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

유방암에서 RUNX3 유전자의 발현

학위논문(석사)--서울대학교 대학원 :의학과 외과학전공,2006.Maste

유방암에서 전신재발의 예측 표지자로서의 게놈 복제수 변화

Thesis(doctors)--서울대학교 대학원 :의학과 외과학전공,2008.2.Docto

Experiences on Obturator Hernia and Review of Korean Cases

Purpose: We performed this study to share experiences in the management of obturator hernia, which is a very rare disease among elderly women, because rarity of this disease will not approve an expert institute or surgeon and because the aging society, Korea, can increase the incidence. Methods: Patient characteristics, clinical manifestations and treatment results were retrospectively collected from the 12 obturator hernia patients since 2000 in the three hospitals of the authors. Twenty-one obturator hernia cases reported in the Korean literatures were reviewed. In addition, we analyzed clinical features and treatment results of the total 33 patients, collectively. Results: Most of the patients were elderly women except one Young, poorly nourished, male patient with pulmonary tuberculosis. Their mean age was 79.6 years. Sixty-four percent (21/33) of the patients had preoperative morbidity. Symptoms from the compression of the obturator nerve, which is an important Clue to the diagnosis, were observed in 67% (22/33). Interestingly, spontaneous or suspicious-spontaneous reductions were reported in 7 (21%) patients. Abdominal CT scan was the major tool for diagnosis. Abdominal approach alone could successfully manage most cases, though 84% (27/32) needed anastomosis of the bowel. Operative mortality was 2 of the 32 cases but morbidity was 44% of the 32 patients and the mean hospital period after operation was 21 days. Conclusion: Management of patients with obturator hernia connotes high morbidity and mortality. Sharing the experience of management, prompt diagnosis and Surgical management and proper peri-operative care as well as appropriate managing the families is essential for improved results. (J Korean Surg Soc 2010;78:41-50)Hwang KT, 2009, J KOREAN SURG SOC, V77, P211, DOI 10.4174/jkss.2009.77.3.211Park CY, 2009, J KOREAN SURG SOC, V76, P192Rodriguez-Hermosa JI, 2008, HERNIA, V12, P289, DOI 10.1007/s10029-007-0328-yCHOI SI, 2008, J KOREAN SURG SOC, V75, P415Haraguchi M, 2007, ANN ACAD MED SINGAP, V36, P413Kim MJ, 2006, DIABETES RES CLIN PR, V73, P8, DOI 10.1016/j.diabres.2005.11.013KIM HA, 2005, J KOREAN SURG SOC, V68, P168Kammori M, 2004, AM J SURG, V187, P549, DOI 10.1016/j.amjsurg.2003.12.041BAE JD, 2004, J KOREAN SURG SOC, V66, P438CHOI HJ, 2002, J KOREAN SURG SOC, V63, P509Schmidt PH, 2001, AM SURGEON, V67, P191CHANG SJ, 2001, J KOREAN SURG SOC, V61, P216Skandalakis LJ, 2000, SURG CLIN N AM, V80, P71YOON YD, 1998, J KOREAN SURG SOC, V54, P1038ZINNER MJ, 1997, MAINGOTS ABDOMINAL O, P540BERGSTEIN JM, 1996, SURGERY, V119, P133KIM SY, 1995, J KOREAN SURG SOC, V49, P146LEE MS, 1994, J KOREAN SURG SOC, V46, P887KIM MY, 1994, J KOREAN RADIOL SOC, V30, P875PARK YS, 1991, J KOREAN SURG SOC, V40, P132KANG YS, 1987, J KOREAN SURG SOC, V33, P116KWON TW, 1987, J KOREAN SURG SOC, V33, P756CHOI KH, 1987, J KOREAN SURG SOC, V32, P723SUH SH, 1968, J KOREAN SURG SOC, V10, P35

Validation of POSSUM-physiological Score as Predictors of Post-operative Morbidity and Mortality after Emergency Operation for Peptic Ulcer Complications

Purpose: The POSSUM (Physiological and Operative Severity Score for Enumeration of Mortality and Morbidity) score was developed to predict post-operative mortality and morbidity rates. The aim of this study was to validate the POSSUM physiologic score (POSSUM-P) in emergent operations for peptic ulcer complications. Methods: We retrospectively collected data on patients who underwent emergent operation for peptic ulcer complications at Boramae Hospital between January 2003 and April 2009. The data included patients` characteristics (underlying disease, medication, duration of symptoms), operative characteristics (operation method, Morbidity, and mortality) and the items for the POSSUM-P (basic information (age, sex, etc.), circulatory and respiratory signs, electrocardiogram, blood pressure, hemoglobin, white blood cell count, potassium level, sodium level, urea level and Glasgow coma scale). The POSSUM-P was calculated and compared according to the morbidity and mortality. Results: One hundred and twelve patients were included. As for operation methods, primary repair (48.2%) was most common, followed by truncal vagotomy with pyloroplasty (27.7%). Thirty-seven patients had morbidities including wound infections (20), pneumonias (14), fluid collections (9), and so on. Eight patients died due to sepsis or pulmonary edema. The means of POSSUM-P were significantly different between patients with and without mortality (37.8 vs. 19.2, P < 0.001) and between patients with and without morbidity (26.7 vs. 17.3, P < 0.001). Those were different between patients with and without postoperative postoperative pneumonia and wound infection (P=0.002 and P=0.029, respectively). Conclusion: The POSSUM physiologic score Could help to predict the mortality or morbidity after emergency operation for complications of peptic ulcer disease, especially postoperative pneumonia or wound infection. (J Korean Surg Soc 2009;77:391-398)Taha AS, 2008, ALIMENT PHARM THER, V28, P878, DOI 10.1111/j.1365-2036.2008.03808.xImhof M, 2008, WORLD J SURG, V32, P408, DOI 10.1007/s00268-007-9370-2Rahman MM, 2007, WORLD J SURG, V31, P2341, DOI 10.1007/s00268-007-9165-5Park DJ, 2005, BRIT J SURG, V92, P1099, DOI 10.1002/bjs.4952Gisbert JP, 2004, DIGEST LIVER DIS, V36, P116, DOI 10.1016/j.dld.2003.10.011Testini M, 2003, WORLD J GASTROENTERO, V9, P2338Noguiera C, 2003, WORLD J SURG, V27, P782, DOI 10.1007/s00268-003-6645-0Eachempati SR, 2002, ARCH SURG-CHICAGO, V137, P730Tsugawa K, 2001, HEPATO-GASTROENTEROL, V48, P156SEO JH, 2001, J KOREAN SURG SOC, V60, P425Dubois F, 2000, WORLD J SURG, V24, P270CHAN WH, 2000, ANN ACAD MED SINGAP, V29, P164Wolfe MM, 1999, NEW ENGL J MED, V340, P1888Jones HJS, 1999, BRIT J SURG, V86, P149Blomgren LGM, 1997, WORLD J SURG, V21, P412Sonnenberg A, 1996, AM J PUBLIC HEALTH, V86, P200HALL JC, 1996, J QUAL CLIN PRACT, V16, P103KIM KY, 1992, J KOREAN SURG SOC, V43, P30COPELAND GP, 1991, BRIT J SURG, V78, P355MARSHALL BJ, 1984, LANCET, V1, P1311BOEY J, 1982, ANN SURG, V195, P265*U MI HLTH SYST, PEPT ULC DIS

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

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

The Impact of Primary Tumor Resection on the Survival of Patients with Stage IV Breast Cancer

Purpose The main treatment for stage IV breast cancer is currently systemic therapy. Surgical resection of the primary tumor is usually done for treating the tumor-related complications Recent studies have suggested that surgery may improve the long-term survival of stage IV breast cancer patients We evaluated the impact of the primary surgical resection site on the survival of stage IV breast cancer patients. Methods We reviewed the records of the stage IV breast cancer patients who were treated at Seoul University Hospital between April 1992 and December 2007 The tumor and clinical characteristics, the type of treatments and the overall survival were compared between the surgically versus nonsurgically treated patients. Results. Of the 198 identified patients, 110 (55 8%) received surgical excision of their primary tumor and 88 (44 2%) did not The mean survival was 67 months vs. 42 months for the surgically treated patients vs the patients without surgery, respectively (p=0 0287) On a multivariate analysis with using the Cox model and after adjusting for the estrogen receptor status, visceral metastases, the number of metastatic sites and trastuzumab treatment, surgery was an independent factor for improved survival (hazard ratio, 0.55; 95% confidence interval, 0.31-0.97; p=0.041). Conclusion Surgical resection of the primary tumor in stage IV breast cancer patients was independently associated with improved survival. Randomized prospective trials are needed to firmly recommend surgical resection of the primary tumor in stage IV breast cancer patients본 연구는 폐암, 유방암/난소암 유전체 연구센터의 연구비를 지원받아 수행 되었음(01-PJ3-PG6-01GN07-0004).Bafford AC, 2009, BREAST CANCER RES TR, V115, P7, DOI 10.1007/s10549-008-0101-7Blanchard DK, 2008, ANN SURG, V247, P732, DOI 10.1097/SLA.0b013e3181656d32*KOR BREAST CANC S, 2008, BREAST CANC FACTS FI, V1, P5Fields RC, 2007, ANN SURG ONCOL, V14, P3345, DOI 10.1245/s10434-007-9527-0Gnerlich J, 2007, ANN SURG ONCOL, V14, P2187, DOI 10.1245/s10434-007-9438-0Rapiti E, 2006, J CLIN ONCOL, V24, P2743, DOI 10.1200/JCO.2005.04.2226Morrow M, 2006, J CLIN ONCOL, V24, P2694, DOI 10.1200/JCO.2006.05.9824Babiera GV, 2006, ANN SURG ONCOL, V13, P776, DOI 10.1245/ASO.2006.03.033Hotta T, 2006, ANTICANCER RES, V26, P1377Abe O, 2005, LANCET, V366, P2087Andre F, 2004, J CLIN ONCOL, V22, P3302, DOI 10.1200/JCO.2004.08.095Giordano SH, 2004, CANCER, V100, P44, DOI 10.1002/cncr.11859Khan SA, 2002, SURGERY, V132, P620, DOI 10.1067/msy.2002.127544Flanigan RC, 2001, NEW ENGL J MED, V345, P1655Demicheli R, 2001, BRIT J CANCER, V85, P490Dauplat J, 2000, SEMIN SURG ONCOL, V19, P42Overgaard M, 1999, SEMIN RADIAT ONCOL, V9, P292DOGHETTO GB, 1999, AM SURGEON, V65, P352BLAND KI, 1998, BREAST COMPREHENSIVE, V2Ragaz J, 1997, NEW ENGL J MED, V337, P956OREILLY MS, 1994, CELL, V79, P315FISHER B, 1989, CANCER RES, V49, P1996*NAT CANC I, BREAST CANC TREATM P