PURPOSE: Numerous non-invasive imaging methods for evaluating the chemotherapy response of breast cancer patients are currently being explored. The aim of present study was to investigate whether the washout rates (WRs) of 99mTc-MIBI could predict the response to chemotherapy in patients suffering with infiltrating ductal carcinoma using the expressions of multidrug resistance-related protein (MRP) and P-glycoprotein (Pgp). METHODS: From May 2002 and March 2004, the patients were randomly and consecutively selected according to the results of immunohistochemical analyses of breast carcinoma specimens before the administration of neoadjuvant chemotherapy. A total 45 infiltrating ductal carcinomas in 45 female patients were selected and they were separated into three groups: group A consisted of tumors with both negative Pgp and MRP expressions (n=15); group B consisted of the tumors that were positive for either a Pgp expression or a MRP expression (n=15); group C consisted of the tumors that were positive for both Pgp and MRP expressions (n=15). All the patients were referred for double phase 99mTc-MIBI mammoscintigraphy after the injection of 925 MBq of 99mTc-MIBI to calculate the WR. The tumor response was evaluated after completion of neoadjuvant chemotherapy. The tumor response was classified as a complete or partial response (the responder group) and stable or progression (the non-responder group). All the patients underwent surgery. RESULTS: The response rate of group C was lower than that of the other groups, but the difference was not statistically significant (p=0.283). The WR of non-responder group was lower than that of the responder group, although the difference was not statistically significant (p=0.674). The washout rates of group C was the highest than other groups and the difference was statistically significant (p=0.001). CONCLUSION: In conclusion, the WR of 99mTc-MIBI is helpful for in vivo determination of both the Pgp and MRP expressions for infiltrating ductal carcinoma of the breast.
Breast Neoplasms ; Breast* ; Carcinoma, Ductal* ; Drug Therapy* ; Female ; Humans ; P-Glycoprotein*

PURPOSE: We wanted to evaluate the risk factors for developing lymphedema following axillary lymph node dissection in breast cancer patients. METHODS: Ninety-six patients who underwent axillary dissection for breast cancer were followed-up for up to 1 year. Lymphedema was assessed using a serial circumferential measurement method. More than a 2 cm difference in circumference was considered as clinically significant lymphedema. The effects of age, the body mass index (BMI), the cancer stage, chemotherapy, radiotherapy, the location of cancer and creating a latissimus dorsi (LD) flap on the development of lymphedema were analyzed. RESULTS: The incidence of lymphedema was increased with the advancing cancer stage. Radiotherapy was found to increase the incidence of lymphedema. Patients who had received an LD flap showed a lower incidence of lymphedema. CONCLUSION: These results could be useful as a clinical guideline for creating a management plan for postoperative lymphedema. Because there are some differences in the results between all the relevant reports, including ours, further research is needed in the form of a large, multi-center, long-term study.
Body Mass Index ; Breast Neoplasms* ; Breast* ; Drug Therapy ; Humans ; Incidence ; Lymph Node Excision ; Lymphedema* ; Radiotherapy ; Risk Factors* ; Superficial Back Muscles

PURPOSE: The determination of HER-2/neu gene amplification has become necessary for the selection of breast cancer patients to undergo anti-HER-2/neu therapy, using a humanized monoclonal antibody. Chromogenic in situ hybridization (CISH) detection of the HER-2/neu gene, a newly developed method, utilizes a robust and unique-sequence DNA probe labeled with digoxygenin, which is sequentially incubated with antidigoxygenin fluorescein, antifluorescein peroxidase and diaminobenzidine. The aim of this study was to establish a CISH assay for the detection of HER-2/neu amplification. The results were compared with those of the immunohistochemistry (IHC) methods, most frequently used for detecting HER-2/neu alteration. METHODS: CISH was performed in 4 groups of infiltrating breast carcinomas. Each group was comprised of 20 cases in which the HER-2/neu stati had previously been scored on a four value scale: 0, 1+, 2+ and 3+ by IHC. The results of CISH and IHC were compared for each tumor group. The HER-2/neu gene amplification detected by CISH was thpically visualized as large DAB-stained clusters or by many dots in the nucleus. RESULTS: The concordance between the CISH and IHC was 95% (kappa=0.901). Three IHC-positive cases (score 2+) showed no gene amplification and one IHC-negative case (score 1+) showed gene amplification by CISH. CONCLUSION: The current study showed excellent agreement between the CISH and IHC methods. CISH is an accurate, practical and economical approach for determining the HER-2/neu stati in breast carcinomas. It is also a useful methodology for confirming the IHC results in paraffin- embedded tumor samples, so offers a promising alternative to IHC in a routine diagnostic setting.
Breast Neoplasms* ; Breast* ; DNA ; Fluorescein ; Gene Amplification ; Genes, vif ; Humans ; Immunohistochemistry ; In Situ Hybridization* ; Peroxidase

PURPOSE: The predictive value of c-erbB2 over-expression, and p53 mutation, to the response rate to neoadjuvant chemotherapy, were assessed in patients with breast cancer. METHODS: Between January 2000 and June 2002, 185 patients, with breast cancer, were put forward for two commonly used chemotherapy regimens prior to surgery. The first 135 received the CMF (cyclophosphamide 600 mg/m2, methotraxate 40 mg/m2, 5-FU 500 mg/m2) regimen, and the remaining 50 the CAF (cyclophosphamide 600 mg/m2, adriamycin 50 mg/m2, 5-FU 500 mg/m2) regimen. The expressions of the estrogen receptor (ER), progesterone receptor (PR), p53 mutation and c-erbB2, were evaluated by immunohistochemistry of needle biopsy samples prior to neoadjuvant chemotherapy. Tumor response was categorized according to the WHO criteria, using the largest diameter in ultrasonography or magnetic resonance imaging. RESULTS: The mean age of the patients in the CMF and CAF groups were 48.8 and 47.4 years. Forty eight (35.6%) and 24 (48.0%) of the patients, in the CMF and CAF groups, respectively, had pathologically partial or complete responses. The tumor size, axillary lymph nodes, lymphatic and vascular invasions, as clinicopathological factors, were significantly correlated with the response to chemotherapy in the CAF group. The absences of ER or PR were also significantly associated with a remission in both the CMF and CAF groups. p53 mutation was not correlated to the response rate of either chemotherapy regimen. There was no significant relationship between the expression of c-erbB2 and the response rate in the CMF group, but a higher percentage of patients with c-erbB2 positive tumors had a response to the CAF regimens. CONCLUSION: p53 mutation is not significantly associated with tumor response, but the over-expression of c-erbB2 can predict the response to the different chemotherapies used in breast cancer.
Biopsy, Needle ; Breast Neoplasms* ; Doxorubicin ; Drug Therapy* ; Estrogens ; Fluorouracil ; Humans ; Immunohistochemistry ; Lymph Nodes ; Magnetic Resonance Imaging ; Receptors, Progesterone ; Ultrasonography

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

No abstract available.
Breast Neoplasms* ; Breast* ; Ion Transport* ; Sodium Iodide* ; Sodium*

No abstract available.
Breast Neoplasms* ; Breast* ; Ion Transport* ; Sodium Iodide* ; Sodium*

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