OBJECTIVE: To find out whether levels of fibrin degradation products (FDP) and D-dimer are increased in breast cancer-related lymphedema (BCRL) as in many vascular diseases. FDP and D-dimer have been used in blood tests to help differentiate deep vein thrombosis in the diagnosis of lymphedema. Levels of FDP and D-dimer are often elevated in patients with BCRL. METHODS: Patients with BCRL (group I), non-lymphedema after breast cancer treatment (group II), and deep venous thrombosis (group III) from January 2012 to December 2016 were enrolled. Levels of FDP and D-dimer were measured in all groups and compared among groups. RESULTS: Mean values of FDP and D-dimer of group I were 5.614±12.387 and 1.179±2.408 μg/μL, respectively. These were significantly higher than their upper normal limits set in our institution. Levels of FDP or D-dimer were not significantly different between group I and group II. However, values of FDP and D-dimer in group III were significantly higher than those in group I. CONCLUSION: Values of FDP and D-dimer were much higher in patients with thrombotic disease than those in patients with lymphedema. Thus, FDP and D-dimer can be used to differentiate between DVT and lymphedema. However, elevated levels of FDP or D-dimer cannot indicate the occurrence of lymphedema.
Breast Neoplasms ; Breast ; Diagnosis ; Fibrin Fibrinogen Degradation Products ; Fibrin ; Hematologic Tests ; Humans ; Lymphedema ; Vascular Diseases ; Venous Thrombosis

BACKGROUND: Primary breast sarcoma (PBS) is rare, comprising approximately 1% of breast malignancies. Rhabdomyosarcoma (RMS) accounts for an extremely small proportion of PBSs, often leading to delayed histologic confirmation. METHODS: Upon reviewing Asan Medical Center’s pathology database between 2000 and 2018, 41 PBS cases were retrieved, including three cases of primary RMS of the breast. Their clinicopathological features were analyzed, and the literature related to PBS and primary RMS of the breast was reviewed. RESULTS: We identified three primary breast RMS cases from our institution database, comprising 7.3% of PBS: one case each of spindle cell/sclerosing RMS (ssRMS), alveolar RMS (aRMS), and embryonal RMS (eRMS). All cases involved adolescents or young adults (14, 16, and 25 years, respectively) who underwent mastectomy or radiotherapy and were confirmed using immunohistochemical testing for myogenin, desmin, and myogenic differentiation. The ssRMS patient experienced recurrence at the operation site 4 months post-surgery despite undergoing concurrent chemoradiotherapy. The aRMS patient had multiple metastases at diagnosis and showed FAX3-FOXO1 fusion transcripts; she died 22 months after the diagnosis. The eRMS patient had enlarged axillary lymph nodes; post-radiotherapy, the lesion recurred as multiple metastases to the bone and lung. She died 18 months post-diagnosis. CONCLUSIONS: Our experience on RMS cases suggests that spindle cell or small round cell malignancy in breasts of young female should raise suspicion for the possibility of primary or secondary RMS. To our knowledge, this is the second report of primary breast ssRMS and it may help clinicians who encounter this rare disease in the future.
Adolescent ; Arm ; Breast ; Chemoradiotherapy ; Chungcheongnam-do ; Desmin ; Diagnosis ; Female ; Humans ; Lung ; Lymph Nodes ; Mastectomy ; Myogenin ; Neoplasm Metastasis ; Pathology ; Radiotherapy ; Rare Diseases ; Recurrence ; Rhabdomyosarcoma ; Sarcoma ; Young Adult

Due to advances in the treatment and diagnosis of cancer, many women survive long after treatment, and therefore express concerns about the impact of estrogen deficiency on their quality of life. Cancer treatment can induce menopause through surgical removal of the ovaries, chemotherapy, or radiation. Women who undergo induced menopause usually experience more sudden and severe menopausal symptoms, including vasomotor symptoms, psychological symptoms, genitourinary symptoms, cardiovascular disease, and osteoporosis. Menopausal hormone therapy (MHT) is especially important in women younger than 40. In this review, we consider the role of MHT after the diagnosis of breast, gynecologic, colorectal, stomach, liver, lung, and hematologic cancers. MHT is advantageous in endometrial cancer type I, cervical squamous cell carcinoma, colorectal cancer, hepatocellular carcinoma, and hematologic malignancies. However, MHT is not recommended for use in breast cancer, endometrial stromal sarcoma, hormone receptor–positive gastric cancer, and lung cancer survivors because it is linked to an increased risk of cancer recurrence. Depending on the type of cancer, clinicians should recommend that cancer survivors receive appropriate MHT in order to reduce vasomotor symptoms and to benefit from its positive effects on the cardiovascular and skeletal systems.
Breast ; Breast Neoplasms ; Carcinoma, Hepatocellular ; Carcinoma, Squamous Cell ; Cardiovascular Diseases ; Colorectal Neoplasms ; Diagnosis ; Drug Therapy ; Endometrial Neoplasms ; Estrogens ; Female ; Hematologic Neoplasms ; Humans ; Liver ; Lung ; Lung Neoplasms ; Menopause ; Osteoporosis ; Ovary ; Quality of Life ; Recurrence ; Sarcoma, Endometrial Stromal ; Stomach ; Stomach Neoplasms ; Survivors

Metastasis of rhabdomysarcoma to the breast is a very rare manifestation in adult males. Herein, we report a case of metastasis from embryonal rhabdomyosarcoma in the left hypothenar muscle that presented as a breast mass in a 38-year-old man, who four months later expired because of multiple bone metastases related to pancytopenia. We describe the various imaging findings, including mammograms, ultrasonography, computerized tomography (CT), positron emission tomography-computed tomography (PET-CT), and magnetic resonance imaging (MRI) of this rare disease. The various imaging findings of this lesion could be helpful for future diagnosis of male breast lesions.
Adult ; Breast ; Diagnosis ; Electrons ; Humans ; Magnetic Resonance Imaging ; Male ; Neoplasm Metastasis ; Pancytopenia ; Rare Diseases ; Rhabdomyosarcoma ; Rhabdomyosarcoma, Embryonal ; Ultrasonography

PURPOSE: The purpose of this study was to estimate the clinical utilization of radiation therapy (RT) in Korea between 2011 and 2015. MATERIALS AND METHODS: We analyzed the claims data from the Health Insurance Review and Assessment Service to estimate the clinical utilization of RT. The source population consisted of all patients who had any of the International Classification of Diseases 10th revision cancer diagnoses (C00-C97) and those with diagnostic codes D00-D48, who were also associated with at least one of the procedure codes related to RT. RESULTS: The total number of patients who received RT in 2011, 2012, 2013, 2014, and 2015 were 54,810, 59,435, 61,839, 64,062, and 66,183, respectively. Among them, the total numbers of male and female patients were 24,946/29,864 in 2011, 27,211/32,224 in 2012, 28,111/33,728 in 2013, 29,312/34,750 in 2014, and 30,266/35,917 in 2015. The utilization rate of RT in cancer patients has also increased steadily over the same period from 25% to 30%. The five cancers that were most frequently treated with RT between 2011 and 2012 were breast, lung, colorectal, liver, and uterine cervical cancers. However, the fifth most common cancer treated with RT that replaced uterine cervical cancer in 2013 was prostate cancer. More than half of cancer patients (64%) were treated with RT in the capital area (Seoul, Gyeonggi, and Incheon). CONCLUSION: The total number of patients who underwent RT increased steadily from 2011 to 2015 in Korea. The utilization rate of RT in cancer patients is also increasing.
Breast ; Diagnosis ; Female ; Gyeonggi-do ; Humans ; Insurance, Health ; International Classification of Diseases ; Korea* ; Liver ; Lung ; Male ; Prostatic Neoplasms ; Radiotherapy ; Uterine Cervical Neoplasms

Pediatric breast disease is uncommon, and primary breast carcinoma in children is extremely rare. Therefore, the approach used to address breast lesions in pediatric patients differs from that in adults in many ways. Knowledge of the normal imaging features at various stages of development and the characteristics of breast disease in the pediatric population can help the radiologist to make confident diagnoses and manage patients appropriately. Most breast diseases in children are benign or associated with breast development, suggesting a need for conservative treatment. Interventional procedures might affect the developing breast and are only indicated in a limited number of cases. Histologic examination should be performed in pediatric patients, taking into account the size of the lesion and clinical history together with the imaging findings. A core needle biopsy is useful for accurate diagnosis and avoidance of irreparable damage in pediatric patients. Biopsy should be considered in the event of abnormal imaging findings, such as non-circumscribed margins, complex solid and cystic components, posterior acoustic shadowing, size above 3 cm, or an increase in mass size. A clinical history that includes a risk factor for malignancy, such as prior chest irradiation, known concurrent cancer not involving the breast, or family history of breast cancer, should prompt consideration of biopsy even if the lesion has a probably benign appearance on ultrasonography.
Acoustics ; Adolescent* ; Adult ; Biopsy ; Biopsy, Large-Core Needle ; Breast Diseases ; Breast Neoplasms ; Breast* ; Child* ; Diagnosis* ; Fibroadenoma ; Gynecomastia ; Humans ; Male ; Phyllodes Tumor ; Risk Factors ; Shadowing (Histology) ; Thorax ; Ultrasonography

OBJECTIVE: Among the various psychiatric disorders, depression is a common comorbid condition in cancer patients. Due to the distinct and diverse nature of cancer, the prevalence of depression may be assumed to be affected by differences in primary cancer sites. In this study, we explored the prevalence rates of depression among the ten most prevalent cancers in South Korea using a national patient sample. METHODS: This was a 1-year cross-sectional study using a national patient sample provided by the South Korean National Health Insurance in 2011. We selected all patients who had received ICD-10 codes of the 10 most prevalent cancers and major depressive disorder. Afterwards, the cancer and depression groups were merged and analyzed. RESULTS: The MDD prevalence rate was highest in lung cancer (11.0%), followed by non-Hodgkin's lymphoma (9.2%), prostate (9.1%), bladder (8.8%), breast (7.8%), cervix (7.8%), colorectal (7.7%), stomach (6.9%), liver (6.5%), and thyroid cancer (5.6%). Within all cancer groups, patients with a MDD diagnosis were significantly older (p<0.05) than non-MDD patients. Colorectal, stomach, and thyroid cancer displayed a higher female proportion in the MDD group than the non-MDD group. In the subgroup analysis, the prevalence rate differed by age and sex. CONCLUSION: The prevalence of depression varied according to cancer types. Patients with lung cancer were the most prone to experience depression. Because clinical and psychological factors may influence MDD prevalence, these factors will need to be studied more closely in the future.
Breast ; Cervix Uteri ; Cross-Sectional Studies ; Depression* ; Depressive Disorder, Major ; Diagnosis ; Epidemiology ; Female ; Humans ; International Classification of Diseases ; Korea* ; Liver ; Lung Neoplasms ; Lymphoma, Non-Hodgkin ; National Health Programs ; Prevalence* ; Prostate ; Psychology ; Stomach ; Thyroid Neoplasms ; Urinary Bladder

Silicone implants are widely used in aesthetic and reconstructive breast surgery. Silicone lymphadenopathy is a well-known rare complication of implant insertion. Silicone leakage from a rupture or silicone bleeding can accumulate in lymph nodes. Foreign body reactions in the affected lymph nodes may be misdiagnosed as metastasis or malignant lymphadeno pathy upon initial presentation if silicone lymphadenopathy is not considered in the initial diagnosis. We report a case of siliconoma with extensive involvement of multiple lymph nodes mimicking malignant features to emphasize that clinicians should carefully evaluate each patient's medical history and disease status during differential diagnosis.
Breast Implants* ; Breast* ; Diagnosis ; Diagnosis, Differential ; Foreign Bodies ; Hemorrhage ; Lymph Nodes ; Lymphatic Diseases* ; Neoplasm Metastasis ; Rupture ; Silicon* ; Silicones*

Silicone implants are widely used in aesthetic and reconstructive breast surgery. Silicone lymphadenopathy is a well-known rare complication of implant insertion. Silicone leakage from a rupture or silicone bleeding can accumulate in lymph nodes. Foreign body reactions in the affected lymph nodes may be misdiagnosed as metastasis or malignant lymphadeno pathy upon initial presentation if silicone lymphadenopathy is not considered in the initial diagnosis. We report a case of siliconoma with extensive involvement of multiple lymph nodes mimicking malignant features to emphasize that clinicians should carefully evaluate each patient's medical history and disease status during differential diagnosis.
Breast Implants* ; Breast* ; Diagnosis ; Diagnosis, Differential ; Foreign Bodies ; Hemorrhage ; Lymph Nodes ; Lymphatic Diseases* ; Neoplasm Metastasis ; Rupture ; Silicon* ; Silicones*

PURPOSE: Idiopathic granulomatous mastitis (IGM) is a rare disease characterized by noncaseating granulomatous inflammation of unknown origin. Because its clinical features are similar to those of other type of mastitis or breast cancer, accurate diagnosis and adequate treatment are essential to ensuring a short symptom duration and improving the quality of life. METHODS: The clinical, radiologic, pathophysiologic, and treatment data for 43 patients diagnosed with IGM at the Breast Cancer Center of Gachon University Gil Medical Center between 2005 and 2016 were retrospectively reviewed. RESULTS: Forty-one patients (95.34%) were of childbearing age, seven (16.27%) had a history of lactation, and five (11.62%) had a history of oral contraceptive use. In terms of radiologic findings, 30 patients (69.77%) were diagnosed with Breast Imaging-Reporting and Data System category ≥4A lesions. Corticosteroid therapy was administered to 36 patients (83.72%); overall, 18 patients (41.86%) did not require surgery and 25 patients (58.13%) underwent partial or total mastectomy. Twelve patients (27.90%) developed recurrence. CONCLUSION: IGM is a benign disease that can be misdiagnosed as breast cancer because of its similar clinical and radiologic findings. Proper diagnosis and treatment can be difficult, but delays may lead to prolonged pain and cosmetic and socioeconomic problems. Efforts should be aimed at establishing the cause of IGM and developing efficient protocols for its diagnosis and treatment.
Breast ; Breast Neoplasms ; Diagnosis* ; Female ; Granulomatous Mastitis* ; Humans ; Immunoglobulin M ; Inflammation ; Information Systems ; Lactation ; Mastectomy, Simple ; Mastitis ; Quality of Life ; Rare Diseases ; Recurrence ; Retrospective Studies* ; Steroids