Efficacy of Breast Ultrasonography for Detection of Local, Regional, and Contralateral Recurrence of Breast Cancer

Purpose: Breast uttrasonography (US) is not recommended for recurrence monitoring after breast cancer surgery due to the lack of evidence for its advantage. The purpose of this study was to evaluate the usefulness of US for detecting local recurrence (LR), regional recurrence (RR) and contralateral breast cancer (CBC) in breast cancer patients during follow-up. Methods: The medical records of 5,833 breast cancer patients who underwent breast cancer surgery between January 2003 and December 2009 were reviewed retrospectively. Physical examination (PE), mammography (MMG), and US were done routinely to detect recurrences. Detection rate for locoregional and contralateral recurrence was compared between the three modalities. Results: During the follow-up period, 125 LR, 46 RR, 83 CBC, and 29 synchronous local and regional recurrences developed in 245 patients among the study population of 5,833 breast cancer patients. Median time to recurrence was 34.7 months. The recurrence detection rate was 51.9%, 43.5%, and 90.1% for PE, MMG, and US, respectively. Mean size of the recurrent lesions detected by US (1.57 cm) was smaller than that of PE (2.69 cm) and MMG (2.03 cm) (p=0.002). Conclusion: Breast US had higher recurrence detection rate for LA, RR, and CBC than PE or MMG after breast cancer surgery. 유방암은 2007년 우리나라 여성 암 발생률 2위(15.1%), 발생 환자 수는 11,606명을 차지하고 있고, 연간 6,6%의 높은 발생률의 증가를 보이고 있다.(1) 또한 지난 10년간 국내의 유방암 치료 성적도 지속적으로 개선되어 5년 생존율은 77.9%에서 89.5%로 11.5% 증가하였다. 이러한 유병률의 증가와 장기 생존율의 향상으로 인해 1999년 이후 9년 동안 유병자 수도 68,136명(11.2%)으로 빠르게 증가하고 있다.(1,2) 이러한 유방암 발생률 증가와 사망률 감소 및 유방암 수술 후 장기생존자의 증가에 따라 동측 유방 내 재발을 포함한 국소재발과 반대측 유방암이 발생하는 환자의 빈도가 최근 증가하고 있다. National Surgical Adjuvant Breast and Bowel Project(NSABP) B-06의 경우 20년의 추적 관찰기간 동안 14.3%의 동측 유방 재발(ipsilateral breast tumor recurrence)을 보고하였고,(3) 10년의 추적 기간 동안 단독 국소-구역 재발(locoregional recurrence)은 12.4%, 4개월 이내 전신재발을 동반한 국소-구역 재발은 19.8% 보고되었다.(4) 유방암으로 치료받은 환자에서 반대측 유방암(contralateral breast cancer)이 생길 확률은 2-11%로 유방암에 걸리지 않은 여성에 비해 2-6배의 높은 위험도를 가진다.(5) 2008년 한국유방암학회 유방암 진료권고안을 비롯하여 서구의 다양한 유방암 진료권고안에서는 국소, 구역, 그리고 반대측 유방암 재발을 진단함에 있어서 1년마다의 추적 관찰과 함께 유방촬영술을 시행하는 것을 권고하고 있다. 그러나 유방초음파나 유방 자기공명영상 등의 추가적 영상검사의 효용은 아직 불확실하여 고위험 환자에서 선택적으로 시행하는 것을 권하고 있다.(6-11)최근 여러 국내외의 연구에서 유방암 수술 후 국소재발이나 액와부 림프절 재발을 조기 발견하는 데 있어 유방초음파의 잠재적 효용성이 보고되고 있다.(12-15) 이에 본 연구에서는 유방암의 국소, 구역, 그리고 반대측 유방암 재발을 진단하는 데 있어서 유방 초음파의 유용성을 단일기관에서 수술받고 추적 관찰받은 한국인 유방암 환자군에서 분석해보고자 하였다.본 논문은 2010년도 정부(교육과학기술부)의 재원으로 한국연구재단의 기초 연구사업 지원을 받아 수행된 것임(2010-0004148).Kelly KM, 2010, EUR RADIOL, V20, P2557, DOI 10.1007/s00330-010-1844-1Kim HJ, 2010, ANN SURG ONCOL, V17, P2670, DOI 10.1245/s10434-010-1087-zJung KW, 2010, J KOREAN MED SCI, V25, P1113, DOI 10.3346/jkms.2010.25.8.1113Aebi S, 2010, ANN ONCOL, V21, pv9, DOI 10.1093/annonc/mdq159Lehman CD, 2009, J NATL COMPR CANC NE, V7, P1109Houssami N, 2009, ANN ONCOL, V20, P1505, DOI 10.1093/annonc/mdp037Moon HJ, 2009, RADIOLOGY, V252, P673, DOI 10.1148/radiol.2523081977Yarnold J, 2009, CLIN ONCOL-UK, V21, P159, DOI 10.1016/j.clon.2008.12.008Kim MJ, 2009, AM J ROENTGENOL, V192, P221, DOI 10.2214/AJR.07.4048Montgomery DA, 2007, BRIT J CANCER, V96, P1802, DOI 10.1038/sj.bjc.6603815Yilmaz MH, 2007, DIAGN INTERV RADIOL, V13, P13Khatcheressian JL, 2006, J CLIN ONCOL, V24, P5091, DOI 10.1200/JCO.2006.08.8575Shin JH, 2005, J ULTRAS MED, V24, P643Taghian A, 2004, J CLIN ONCOL, V22, P4247, DOI 10.1200/JCO.2004.01.042Ciatto S, 2004, EUR J CANCER, V40, P1496, DOI 10.1016/j.ejca.2004.03.010Fisher B, 2002, NEW ENGL J MED, V347, P1233KIM SH, 2000, J KOREAN RADIOL SOC, V42, P1009Chen Y, 1999, CANCER EPIDEM BIOMAR, V8, P855GORDON PB, 1995, CANCER, V76, P626GIUSEPPETTI GM, 1989, RADIOL MED, V78, P339*NAT COMPR CANC NE, NCCN CLIN PRACT GUID*AM COLL RAD, ACR BREAST IM REP DA*NAT CANC INF CTR, CANC STAT*KOR BREAST CANC S, 3 BREAST CANC MAN RE

Clinicopathological Characteristics and Factors Affecting Recurrence of Ductal Carcinoma In Situ in Korean Women

Purpose: As breast cancer screening becomes more popular in Korea, incidence of ductal carcinoma in situ (DCIS) of breast has increased to more than 10% of all breast cancer diagnosed. We aimed to show the clinicopathological characteristics and factors affecting recurrence of DCIS in Korean women. Methods: We retrospectively reviewed 152 DCIS patients who underwent breast conserving surgery in Seoul National University Hospital between January 1995 and December 2005. Results: Mean age at diagnosis was 46.7 years (24 to 66 years). Mean follow up duration of the patients was 73.82 months (0.80 to 168.43 months). Recurrence of disease occurred in 19 (12.5%) patients: 2 in contralateral breast, 15 in ipsilateral breast, and 2 in axilla. One patient showed ipsilateral breast recur after excision of axillary metastasis. Eight (42.11%) of all recurrence was infiltrating ductal carcinoma and one of them showed bone metastasis during follow up. In an multivariate analysis of factors affecting recurrence, younger age at diagnosis and omission of radiotherapy had significant association with recurrence (p=0.005 and p=0.002, respectively). However, tumor size (p=0.862), microinvasion (p=0.988), histologic grade (p=0.157), estrogen receptor status (p=0.401) and resection margin status (p=0.112) were not significantly correlated with recurrence. There was no breast cancer associated mortality. Conclusion: In this study, we found that the younger age at diagnosis and omission of adjuvant radiotherapy are independent predictors of recurrence in Korean DCIS patients.Pinder SE, 2010, BRIT J CANCER, V103, P94, DOI 10.1038/sj.bjc.6605718Bundred NJ, 2010, CLIN CANCER RES, V16, P1605, DOI 10.1158/1078-0432.CCR-09-1623Virnig BA, 2010, J NATL CANCER I, V102, P170, DOI 10.1093/jnci/djp482Allegra CJ, 2010, J NATL CANCER I, V102, P161, DOI 10.1093/jnci/djp485Thomas J, 2010, BRIT J CANCER, V102, P285, DOI 10.1038/sj.bjc.6605513Collins LC, 2009, AM J SURG PATHOL, V33, P1802Hughes LL, 2009, J CLIN ONCOL, V27, P5319, DOI 10.1200/JCO.2009.21.8560Shah DN, 2009, BREAST J, V15, P649, DOI 10.1111/j.1524-4741.2009.00838.xGoodwin A, 2009, BREAST, V18, P143, DOI 10.1016/j.breast.2009.04.003Chung YS, 2009, J BREAST CANCER, V12, P106, DOI 10.4048/jbc.2009.12.2.106Dunne C, 2009, J CLIN ONCOL, V27, P1615, DOI 10.1200/JCO.2008.17.5182Kuerer HM, 2009, J CLIN ONCOL, V27, P279, DOI 10.1200/JCO.2008.18.3103Luini A, 2009, BREAST CANCER RES TR, V113, P397, DOI 10.1007/s10549-008-9929-0von Smitten K, 2008, J SURG ONCOL, V98, P585, DOI 10.1002/jso.21038Ko SS, 2008, J SURG ONCOL, V98, P318, DOI 10.1002/jso.21110Sakorafas GH, 2008, CANCER TREAT REV, V34, P483, DOI 10.1016/j.ctrv.2008.03.001Morrow M, 2008, ANN SURG ONCOL, V15, P2641, DOI 10.1245/s10434-008-0083-zIntra M, 2008, ANN SURG, V247, P315, DOI 10.1097/SLA.0b013e31815b446bAllred DC, 2008, CLIN CANCER RES, V14, P370, DOI 10.1158/1078-0432.CCR-07-1127RHEE J, 2008, BMC CANCER, V8, pNIL19, DOI DOI 10.1186/1471-2407-8-307Moore KH, 2007, ANN SURG ONCOL, V14, P2911, DOI 10.1245/s10434-007-9414-8Sontag L, 2005, J THEOR BIOL, V232, P179, DOI 10.1016/j.jtbi.2004.08.002Boland GP, 2003, BRIT J SURG, V90, P426, DOI 10.1002/bjs.4051Vicini FA, 2002, J CLIN ONCOL, V20, P2736, DOI 10.1200/JCO.2002.07.137Neuschatz AC, 2002, CANCER, V94, P1917, DOI 10.1002/cncr.10460Bartelink H, 2001, NEW ENGL J MED, V345, P1378Bijker N, 2001, J CLIN ONCOL, V19, P2263LEE HD, 2001, J KOREAN SURG SOC, V60, P495FRYKBERG ER, 1997, BREAST J, V3, P227

A Comparative Study between the Preoperative Diagnostic Tumor Size and the Postoperative Pathologic Tumor Size in Patients with Breast Tumors

Purpose: This comparative study analyzed the relationship between the preoperative diagnostic tumor size and the postoperative pathologic tumor size for breast cancer patients and benign breast tumor patients. Methods: We analyzed the clinicopathological information of 191 breast cancer patients and 187 benign breast tumor patients by conducting a retrospective chart review. The preoperative diagnostic tumor sizes were measured using physical examination, mammography and sonography in the benign breast tumor patients and they were additionally measured by computerized tomography and magnetic resonance imaging in the breast cancer patients. Body mass index (BMI) was defined as the ratio of the body weight in kilograms to the square of height in meters. Results: The tumor sizes measured by mammography (r=0.66) and physical examination (r=0.87) were highly correlated to the pathologic tumor size in the breast cancer patients and benign the breast tumor patients, respectively. Physical examination and magnetic resonance imaging had a tendency to overestimate the tumor size and sonography underestimated the pathologic tumor size in the breast cancer patients. The correlation coefficient for the physical examination was increased when the patient age was less than 50 years and the BMI was less than 25. Multiple regression analysis revealed that assessing the tumor size according to physical examination, mammography and sonography were effective for determining estimation of pathologic tumor size in the benign breast tumor patients, but assessing the tumor size by physical examination and sonography was not effective for determining the tumor size in breast cancer patients. Conclusion: Mammography and physical examination can be useful to estimate the pathologic tumor size in breast cancer patients and benign breast tumor patients, respectively. Physical examination can be useful to estimate the size when a breast tumor is palpable, the age of a patient is less than 50, and the BMI is less than 25.Devolli-Disha E, 2009, BOSNIAN J BASIC MED, V9, P131Almubarak M, 2009, ONCOLOGY-NY, V23, P255Price J, 2009, J MED IMAG RADIAT ON, V53, P69, DOI 10.1111/j.1754-9485.2009.02040.xTohno E, 2009, BREAST CANCER-TOKYO, V16, P18, DOI 10.1007/s12282-008-0082-8Uematsu T, 2008, BREAST CANCER RES TR, V112, P461, DOI 10.1007/s10549-008-9890-yUchida K, 2008, BREAST CANCER-TOKYO, V15, P165, DOI 10.1007/s12282-007-0024-xJiang YX, 2007, ULTRASOUND MED BIOL, V33, P1873, DOI 10.1016/j.ultrasmedbio.2007.06.002Honjo S, 2007, JPN J CLIN ONCOL, V37, P715, DOI 10.1093/jjco/hym090Kim DY, 2007, KOREAN J RADIOL, V8, P32Fasching PA, 2006, EUR J RADIOL, V60, P398, DOI 10.1016/j.ejrad.2006.08.002Greene T, 2006, J AM COLL SURGEONS, V203, P894, DOI 10.1016/j.jamcollsurg.2006.08.017Watermann DO, 2005, ULTRASOUND MED BIOL, V31, P167, DOI 10.1016/j.ultrasmedbio.2004.11.005Cheung YC, 2004, ANN SURG ONCOL, V11, P756, DOI 10.1245/ASO.2004.12.008Bosch AM, 2003, EUR J RADIOL, V48, P285, DOI 10.1016/S0720-048X(03)00081-0CHOI GH, 2003, J KOREAN SURG SOC, V58, P331LEE CS, 2003, J BREAST CANCER, V6, P87Weatherall PT, 2001, J MAGN RESON IMAGING, V13, P868Saarenmaa I, 2001, BREAST CANCER RES TR, V67, P117Evans N, 2000, CLIN RADIOL, V55, P261Buchberger W, 1999, AM J ROENTGENOL, V173, P921Herrada J, 1997, CLIN CANCER RES, V3, P1565Davis PL, 1996, BREAST CANCER RES TR, V37, P1GORDON PB, 1995, CANCER, V76, P626MEDEN H, 1995, INT J GYNECOL OBSTET, V48, P193FOROUHI P, 1994, BRIT J SURG, V81, P223PAIN JA, 1992, EUR J SURG ONCOL, V18, P44FORNAGE BD, 1987, CANCER, V60, P765

Factors Affecting the Ipsilateral Breast Tumor Recurrence after Breast Conserving Therapy in Patients with T1 and T2 Tumors

본 논문은 2008년 대한외과학회 추계학술대회에서 구연 발표되었음.Purpose: Nearly half of all breast cancers are treated with breast conserving therapy (BCT). The purpose of this study was to identify the risk factors for ipsilateral breast tumor recurrence (IBTR) after BCT in T1 and T2 breast cancer patients. Methods: The medical records of 294 T1 or T2 breast cancer patients who underwent BCT at Seoul National University Hospital between January 1998 and December 2002 were retrospectively reviewed. Kaplan-Meier curves and Cox proportional regression analysis were used to identify the significant clinicopathologic factors that influence IBTR. Results: Among the 294 patients, 12 patients (4.8%) developed IBTR after a median follow-up of 82 months. Univariate analysis demonstrated that younger age (<= 35 year) had significant associations with IBTR (p=0.006). Tumor size, lymph node status, histologic grade, extensive intraductal component, lymphovascular invasion, and close resection margins were not significant factor associated with IBTR. The triple negative breast cancer subtype also did not have significant association with IBTR. Multivariate analysis showed that the younger age at diagnosis was a significant predictor of IBTR with a FIR of 3.86 (p=0.036; 95% CI, 1.09-13.60). Conclusion: Younger age at diagnosis (<= 35) may be associated with an increased risk of IBTR in patients who underwent BCT.Han W, 2010, BREAST CANCER RES TR, V119, P193, DOI 10.1007/s10549-009-0388-zBenson JR, 2009, LANCET, V373, P1463Luini A, 2009, BREAST CANCER RES TR, V113, P397, DOI 10.1007/s10549-008-9929-0Nguyen PL, 2008, J CLIN ONCOL, V26, P2373, DOI 10.1200/JCO.2007.14.4287Lee JW, 2007, J BREAST CANCER, V10, P206Dent R, 2007, CLIN CANCER RES, V13, P4429, DOI 10.1158/1078-0432.CCR-06-3045KANG SH, 2007, J KOREAN SURG SOC, V73, P385Haffty BG, 2006, J CLIN ONCOL, V24, P5652, DOI 10.1200/JCO.2006.06.5664Ahn SH, 2006, BREAST CANCER RES TR, V99, P209, DOI 10.1007/s10549-006-9188-xWapnir IL, 2006, J CLIN ONCOL, V24, P2028, DOI 10.1200/JCO.2005.04.3273Komoike Y, 2006, CANCER, V106, P35, DOI 10.1002/cncr.21551Abe O, 2005, LANCET, V366, P2087Noh WC, 2005, WORLD J SURG, V29, P1001, DOI 10.1007/s00268-005-7928-4Kim KJ, 2005, JPN J CLIN ONCOL, V35, P126, DOI 10.1093/jjcolyhi039Han WS, 2004, BMC CANCER, V4, DOI 10.1186/1471-2407-4-82MORROW M, 2004, DIS BREAST, P719Arriagada R, 2003, ANN ONCOL, V14, P1617, DOI 10.1093/annonc/mdg452Singletary SE, 2002, AM J SURG, V184, P383Veronesi U, 2002, NEW ENGL J MED, V347, P1227Fisher B, 2002, NEW ENGL J MED, V347, P1233Freedman GM, 2002, J CLIN ONCOL, V20, P4015, DOI 10.1200/JCO.2002.03.155Haffty BG, 2002, LANCET, V359, P1471Jobsen JJ, 2001, EUR J CANCER, V37, P1820Sasson AR, 2001, CANCER, V91, P1862Voogd AC, 2001, J CLIN ONCOL, V19, P1688Park CC, 2000, J CLIN ONCOL, V18, P1668Freedman G, 1999, INT J RADIAT ONCOL, V44, P1005Peterson ME, 1999, INT J RADIAT ONCOL, V43, P1029SUH CO, 1997, J KOREAN SOC THER RA, V15, P331BORGER J, 1994, J CLIN ONCOL, V12, P653WAZER DE, 1992, J CLIN ONCOL, V10, P356SOLIN LJ, 1991, INT J RADIAT ONCOL, V21, P279JACQUEMIER J, 1990, BRIT J CANCER, V61, P873VERONESI U, 1990, EUR J CANCER, V26, P671FOURQUET A, 1989, INT J RADIAT ONCOL, V17, P719LOCKER AP, 1989, BRIT J SURG, V76, P890

The Breast and Ovarian Cancer Risks in Korea Due to Inherited Mutations in BRCA1 and BRCA2: A Preliminary Report

본 논문은 2007 Global Breast Cancer Conference (GBCC)에서 포스터 발표되었음.Purpose: To estimate the cumulative risk till each age (penetrance) of breast and ovarian cancers among female family members with BRCA1 and BRCA2 mutation. Methods: Among the 61 BRCA1 mutation carriers in the 42 families and 47 BRCA2 mutation carriers in 31 families identified at 5 academic breast clinics, the probands were excluded to estimate the cumulative risk till each age of breast cancer in the Korean BRCA1 and BRCA2 carriers. Using Kaplan-Meier analyses, cumulative cancer risk estimates were determined. Results: By the age 70, the female breast cancer risk for the BRCA1 and BRCA2 mutation carriers was 72.1% (95% confidence interval [CI]=59.5% to 84.8%) and 66.3% (95% CI=41.2% to 91.5%), respectively, and the ovarian cancer risk was 24.6% (95% CI=0% to 50.3%) and 11.1% (95% CI=0% to 31.6%), respectively. The contralateral breast cancer risk at 5 years after primary breast cancer was estimated as 16.2% (95% CI=9.3% to 23.1%) for the 52 breast cancer patients with the BRCA1 mutation and 17.3% (95% CI=9.7% to 24.0%) for the 35 breast cancer patients with the BRCA2 mutation. Conclusion: The penetrance of BRCA mutations in Korea is largely consistent with the previous studies on Western populations. However, the small number of the cases, the high proportions of probands in the study subjects, the short term follow-up, and large confidence intervals are the limitations of the current study. The Korean Hereditary Breast Cancer Study (KOHBRA Study) may definitely answer this question.Kim KS, 2008, J BREAST CANCER, V11, P95Kim EK, 2007, J BREAST CANCER, V10, P241Vogl FD, 2007, FAM CANCER, V6, P63, DOI 10.1007/s10689-006-9106-8Ahn SH, 2007, CANCER LETT, V245, P90, DOI 10.1016/j.canlet.2005.12.031Schlich-Bakker KJ, 2006, PATIENT EDUC COUNS, V62, P13, DOI 10.1016/j.pec.2005.08.012Metcalfe K, 2004, J CLIN ONCOL, V22, P2328, DOI 10.1200/JCO.2004.04.033Choi DH, 2004, J CLIN ONCOL, V22, P1638, DOI 10.1200/JCO.2004.04.179King MC, 2003, SCIENCE, V302, P643Antoniou A, 2003, AM J HUM GENET, V72, P1117Kauff ND, 2003, CANCER, V97, P1601, DOI 10.1002/cncr.11225Liede A, 2002, HUM MUTAT, V20, P413, DOI 10.1002/humu.10154Brose MS, 2002, J NATL CANCER I, V94, P1365IKEDA N, 2002, J BREAST CANCER, V5, P194Eng C, 2001, J MED GENET, V38, P824Risch HA, 2001, AM J HUM GENET, V68, P700ROBSON ME, 2001, CURR PROB SURG, V38, P387Ponder BAJ, 2000, BRIT J CANCER, V83, P1301Matloff ET, 2000, J CLIN ONCOL, V18, P2484Wagner TMU, 2000, BRIT J CANCER, V82, P1249Julian-Reynier C, 2000, EUR J HUM GENET, V8, P204Schrag D, 2000, JAMA-J AM MED ASSOC, V283, P617Antoniou AC, 2000, GENET EPIDEMIOL, V18, P173Arnold N, 1999, HUM MUTAT, V14, P333Newman B, 1998, JAMA-J AM MED ASSOC, V279, P915Ford D, 1998, AM J HUM GENET, V62, P676Claus EB, 1996, CANCER, V77, P2318Nieto FJ, 1996, AM J EPIDEMIOL, V143, P1059FORD D, 1995, AM J HUM GENET, V57, P1457EASTON DF, 1995, AM J HUM GENET, V56, P265FORD D, 1994, LANCET, V343, P692KAPLAN EL, 1958, J AM STAT ASSOC, V53, P457

The Change of Practice Patterns of the Hereditary Breast Cancer Management in Korea after the Korean Hereditary Breast Cancer Study

본 논문은 2010 한국유방암학회 춘계학술대회에서 구연 발표되었음.Purpose: The objective of this study was to evaluate the change in the practice patterns for managing hereditary breast and ovarian cancer (HBOC) among Korean physicians after the Korean Hereditary Breast Cancer (KOHBRA) study. Methods: The first survey was performed from July to August 2007, at the initiation of the KOHBRA study, and the follow-up survey was conducted from July to December 2009. Members of the Korean Breast Cancer Society were invited to participate in the study by e-mail. The 2009 survey was conducted with a self-administered questionnaire concerning HBOC management and was identical to the previous questionnaire. Results: According to the 2009 survey, most physicians (60.0%) tended to draw a pedigree (48.0% in 2007 survey). The rate of genetic test recommendations for patients at risk for HBOC was higher in the 2009 survey (84.0%) than that in the 2007 survey (64.0%). Physicians tended to select a BRCA genetic testing candidate more appropriately than in the previous survey (42.4% answered right in 2007 survey; 74.4% in 2009 survey). Fifteen of 25 participants (60.0%) provided genetic counseling before their patients underwent a genetic test, which was higher than that (40.0%) in the 2007 survey. According to the 2009 survey, half of the genetic counseling was being conducted by KOHBRA study research nurses; whereas most of the genetic counseling was conducted by physicians in 2007. Conclusion: The KOHBRA study has played an important role in the appropriate selection of candidates for genetic testing. However, more effort should be placed on improving the pre-test genetic counseling rate.본 연구는 보건복지부 암정복연구비의 지원을 받아 시행되었음(과제번호 0720450).Robson ME, 2010, J CLIN ONCOL, V28, P893, DOI 10.1200/JCO.2009.27.0660Han SA, 2009, J BREAST CANCER, V12, P92, DOI 10.4048/jbc.2009.12.2.92Ko SS, 2008, J SURG ONCOL, V98, P318, DOI 10.1002/jso.21110Kim KS, 2008, J BREAST CANCER, V11, P95Kim EK, 2007, J BREAST CANCER, V10, P241Chenevix-Trench G, 2007, BREAST CANCER RES, V9, DOI 10.1186/bcr1670Fisher B, 2005, J NATL CANCER I, V97, P1652, DOI 10.1093/jnci/dji372Eisen A, 2005, J CLIN ONCOL, V23, P7491, DOI 10.1200/JCO.2004.00.7138Nelson HD, 2005, ANN INTERN MED, V143, P362Green MJ, 2004, JAMA-J AM MED ASSOC, V292, P442Choi DH, 2004, J CLIN ONCOL, V22, P1638, DOI 10.1200/JCO.2004.04.179Ahn SH, 2004, J KOREAN MED SCI, V19, P269Rebbeck TR, 2004, J CLIN ONCOL, V22, P1055, DOI 10.1200/JCO.2004.04.188Antoniou A, 2003, AM J HUM GENET, V72, P1117Rebbeck TR, 2002, NEW ENGL J MED, V346, P1616KANG HC, 2002, HUM MUTAT, V20, P235Malone KE, 2000, CANCER, V88, P1393Hartmann LC, 1999, NEW ENGL J MED, V340, P77Fisher B, 1998, J NATL CANCER I, V90, P1371Ford D, 1998, AM J HUM GENET, V62, P676Parmigiani G, 1998, AM J HUM GENET, V62, P145ShattuckEidens D, 1997, JAMA-J AM MED ASSOC, V278, P1242Dinkel MK, 1997, J CLIN ONCOL, V15, P2157Claus EB, 1996, CANCER, V77, P2318WOOSTER R, 1995, NATURE, V378, P789OH JH, 1995, J KOREAN CANC ASS, V27, P1061FRIEDMAN LS, 1994, NAT GENET, V8, P399*NAT COMPR CANC NE, NCCN CLIN PRACT GUID

Content Analysis of Questions Related to Breast Cancer Raised through Internet Counseling in Korea

Purpose: The purpose of this study was to analyze the data regarding questions raised by women with breast cancer through Internet counseling in Korea. Methods: The data were collected from one internet web-site, providing counseling by physicians. A total of 617 questions were analyzed by content analysis method. Results: About 90 percent of the counselees were patients themselves. But most of the general and health-related characteristics of them were not known from the data. As a result of content analysis, 617 questions were grouped into 9 major categories. The most common major category was identified as life after treatment (212 questions, 34.2%), followed by chemotherapy (139 questions, 22.3%) and hormone therapy (115 questions, 18.9%). Questions regarding physical symptoms were the most frequent one in the major categories of life after treatment, chemotherapy, and radiotherapy, while questions regarding psychological problems were the least. Conclusion: The findings of this study indicate that it is important for health professionals to provide continuous on-line informational support to women with breast cancer, even after all the treatment is over, especially focusing on physical symptoms. In addition, off-line program needs to be reinforced to provide emotional support that is not well delivered by on-line program

Ectopic Extramammary Paget`s Disease of the Breast Skin: A Case Report

Whereas extramammary Paget`s disease commonly occurs in the apocrine gland rich skin areas, ectopic extramammary Paget`s disease develops in the skin areas that are devoid of apocrine glands. We experienced the case of a 34 year-old female patient who had a skin lesion in the upper outer quadrant of the right breast for 5 years and that lesion was diagnosed as Paget`s disease according to the punch biopsy. There was no other underlying malignancy, and so wide excision was performed. The final pathologic diagnosis was Paget`s disease confined to the epidermis and the size of the tumor was 3.0 x 1.1 cm. Positive staining for cytokeratin 7, epithelial membrane antigen and negative staining for S-100 protein and HMB-45 was observed on the immunohistochemical tests. We report here on an extremely unusual case of ectopic extramammary Paget`s disease of the breast skin, and we include a review of the relevant literature.Youn HJ, 2008, J BREAST CANCER, V11, P156Kanitakis J, 2007, J EUR ACAD DERMATOL, V21, P581, DOI 10.1111/j.1468-3083.2007.02154.xPAGET J, 2007, J EUR ACAD DERMATOL, V21, P581CROCKER HR, 2007, J EUR ACAD DERMATOL, V21, P581MURATA Y, 2005, EUR J DERMATOL, V15, P168Hendi A, 2004, J AM ACAD DERMATOL, V51, P767, DOI 10.1016/j.jaad.2004.07.004Hatta N, 2004, DERMATOL SURG, V30, P1329Cohen MA, 2004, DERMATOL SURG, V30, P1361Salamanca J, 2004, J CUTAN PATHOL, V31, P341McCarter MD, 2003, DIS COLON RECTUM, V46, P612, DOI 10.1097/01.DCR.0000064693.57166.F1Lloyd J, 2000, J CLIN PATHOL, V53, P742Inoue S, 2000, DERMATOLOGY, V201, P178BRASH DE, 1997, CANC PRINCIPLES PRAC, P1565CHANDA JJ, 1985, J AM ACAD DERMATOL, V13, P1009ASHIKARI R, 1970, CANCER, V26, P680FARDAL RW, 1964, POSTGRAD MED, V36, P584

COL18A1 as the Candidate Gene for the Prognostic Marker of Breast Cancer According to the Analysis of the DNA Copy Number Variation by Array CGH

Purpose: We tried to select and validate the candidate gene for the prognostic marker of breast cancer by comparing the analysis of copy number variation (CNV) between normal breast tissues and breast cancer tissues by performing array comparative genomic hybridization (CGH) Methods: Array CGH was performed with using the fresh frozen tissues of 77 breast cancer patients. We selected the clones with more than a 20% frequency of gain or loss, and the clones with gain or loss in more than 2 consecutive clones We finally selected the clones that were statistically significant on the survival analysis. We searched for the candidate gene that belonged to the candidate clones and we selected the final candidate gene that is assumed to be most related to the carcinogenesis of breast cancer by searching for information of the individual gene. We performed RT-PCR to validate the RNA expression of the final candidate gene with using the breast tissues of another 20 breast cancer patients. Results: Eleven (10 in the gain group and 1 in the loss group) clones were finally selected as candidate clones. The significant CNVs with gain were found in the regions of 1q23 1, 1q41, 1q44, 5p15.33, 8q21 3, 15q26.3, 17q12 and 21q22 3 and the significant CNV with loss was found in 14q32 33. COL18A1 (21q22.3) was selected as the final candidate gene and the RT-PCR results revealed that the expression of COL18A1 was up-regulated in the cancer tissues of 18 of the other 20 (90%) breast cancer patients. Conclusion: We selected COL18A1 (21q22 3) as the candidate gene for the prognostic marker of breast cancer by comparing the analysis of CNVs from the array CGH. The RNA of COL18A1 was over-expressed in breast cancer tissue, as determined by RT-PCR.Thomassen M, 2009, BREAST CANCER RES TR, V113, P239, DOI 10.1007/s10549-008-9927-2Hwang KT, 2008, INT J CANCER, V123, P1807, DOI 10.1002/ijc.23672Tan DSR, 2008, PATHOBIOLOGY, V75, P63, DOI 10.1159/000123844Sotiriou C, 2007, NAT REV CANCER, V7, P545, DOI 10.1038/nrc2173Balasubramanian SP, 2007, BMC CANCER, V7, DOI 10.1186/1471-2407-7-107Chand N, 2007, INT J AD HOC UBIQ CO, V2, P58, DOI 10.1504/IJAHUC.2007.011604Woo IS, 2006, INT J CANCER, V119, P2901, DOI 10.1002/ijc.22216Lourenco GJ, 2006, BREAST CANCER RES TR, V100, P335, DOI 10.1007/s10549-006-9259-zKim MY, 2006, GASTROENTEROLOGY, V131, P1913, DOI 10.1053/j.gastro.2006.10.021Brzezianska E, 2006, MUTAT RES-FUND MOL M, V599, P26, DOI 10.1016/j.mrfmmm.2005.12.013Dang CX, 2006, J GASTROEN HEPATOL, V21, P850, DOI 10.1111/j.1440-1746.2006.04074.xHan W, 2006, BMC CANCER, V6, DOI 10.1186/1471-2407-6-92van Beers EH, 2006, BREAST CANCER RES, V8, DOI 10.1186/bcr1510Hu TH, 2005, MODERN PATHOL, V18, P663, DOI 10.1038/modpathol.3800336Tokusashi Y, 2005, INT J CANCER, V114, P39, DOI 10.1002/ijc.20685Nessling M, 2005, CANCER RES, V65, P439Naylor TL, 2005, BREAST CANCER RES, V7, pR1186, DOI 10.1186/bcr1356Davies JJ, 2005, CHROMOSOME RES, V13, P237, DOI 10.1007/s10577-005-2168-xSWIDZINSKA E, 2005, ROSZ AKAD MED BIALYM, V50, P197Iizasa T, 2004, CLIN CANCER RES, V10, P5361Kikuchi E, 2004, CLIN CANCER RES, V10, P1835Rennstam K, 2003, CANCER RES, V63, P8861Beck MT, 2003, CANCER RES, V63, P3598Chebil G, 2003, ACTA ONCOL, V42, P43KIM HS, 2003, J BREAST CANCERER, V6, P58Liu D, 2002, BRIT J CANCER, V87, P423, DOI 10.1038/sj.bjc.6600456HAN W, 2002, J BREAST CANCERER, V2, P284Nakatani K, 1999, J BIOL CHEM, V274, P21528