Purpose: This study evaluated the effectiveness of different surveillance intensities on morbidity and mortality in women with breast cancer. Methods: This retrospective study included patients who had undergone breast cancer surgery in the Republic of Korea between 2009 and 2011. The patients were divided into two groups based on the intensity of their postsurgical surveillance: intensive surveillance group (ISG) and less-intensive surveillance group. Surveillance intensity was measured based on the frequency and type of follow-up diagnostic tests conducted, including mammography, ultrasonography, computed tomography, magnetic resonance imaging, bone scans, and positron emission tomography scans. Results: We included 1,356 patients with a median follow-up period of 121.2 months (range, 12.8–168.0 months). The analysis revealed no significant difference in the overall survival (OS) between the two groups within five years of surgery. However, patients with ISG exhibited significantly better breast cancer-specific survival (BCSS) and distant metastasisfree survival (DMFS) within the same period. Five years after surgery, the differences in survival outcomes between the groups were not statistically significant. Conclusion Intensive surveillance did not demonstrate a significant improvement in OS for patients with breast cancer beyond five years postoperatively. However, within the first five years, intensive surveillance was associated with better BCSS and DMFS. These findings suggest that personalized surveillance strategies may benefit specific patient subsets, particularly in the early years after treatment. Further nationwide randomized studies are warranted to refine surveillance guidelines and optimize outcomes in patients with breast cancer.

Purpose: Advances in chemotherapeutic and targeted agents have increased pathologic complete response (pCR) rates after neoadjuvant systemic therapy (NST). Vacuum-assisted biopsy (VAB) has been suggested to accurately evaluate pCR. This study aims to confirm the non-inferiority of the 5-year disease-free survival of patients who omitted breast surgery when predicted to have a pCR based on breast magnetic resonance imaging (MRI) and VAB after NST, compared with patients with a pCR who had undergone breast surgery in previous studies. Methods The Omission of breast surgery for PredicTed pCR patients wIth MRI and vacuumassisted bIopsy in breaST cancer after neoadjuvant systemic therapy (OPTIMIST) trial is a prospective, multicenter, single-arm, non-inferiority study enrolling in 17 tertiary care hospitals in the Republic of Korea. Eligible patients must have a clip marker placed in the tumor and meet the MRI criteria suggesting complete clinical response (post-NST MRI size ≤ 1 cm and lesion-to-background signal enhancement ratio ≤ 1.6) after NST. Patients will undergo VAB, and breast surgery will be omitted for those with no residual tumor. Axillary surgery can also be omitted if the patient was clinically node-negative before and after NST and met the stringent criteria of MRI size ≤ 0.5 cm. Survival and efficacy outcomes are evaluated over five years.Discussion: This study seeks to establish evidence for the safe omission of breast surgery in exceptional responders to NST while minimizing patient burden. The trial will address concerns about potential undertreatment due to false-negative results and recurrence as well as improved patient-reported quality of life issues from the omission of surgery. Successful completion of this trial may reshape clinical practice for certain breast cancer subtypes and lead to a safe and less invasive approach for selected patients.

This study aimed to evaluate the imaging and pathological findings in axillary lymph nodes in patients with breast cancer who received concurrent ipsilateral coronavirus disease 2019 (COVID-19) vaccination. Of the 19 women with breast cancer who received concurrent COVID-19 vaccination shot in the arm ipsilateral to breast cancer, axillary lymphadenopathy was observed in 84.2% (16 of 19) of patients on ultrasound (US) and 71.4% (10 of 14) of patients on magnetic resonance imaging (MRI), and 21.0% (4 of 19) of patients were diagnosed with metastasis. Abnormal US and MRI findings of cortical thickening, effacement of the fatty hilum, round shape, and asymmetry in the number or size relative to the contralateral side were noted in more than half of the non-metastatic and metastatic lymph nodes; however, statistical significance was not noted. Axillary lymphadenopathy is commonly observed in patients with breast cancer who receive concurrent ipsilateral COVID-19 vaccination without specific differential imaging features. Thus, understanding the limitations of axillary imaging and cautious interpretation is necessary to avoid overestimation or underestimation of the axillary disease burden.

Purpose: Li-Fraumeni syndrome (LFS) is a rare autosomal cancer syndrome caused by a germline mutation in the TP53 gene. Breast cancer in LFS patients is of various subtypes;however, limited data are available on the clinicopathological features of these subtypes and their appropriate treatments. This study aimed to review the clinical features and treatments for breast cancer in South Korean patients with germline TP53 mutations. Methods: Data on the clinicopathological features and treatment of all breast cancer patients with LFS were collected retrospectively from the available database of 4 tertiary hospitals in the Republic of Korea. Results: Twenty-one breast cancer cases in 12 unrelated women with confirmed germline TP53 mutations were included in the study. The median age at diagnosis was 33.5 years. The histopathological diagnosis included invasive ductal carcinoma (n = 16), ductal carcinoma in situ (n = 3), and malignant phyllodes tumor (n = 2). While 42% and 31% of the cases were positive for estrogen and progesterone receptors, respectively, 52.6% were human epidermal growth factor receptor 2 (HER2) positive, and 21% were triple-negative. The treatments included mastectomy (52%) and breast-conserving surgery (38%). Five patients underwent radiotherapy (RT). The median follow-up period was 87.5 (8–222) months. There were 3 ipsilateral and 4 contralateral breast recurrences during the follow-up, and 8 patients developed new primary cancers. In the post-RT subgroup, there were 2 ipsilateral and 2 contralateral breast recurrences in 1 patient, and 4 patients had a new primary cancer. Conclusion As reported in other countries, breast cancer in LFS patients in South Korea had an early onset and were predominantly but not exclusively positive for HER2.A multidisciplinary approach with adherence to the treatment guidelines, considering mastectomy, and avoiding RT is encouraged to prevent RT-associated sequelae in LFS patients.

Purpose: Li-Fraumeni syndrome (LFS) is a rare autosomal cancer syndrome caused by a germline mutation in the TP53 gene. Breast cancer in LFS patients is of various subtypes;however, limited data are available on the clinicopathological features of these subtypes and their appropriate treatments. This study aimed to review the clinical features and treatments for breast cancer in South Korean patients with germline TP53 mutations. Methods: Data on the clinicopathological features and treatment of all breast cancer patients with LFS were collected retrospectively from the available database of 4 tertiary hospitals in the Republic of Korea. Results: Twenty-one breast cancer cases in 12 unrelated women with confirmed germline TP53 mutations were included in the study. The median age at diagnosis was 33.5 years. The histopathological diagnosis included invasive ductal carcinoma (n = 16), ductal carcinoma in situ (n = 3), and malignant phyllodes tumor (n = 2). While 42% and 31% of the cases were positive for estrogen and progesterone receptors, respectively, 52.6% were human epidermal growth factor receptor 2 (HER2) positive, and 21% were triple-negative. The treatments included mastectomy (52%) and breast-conserving surgery (38%). Five patients underwent radiotherapy (RT). The median follow-up period was 87.5 (8–222) months. There were 3 ipsilateral and 4 contralateral breast recurrences during the follow-up, and 8 patients developed new primary cancers. In the post-RT subgroup, there were 2 ipsilateral and 2 contralateral breast recurrences in 1 patient, and 4 patients had a new primary cancer. Conclusion As reported in other countries, breast cancer in LFS patients in South Korea had an early onset and were predominantly but not exclusively positive for HER2.A multidisciplinary approach with adherence to the treatment guidelines, considering mastectomy, and avoiding RT is encouraged to prevent RT-associated sequelae in LFS patients.

This study was conducted to provide basic understanding regarding possible enamel erosion by three kinds of fist-aid antipyretic and analgesic medicines over a period of time, with comparison and analysis of the resulting deciduous teeth surface and microhardness changes. The analysis was performed using energy dispersive X-ray spectroscopy (EDX) and scanning electron microscope (SEM) to examine the surface erosion and changes. The Kruskal-Wallis test show differences in surface erosion and changes after 3, 5 and 8 days of treatment as well as before and after the treatment in each group. According to the results, there was no significant difference in the early deciduous teeth enamel surface microhardness (p>0.01). However there were signigicant changes after 3, 5, and 8 days (p<0.01). Calcim (Ca) and phosphorous (P) analysis using EDX showed significant differences in the enamel characteristics according to each tissue area after 8 days (p<0.05), but there was no significant difference in any of the areas for P content (p>0.05). In the surface observation with the SEM treatment with Children's Tylenol® tablet, which has the lowest pH, looked the roughest, followed by Brufen syrup for children and Children's Tylenol® suspension. Based on these results, it should be considered that antipyretic and analgesic medicines for children, which have lower pH values, may cause tooth erosion. Hence, it is necessary to give special attention to oral hygiene in young children or infants by brushing their teeth after such drugs are administered.
Child* ; Dental Enamel* ; Humans ; Hydrogen-Ion Concentration ; Ibuprofen ; Infant ; Oral Hygiene ; Spectrometry, X-Ray Emission ; Tooth ; Tooth Erosion ; Tooth, Deciduous

This study compared and analyzed the occluding effects of fluoride compounds and desensitizers, which are commonly used in dental clinics, on dentinal tubules. This study also evaluated the persistence of the active ingredients over time by performing toothbrushing with an electric toothbrush. Thirty-five molar teeth, which had been extracted within the past 3 months from healthy people without tooth decays, amalgam fillings, or dental crowns, were divided into 4 pieces each. Of these, 135 teeth pieces were used as study specimens. These specimens were divided into a control group, an untreated group, and 5 experimental groups (acidulated fluoride gel, fluoride varnish, Gluma, Super Seal, and SE-Bond). The specimens were then subjected to toothbrushing equivalent to 1 week (140 times), 2 weeks (280 times), and 4 weeks (560 times), and the occluding effects on dentinal tubules in 3 regions of each specimen were examined under a scanning electron microscope. The fluoride varnish treated group showed the highest degree of dentinal tubule occlusion effects during the first, second, and fourth weeks of toothbrushing, with the SE-Bond treated group showing the second highest degree and the Gluma treated group showing the lowest degree. After 4 weeks of toothbrushing, the Gluma treated group and the Super Seal treated group showed the lowest degrees of dentinal tubule occlusion effects. In summary, the fluoride varnish treated group and the SE-Bond treated group displayed higher occlusion effects even after 4 weeks of treatment than did the other experimental groups. Therefore, it is the authors' belief that fluoride varnish and SE-Bond are effective for treating dentinal hyperesthesia.
Crowns ; Dental Clinics ; Dentin Desensitizing Agents ; Dentin Sensitivity ; Dentin* ; Fluorides* ; Hyperesthesia ; Molar ; Paint ; Tooth ; Toothbrushing

Peritoneal desmoplastic small round cell tumor is a very rare malignant neoplasm and has specific clinical features; It is predominant in children and young males and has a well-demarcated large intra-abdominal tumor, which has not been associated with a primary visceral organ, with diffusely scattered multiple small tumors and rarely involves ovaries. It is a very aggressive and fast growing tumor along the peritoneal surfaces of the abdomen and pelvis. It has a typical histologic features and a specific immunohistochemical staining pattern. There is no definite treatment. It responses to surgery and chemotherapy at early period of therapy but relapses soon and rapidly progresses and then causes the death. We have experienced a peritoneal desmoplastic small round cell tumor which involved both ovaries, so we report this case with a brief review of literature.
Abdomen ; Child ; Desmoplastic Small Round Cell Tumor* ; Drug Therapy ; Female ; Humans ; Male ; Ovary* ; Pelvis ; Recurrence

Axillary osmidrosis is caused by excessive secretion of apocrine gland, which causes an acidic spicy odor and social embarrassment. Recently, many kinds of treatment for osmidrosis are introduced, but one of the conventional surgical method, dermal shaving is still the most effective method for osmidrosis. But it is often accompanied by complications like seroma, hematoma, necrosis, large scar, and long immobilization period. So, to reduce these disadvantages, we used fibrin glue which has the effect of reducing hematoma, encouraging capillary ingrowth by reinforcement of the flap fixation. Then, we compared the dermal shaving with fibrin glue spraying group with only dermal shaving group by retrospective study for clinical effect. From January 2001 to January 2005, a total of 56 patients were underwent dermal shaving operation for treatment of osmidrosis. Fibrin glue using group, the study group was 11 patients, 22 cases and dermal shaving only group without using fibrin glue, the control group was 45 patients, 90 cases. During operation, fibrin glue was sprayed after dermal shaving, just before completing skin closure. We compared the data from the view point of complications, the time for graft take(pressure dressing) and total occlusive dressing period(immobilzation period). Complication rate was lower in study group. There was 1 case of hematoma in the study group (4.5%), and 10 cases of hematoma, 1 case of seroma and 1 case of partial necrosis in the control group(13.3%). In both group, hematoma was the most common complication. The time for graft take were shorter in the study group than the control group(11.6 vs 13.6 days) and total dressing period was shorter in study group, too(14.3 vs 17.7 days). Statistically, significant difference was found in both the time for graft take and total dressing period. Using fibrin glue in dermal shaving was effective for lowering complication rate, reducing the time for graft take and total dressing period.
Apocrine Glands ; Bandages ; Capillaries ; Cicatrix ; Fibrin Tissue Adhesive* ; Fibrin* ; Hematoma ; Humans ; Immobilization ; Necrosis ; Occlusive Dressings ; Odors ; Retrospective Studies ; Seroma ; Skin ; Transplants

OBJECTIVE: To describe the angiographic embolization as a safe and an effective alternative treatment in the management of obstetrical hemorrhage and in preserving fertility. METHODS: Between March 1999 and May 2003, 43 patients at Asan Medical Center underwent angiographic embolization for the management of obstetrical hemorrhage. All cases received arterial embolization because of obstetrical hemorrhage unresponsive to conservative management or prophylaxis for massive obstetrical hemorrhage. Medical records were reviewed and detailed to collect adequate clinical data such as clinical status, underlying conditions, amount of transfusion, embolization sites, materials of embolization, duration of the procedure, complications associated with embolization, hospital stay, and the success rate. Patients were contacted by telephone to obtain long-term outcome for menstruation, desire for conception, and subsequent pregnancies. RESULTS: We have experienced the clinical successful embolization in 37 (86.0%) of 43 patients of obstetrical hemorrhage resulting from various causes. The main cause of hemorrhage was atony of uterus (n=17), followed by abnormal placentation (n=6), genital tract laceration (n=5). The average amount of blood transfusion was 7.0 units (range; 0-36 units). The average length of the time for the procedure was 68.2 minutes (range; 30-150 minutes). The average duration of hospitalization was 6.4 days (range; 3-20 days). The main complication after embolization was numbness and pain on right lower extremities in 5 cases and vessel dissection occurred in 1 case. But there was no major complication related to the procedure. We were able to follow up 28 patients. In all cases menses resumed spontaneously soon after the procedure. Seven cases of long-term follow-up became pregnant, and 3 cases of them completed gestations giving birth to healthy babies. CONCLUSION: The results suggest that angiographic embolization is a relatively noninvasive and highly effective method for the management of obstetrical hemorrhage and a useful technique for preserving fertility.
Blood Transfusion ; Chungcheongnam-do ; Female ; Fertility ; Fertilization ; Follow-Up Studies ; Hemorrhage* ; Hospitalization ; Humans ; Hypesthesia ; Lacerations ; Length of Stay ; Lower Extremity ; Medical Records ; Menstruation ; Parturition ; Placentation ; Pregnancy ; Telephone ; Uterus