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 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.
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.Prospective Multicenter Study Comparing Magnetic Resonance Imaging and Ultrasonography for Second Breast Cancer Surveillance in Women With Prior Breast Cancer and Dense Breasts: KBCSG-27 Trial
Yun-Woo CHANG ; Young Mi PARK ; Kyunga KIM ; Min-Ji KIM ; Myoung Kyoung KIM ; Jonghan YU ; Eun Sook KO
Journal of Breast Cancer 2025;28(6):427-436
Purpose:
Surveillance guidelines following breast cancer surgery recommend mammography as the sole imaging modality. However, the accuracy of mammography is low in younger women and in those with dense breast tissue. Additional imaging modalities, such as ultrasonography and magnetic resonance imaging (MRI), may offer diagnostic benefits.This prospective, multicenter study (KBCSG-27) aims to compare the diagnostic performances of mammography, ultrasonography, and MRI for detecting second breast cancer (SBC) in women with a personal history of breast cancer (PHBC) and dense breasts.
Methods
This study will recruit approximately 1,756 women, aged 20–75 years, who were treated for stage 0–III breast cancer and have dense breast tissue on mammography.Participants will undergo two annual breast screenings, each consisting of mammography, ultrasonography, and MRI. MRI will be performed using either abbreviated magnetic resonance imaging (AB-MRI) or full-protocol magnetic resonance imaging (FP-MRI), which will be randomly assigned such that each participant receives both protocols alternately.Radiologists will independently interpret all images. A combination of pathology results and 12-month follow-up will serve as the reference standard. A patient-reported outcome (PRO) tool will be used to assess patients’ experiences and preferences between AB-MRI and FPMRI. The primary objective is to compare the cancer detection rates of ultrasonography versus AB-MRI and ultrasonography versus FP-MRI. Secondary outcomes include comparisons of the invasive cancer detection rates, abnormal interpretation rates, sensitivity, specificity, positive and negative predictive values, accuracy, and interval cancer rates. Subgroup analyses will be conducted based on age, menopausal status, mammographic breast density, and molecular subtype. Additionally, PRO results of AB-MRI and FP-MRI will be compared.Discussion: This ongoing, prospective, multicenter study aims to evaluate the performance of ultrasonography, AB-MRI, and FP-MRI in SBC surveillance in women with PHBC and dense breasts. Enrollment is expected to be completed by 2025, with results anticipated after 2028.
8.Facial Dermatoses Associated With Mask-Wearing in the COVID-19 Era:A Nationwide, Cross-Sectional, Multicenter, Questionnaire-based Study
Myoung Eun CHOI ; Woo Jin LEE ; Joo Yeon KO ; Kwang Joong KIM ; Jung Eun KIM ; Hei Sung KIM ; Kui Young PARK ; Mi Youn PARK ; Dae Hun SUH ; Kihyuk SHIN ; Min Kyung SHIN ; Hyo Hyun AHN ; Weon Ju LEE ; Jee Bum LEE ; Hee Jung LEE ; Min Soo JANG ; Seung Hyun CHEONG ; Soyun CHO ; Yu Sung CHOI ; You Won CHOI ; Hoon CHOI ; Mi Woo LEE
Annals of Dermatology 2024;36(2):81-90
Background:
Daily usage of facial masks during coronavirus disease 2019 pandemic influenced on facial dermatoses.
Objective:
This study investigated the impact of mask-wearing habits on facial dermatoses.
Methods:
A nationwide, observational, questionnaire-based survey was conducted from July through August 2021, involving 20 hospitals in Korea.
Results:
Among 1,958 facial dermatoses, 75.9% of patients experienced aggravation or development of new-onset facial dermatoses after wearing masks. In aggravated or newly developed acne patients (543 out of 743), associated factors were healthcare provider, female gender, and a long duration of mask-wearing. Irritating symptoms, xerosis, and hyperpigmentation were more frequently observed in this group. Aggravated or newly developed rosacea patients (515 out of 660) were likely to be female, young, and have a long duration of mask-wearing per day. Seborrheic dermatitis patients who experienced aggravation or de novo development (132 out of 184) were younger, and they more frequently involved the chin and jaw in addition to the nasolabial folds and both cheeks. Contact dermatitis patients (132 out of 147) with aggravation or de novo development tended to be female, involve both cheeks, and complain of pruritus. Aggravated or newly developed atopic dermatitis patients (165 out of 224) were more likely to be female, and had a higher baseline investigator global assessment score before mask-wearing.
Conclusion
Clinical features and factors related to aggravation were different according to the types of facial dermatoses.
9.Analysis of Prognoses according to Breast MRI Results in Patients with Axillary Lymph Node Metastases from an Unknown Primary Origin
E-Ryung CHOI ; Ok Hee WOO ; Eun Young KO ; Boo-Kyung HAN ; Ji Soo CHOI ; Eun Sook KO ; Haejung KIM ; Myoung Kyoung KIM ; Jeong Eon LEE
Yonsei Medical Journal 2023;64(10):633-640
Purpose:
To compare the prognosis of patients with axillary adenocarcinoma from an unknown primary (ACUPax) origin with negative MRI results and those with MRI-detected primary breast cancers.
Materials and Methods:
The breast MRI images of 32 patients with ACUPax without signs of primary breast cancer on mammography and ultrasound (US) were analyzed. Spot compression-magnification mammography and second-look US were performed for the area of MRI abnormality in patients with positive results; any positive findings corresponding to the MRI abnormality were confirmed by biopsy. If suspicious MRI lesions could not be localized on mammography or US, MR-guided biopsy or excision biopsy after MR-guided localization was performed. We compared the prognosis of patients with negative breast MRI with that for patients with MRI-detected primary breast cancers.
Results:
Primary breast cancers were confirmed in 8 (25%) patients after breast MRI. Primary breast cancers were not detected on MRI in 24 (75%) patients, including five cases of false-positive MRI results. Twenty-three patients underwent axillary lymph node dissection (ALND) followed by whole breast radiation therapy (WBRT) and chemotherapy (n=17) or subsequent chemotherapy only (n=2). Recurrence or distant metastasis did not occur during follow up in 7/8 patients with MRI-detected primary breast cancers and 22/24 patients with negative MRI results. Regional recurrence or distant metastasis did not occur in any MR-negative patient who received adjuvant chemotherapy after ALND and WBRT.
Conclusion
The prognoses of MR-negative patients with ACUPax who received ALND and WBRT followed by chemotherapy were as good as those of patients with MRI-detected primary breast cancers.
10.Guselkumab Treatment for Psoriasis in Bio-Naïve and Bio-Experienced Patients:Multicenter Study Based on a 1-Year Follow-Up
Seona OH ; Su Min LEE ; Byeong Chang KO ; Jung Eun SEOL ; Un Ha LEE ; Myoung-Shin KIM ; So Young JUNG ; Minkyung OH ; Hai-Jin PARK
Korean Journal of Dermatology 2023;61(5):265-274
Background:
Guselkumab is a monoclonal antibody that selectively blocks the p19 subunit of interleukin-23. It has shown good efficacy and safety profile in several clinical trials of plaque psoriasis. However, studies on the efficacy of guselkumab in patients treated with other biologics are lacking.
Objective:
We aimed to investigate the efficacy and safety profile of guselkumab in patients with moderate-to-severe plaque psoriasis. We also compared the efficacy of guselkumab between biologic-naïve (Bio-Naïve) and biologicexperienced (Bio-Ex) patients.
Methods:
This multicenter, retrospective study included 72 patients treated with guselkumab. The patients’ clinical characteristics and psoriasis area and severity index (PASI) scores were recorded at each visit. The PASI90 and PASI100 responses and mean PASI scores were compared between the Bio-Naïve and Bio-Ex groups.
Results:
Fifty-five Bio-Naïve patients and 17 Bio-Ex patients were included in the study. At week 20, there were no significant differences in the PASI90 (64.2% vs. 53.8%) and PASI100 (28.3% vs. 15.4%) responses between the groups. However, at weeks 36 and 44, the PASI90 response (week 36: 89.2% vs. 36.4% and week 44: 97.8% vs. 63.6%) and the PASI100 response (week 36: 64.9% vs. 18.2% and week 44: 68.9% vs. 27.3%) were significantly higher in the Bio-Naïve group (p<0.05). There were no differences in PASI90 and PASI100 responses between the groups in terms of other clinical characteristics and comorbidities at week 20.
Conclusion
The efficacy of guselkumab remained consistent among patients in whom other biologics had failed. However, the efficacy was slightly lower in the Bio-Ex group than in the Bio-Naïve group.

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