation was not associated with DFS (HR, 1.117; 95% CI, 0.223 to 5.583; P=0.893) or OS (HR, 1.529; 95% CI, 0.300 to 7.781; P=0.609) in male patients.
Conclusion
Adding breast MRI to US in the preoperative evaluation was not associated with survival outcomes in male breast cancer patients, and the pathologic index cancer size was associated with worse DFS.
6.Impact of adding preoperative magnetic resonance imaging to ultrasonography on male breast cancer survival: a matched analysis with female breast cancer
Jeongmin LEE ; Ka Eun KIM ; Myoung Kyoung KIM ; Haejung KIM ; Eun Sook KO ; Eun Young KO ; Boo-Kyung HAN ; Ji Soo CHOI
Ultrasonography 2025;44(1):72-82
Purpose:
The study investigated whether incorporating magnetic resonance imaging (MRI) alongside ultrasonography (US) in the preoperative evaluation is associated with differing survival outcomes between male and female breast cancer patients in a matched analysis. Additionally, clinicopathological prognostic factors were analyzed.
Methods:
Between January 2005 and December 2020, 93 male and 28,191 female patients who underwent breast surgery were screened. Exact matching analysis was conducted for age, pathologic T and N stages, and molecular subtypes. The clinicopathological characteristics and preoperative imaging methods of the matched cohorts were reviewed. Disease-free survival (DFS) and overall survival (OS) were assessed using Kaplan-Meier analysis, and Cox proportional hazards regression analysis was used to identify prognostic factors.
Results:
A total of 328 breast cancer patients (61 men and 267 women) were included in the matched analysis. Male patients had worse DFS (10-year DFS, 70.6% vs. 89.2%; P=0.001) and OS (10-year OS, 64.4% vs. 96.3%; P<0.001) than female patients. The pathologic index cancer size (hazard ratio [HR], 2.013; 95% confidence interval [CI], 1.063 to 3.810; P=0.032) was associated with worse DFS, whereas there were no significant factors associated with OS. Adding MRI to US for preoperative evaluation was not associated with DFS (HR, 1.117; 95% CI, 0.223 to 5.583; P=0.893) or OS (HR, 1.529; 95% CI, 0.300 to 7.781; P=0.609) in male patients.
Conclusion
Adding breast MRI to US in the preoperative evaluation was not associated with survival outcomes in male breast cancer patients, and the pathologic index cancer size was associated with worse DFS.
7.Impact of adding preoperative magnetic resonance imaging to ultrasonography on male breast cancer survival: a matched analysis with female breast cancer
Jeongmin LEE ; Ka Eun KIM ; Myoung Kyoung KIM ; Haejung KIM ; Eun Sook KO ; Eun Young KO ; Boo-Kyung HAN ; Ji Soo CHOI
Ultrasonography 2025;44(1):72-82
Purpose:
The study investigated whether incorporating magnetic resonance imaging (MRI) alongside ultrasonography (US) in the preoperative evaluation is associated with differing survival outcomes between male and female breast cancer patients in a matched analysis. Additionally, clinicopathological prognostic factors were analyzed.
Methods:
Between January 2005 and December 2020, 93 male and 28,191 female patients who underwent breast surgery were screened. Exact matching analysis was conducted for age, pathologic T and N stages, and molecular subtypes. The clinicopathological characteristics and preoperative imaging methods of the matched cohorts were reviewed. Disease-free survival (DFS) and overall survival (OS) were assessed using Kaplan-Meier analysis, and Cox proportional hazards regression analysis was used to identify prognostic factors.
Results:
A total of 328 breast cancer patients (61 men and 267 women) were included in the matched analysis. Male patients had worse DFS (10-year DFS, 70.6% vs. 89.2%; P=0.001) and OS (10-year OS, 64.4% vs. 96.3%; P<0.001) than female patients. The pathologic index cancer size (hazard ratio [HR], 2.013; 95% confidence interval [CI], 1.063 to 3.810; P=0.032) was associated with worse DFS, whereas there were no significant factors associated with OS. Adding MRI to US for preoperative evaluation was not associated with DFS (HR, 1.117; 95% CI, 0.223 to 5.583; P=0.893) or OS (HR, 1.529; 95% CI, 0.300 to 7.781; P=0.609) in male patients.
Conclusion
Adding breast MRI to US in the preoperative evaluation was not associated with survival outcomes in male breast cancer patients, and the pathologic index cancer size was associated with worse DFS.
8.Associations of depression, daily singing, and healthy lifestyle on the risk of dysphagia and frailty among community-dwelling older adults: A cross-sectional correlation study
Journal of Korean Gerontological Nursing 2025;27(4):427-438
This study examined the risk of dysphagia and frailty in community-dwelling older adults and identified related factors including general characteristics, depression, daily singing, and healthy lifestyle. Methods: A descriptive correlational study was conducted with 183 older adults aged 65 or older from senior and welfare centers in Korea. Data were collected through self-reported questionnaires between January and February 2025. Measurements included risk of dysphagia, frailty, depression, and healthy lifestyle (smoking, drinking, exercise, and nutrition). Data were analyzed using descriptive statistics, Chi-square test, t-tests, ANOVA, Pearson’s correlation, and multiple regression. Results: The prevalence of pre-frailty was 46.4% (n=85), and the risk of dysphagia was 30.6% (n=56). Dysphagia risk, frailty, depression, daily singing, and healthy lifestyle showed significant correlations. The number of comorbid conditions (β=.26, p<.001), depression (β=.16, p=.037), nutrition (β=-.16, p=.040) were significant predictors of risk of dysphagia with an adjusted R2 of 20.0% (F=8.58, p<.001). For frailty, significant predictors were dysphagia risk (β=.27, p<.001), number of comorbid conditions (β=.23, p<.001), nutrition (β=-.22, p<.001), high school education or above (β=-.15, p=.010), and physical activity (β=-.15, p=.006), with an adjusted R2 of 49.9% (F=13.92, p<.001). Conclusion: The number of comorbid conditions, dysphagia risk, nutritional status, and physical activity were identified as major influencing factors of frailty. Screening for dysphagia risk among older adults with multiple comorbidities, along with interventions to improve nutrition and physical activity, may contribute to the prevention of dysphagia and frailty in this population.
9.Impact of Grit, Teamwork, Organizational Communication Competence, Perception of Patient Safety Culture on Patient Safety Nursing Activities in Integrated Nursing Care Units
Journal of Korean Academy of Nursing Administration 2025;31(3):237-248
This study examined factors influencing patient safety nursing activities in integrated nursing care units. Methods: A survey was conducted with 134 nurses from hospitals (100~300 beds) in Busan using self-administered questionnaires (August 17–September 15, 2024). Data were analyzed using descriptive statistics, Pearson correlation, and multiple regression analysis. Results: The mean score for patient safety nursing activities was 4.31±0.55. Positive correlations were found with grit, teamwork, communication, and patient safety culture awareness. The predictor variables explained 46.0% of the variance in patient safety nursing activities. Significant factors included communication (β=.31, p=.032) and leadership (β=.29, p=.035) within teamwork, incident reporting frequency (β=.24, p<.001) within patient safety culture awareness, and experience in patient safety education (β=.17, p=.018). Conclusion: The findings of this study highlight the importance of enhancing teamwork, particularly in leadership and communication, and creating a safety culture that promotes incident reporting and education to strengthen patient safety nursing practices. Improving patient safety training, developing systematic evaluation and feedback mechanisms, and establishing structured support systems through campaigns and workshops will boost staff involvement and elevate the quality of patient safety practices.
10.Information-Motivation-Behavioral Skill model-based physical restraint education program for nursing care providers in long-term care hospitals: A quasi-experimental repeated measures non-equivalent control group design
Journal of Korean Gerontological Nursing 2024;26(3):288-301
This study aimed to develop a physical restraints education program using the Information-Motivation-Behavioral Skill (IMB) model and examine its effects on physical restraint-related knowledge, attitudes, nursing practices, and person-centered care of nursing care providers in long-term care hospitals. Methods: A nonequivalent control group repeated measures quasi-experimental design was used. The participants were 54 nursing care providers (intervention group=27, control group=27) in long-term care hospitals from B city. The IMB model-based education program was developed and implemented once a week for 3 weeks. The program involved brain writing, lectures, poster or slogan creation, writing diary to reduce the use of restraint, and shouting slogans. Data were collected using self-reported questionnaires at pretest, immediately after the program completed (3 weeks after pretest), and 4 weeks after completing the program (7 weeks after pretest). Analysis was conducted using χ²-test, Fisher’s exact test, t-test, Mann-Whitney U-test, and repeated measures ANCOVA with the SPSS/WIN 28.0 program. Results: The participants consisted of nurses (40.7%), nursing assistants (40.7%), and care workers (18.5%). The education program had statistically significant effects on knowledge (F=46.38, p<.001), attitude (F=42.70, p<.001), nursing practice (F=31.29, p<.001), and person-centered care (F=27.74, p<.001) regarding physical restraints. The intervention’s effects remained for 4 weeks after the completion of the intervention. Conclusion: This education program effectively enhanced nursing care providers’ knowledge, attitude, nursing practice, and person-centered care concerning physical restraints. Future research is warranted to provide a regularly repeated program and evaluate the direct effects on the frequency of physical restraints for nursing care providers in long-term care hospitals.

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