Pub Date : 2002-09-01DOI: 10.4048/JKBCS.2002.5.3.194
N. Ikeda, Y. Miyoshi, K. Yoneda, M. Kinoshita, S. Noguchi
The purpose of this investigation is to study the frequency and penetrance of BRCA1 and BRCA2 germline mutations in Japanese familial breast cancer patients. Mutation analysis of BRCA1 and BRCA2 by protein truncation test was conducted on the 120 breast cancer patients (probands) with at least one breast cancer (site-specific breast cancer families, n=105) or one ovarian cancer (breast/ovarian cancer families, n=15) patient in their first-degree relatives. Eight BRCA1 (7.6%) and ten BRCA2 (9.5%) mutations were found in site-specific breast cancer families (n=105), and seven BRCA1 (46.7%) but no BRCA2 (0%) mutations were found in breast/ovarian cancer families (n=15). In site-specific breast cancer families, mutation frequency of BRCA1 and BRCA2 was high in families with more than three breast cancer patients (30%, 6/20), early onset (40≤ years old) breast cancer patients (41.1%, 14/34), or bilateral breast cancer patients (40%, 6/15). Cumulative incidence of breast cancer by age 70 was estimated to be 78% and 80% for BRCA1 and BRCA2 mutation carriers, respectively, and that
{"title":"Frequency of BRCA1 and BRCA2 Germline Mutations Detected by Protein Truncation Test and Cumulative Risks of Breast and Ovarian Cancer among Mutation Carriers in Japanese Breast Cancer Families","authors":"N. Ikeda, Y. Miyoshi, K. Yoneda, M. Kinoshita, S. Noguchi","doi":"10.4048/JKBCS.2002.5.3.194","DOIUrl":"https://doi.org/10.4048/JKBCS.2002.5.3.194","url":null,"abstract":"The purpose of this investigation is to study the frequency and penetrance of BRCA1 and BRCA2 germline mutations in Japanese familial breast cancer patients. Mutation analysis of BRCA1 and BRCA2 by protein truncation test was conducted on the 120 breast cancer patients (probands) with at least one breast cancer (site-specific breast cancer families, n=105) or one ovarian cancer (breast/ovarian cancer families, n=15) patient in their first-degree relatives. Eight BRCA1 (7.6%) and ten BRCA2 (9.5%) mutations were found in site-specific breast cancer families (n=105), and seven BRCA1 (46.7%) but no BRCA2 (0%) mutations were found in breast/ovarian cancer families (n=15). In site-specific breast cancer families, mutation frequency of BRCA1 and BRCA2 was high in families with more than three breast cancer patients (30%, 6/20), early onset (40≤ years old) breast cancer patients (41.1%, 14/34), or bilateral breast cancer patients (40%, 6/15). Cumulative incidence of breast cancer by age 70 was estimated to be 78% and 80% for BRCA1 and BRCA2 mutation carriers, respectively, and that","PeriodicalId":414717,"journal":{"name":"Journal of Korean Breast Cancer Society","volume":"65 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2002-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"115354614","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2002-09-01DOI: 10.4048/JKBCS.2002.5.3.202
D. Kang, D. Noh
Breast cancer is the most prevalent cancer among women in Western countries and its prevalence is also increasing in Asia. (1,2) In 1994, the incidence rate of female breast cancer in Korea, adjusted for the world population, was 10.9 per 100,000, which was far lower than those of Western countries and even lower than those of other Asian countries. The major risk factors relating to breast cancer can be traced to reproductive events influencing lifetime levels of hormones.(3,4) A large proportion of breast cancer cases cannot, however, be explained by the above risk factors. The identification of susceptibility factors predisposing an individual to breast cancer, if exposed to particular environmental agents, could possibly give further insight into the etiology of this malignancy. Inherited differences in the capacity to metabolize environmental carcinogens have recently been suggested to modify individual susceptibilities to breast cancer. Therefore, the identification of new breast cancer susceptibility genes might yield new insight into breast tumorigenesis, and could provide targets for future therapeutic developments. In this respect the most interesting candidate genes include those mediating a range of functions, such as carcinogen metabolism, DNA repair, steroid hormone metabolism, signal transduction, and cell cycle control. Although the relative risks of these low penetrance susceptibility genes, to the development of breast cancer, are generally lower than those from high penetrance susceptibility genes (e.g., BRCA1, BRCA2, etc.), the attributable risk of low penetrance genes are much higher than those of the high penetrance genes, since the frequency of their variant alleles are higher in the general population. Thus, higher public health significance lays with these low penetrance genes, With their use it may be possible to obtain greater mechanistic insights into human breast carcinogenesis as well as targeted preventive approaches to the individuals with ‘at risk’ genotypes (Table 1). We have conducted a hospital based case-control study in South Korea to further evaluate the potential modifying role of the genetic polymorphisms of selected genes involved in the metabolism of carcinogens, estrogen metabolism, signal transduction, and DNA repair, also taking into account the potential interaction between these and known risk factors of breast cancer (Table 2). The results from selected genes will be presented in this mini-review.
{"title":"Genetic Susceptibility of Breast Cancer in Korea -Molecular Epidemiological Approaches-","authors":"D. Kang, D. Noh","doi":"10.4048/JKBCS.2002.5.3.202","DOIUrl":"https://doi.org/10.4048/JKBCS.2002.5.3.202","url":null,"abstract":"Breast cancer is the most prevalent cancer among women in Western countries and its prevalence is also increasing in Asia. (1,2) In 1994, the incidence rate of female breast cancer in Korea, adjusted for the world population, was 10.9 per 100,000, which was far lower than those of Western countries and even lower than those of other Asian countries. The major risk factors relating to breast cancer can be traced to reproductive events influencing lifetime levels of hormones.(3,4) A large proportion of breast cancer cases cannot, however, be explained by the above risk factors. The identification of susceptibility factors predisposing an individual to breast cancer, if exposed to particular environmental agents, could possibly give further insight into the etiology of this malignancy. Inherited differences in the capacity to metabolize environmental carcinogens have recently been suggested to modify individual susceptibilities to breast cancer. Therefore, the identification of new breast cancer susceptibility genes might yield new insight into breast tumorigenesis, and could provide targets for future therapeutic developments. In this respect the most interesting candidate genes include those mediating a range of functions, such as carcinogen metabolism, DNA repair, steroid hormone metabolism, signal transduction, and cell cycle control. Although the relative risks of these low penetrance susceptibility genes, to the development of breast cancer, are generally lower than those from high penetrance susceptibility genes (e.g., BRCA1, BRCA2, etc.), the attributable risk of low penetrance genes are much higher than those of the high penetrance genes, since the frequency of their variant alleles are higher in the general population. Thus, higher public health significance lays with these low penetrance genes, With their use it may be possible to obtain greater mechanistic insights into human breast carcinogenesis as well as targeted preventive approaches to the individuals with ‘at risk’ genotypes (Table 1). We have conducted a hospital based case-control study in South Korea to further evaluate the potential modifying role of the genetic polymorphisms of selected genes involved in the metabolism of carcinogens, estrogen metabolism, signal transduction, and DNA repair, also taking into account the potential interaction between these and known risk factors of breast cancer (Table 2). The results from selected genes will be presented in this mini-review.","PeriodicalId":414717,"journal":{"name":"Journal of Korean Breast Cancer Society","volume":"496 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2002-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"129276507","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2002-09-01DOI: 10.4048/JKBCS.2002.5.3.189
V. Sacchini
189 There are debates among breast cancer surgeons around the world regarding what is still considered “experimental” and what is considered routine in the surgical management of breast cancer. During the last 5 years there have been important changes in the surgical approach to breast cancer. These have been applied to the routine management of breast cancer in a rapid pace never seen before. The conservative treatment of breast cancer took approximately 20 years to become well accepted and applied worldwide. The 25-year findings still needed to be published to convince some reluctant surgeons that the procedures were safe.(1,2) Recently proposed procedures, the sentinel node biopsy, for example, were quite uniformly accepted(3) as routine management only a few years after the first consistent preliminary results were published.(4,5) The sentinel node procedure is only one example of the several proposed procedures during the last 5 years; others include intraoperative radiation therapy(6) and new localization techniques on nonpalpable breast lesions.(7,8) Several factors may explain this fast change in the routine surgical management. The detection of small tumor is the most important explanation of the continuous trend in developing less aggressive surgery and improving the quality of life of breast cancer patients. In the last 10 years surgeons have had to face a new entity of breast cancers: often, ductal carcinoma in situ (DCIS), sometimes with microinvasion and small tumors with low probability of axillary node involvement. The surgical approach and even the surgical techniques in use 10 years ago are often no longer applicable to the “modern breast cancer patients”; the surgery is becoming more and more sophisticated. The patients are more aware of this sophistication and are searching for the “best” treatment. This induces surgeons and hospitals to offer the modern treatments in order to be competitive. This acceleration in putting experimental procedures into practice may sometimes be excessive, especially when the benefit of a new procedure is not well demonstrated and clinical trials are still in progress. On the other hand, patients participate more in the decision of their treatment and better understand the risks and benefits of a specific treatment. They may accept the risk of a new treatment with the benefit, for example, of a less aggressive surgery. Another important element that safeguards patients is the use of a controlled clinical trial. More often, clinical trials are designed to be multicentric and involve several institutions, sometimes small ones that benefit from the experience and quality control of the bigger centers. The most important task for a physician facing new proposals is to honestly consider the evidence of whether or not the method is safe and better than previous techniques. If evidence is not provided, the physician should consider joining a clinical trial and should never apply the procedure only becaus
{"title":"Surgery of Breast Cancer during the Last 5 Years: More Sophisticated and Specialized?","authors":"V. Sacchini","doi":"10.4048/JKBCS.2002.5.3.189","DOIUrl":"https://doi.org/10.4048/JKBCS.2002.5.3.189","url":null,"abstract":"189 There are debates among breast cancer surgeons around the world regarding what is still considered “experimental” and what is considered routine in the surgical management of breast cancer. During the last 5 years there have been important changes in the surgical approach to breast cancer. These have been applied to the routine management of breast cancer in a rapid pace never seen before. The conservative treatment of breast cancer took approximately 20 years to become well accepted and applied worldwide. The 25-year findings still needed to be published to convince some reluctant surgeons that the procedures were safe.(1,2) Recently proposed procedures, the sentinel node biopsy, for example, were quite uniformly accepted(3) as routine management only a few years after the first consistent preliminary results were published.(4,5) The sentinel node procedure is only one example of the several proposed procedures during the last 5 years; others include intraoperative radiation therapy(6) and new localization techniques on nonpalpable breast lesions.(7,8) Several factors may explain this fast change in the routine surgical management. The detection of small tumor is the most important explanation of the continuous trend in developing less aggressive surgery and improving the quality of life of breast cancer patients. In the last 10 years surgeons have had to face a new entity of breast cancers: often, ductal carcinoma in situ (DCIS), sometimes with microinvasion and small tumors with low probability of axillary node involvement. The surgical approach and even the surgical techniques in use 10 years ago are often no longer applicable to the “modern breast cancer patients”; the surgery is becoming more and more sophisticated. The patients are more aware of this sophistication and are searching for the “best” treatment. This induces surgeons and hospitals to offer the modern treatments in order to be competitive. This acceleration in putting experimental procedures into practice may sometimes be excessive, especially when the benefit of a new procedure is not well demonstrated and clinical trials are still in progress. On the other hand, patients participate more in the decision of their treatment and better understand the risks and benefits of a specific treatment. They may accept the risk of a new treatment with the benefit, for example, of a less aggressive surgery. Another important element that safeguards patients is the use of a controlled clinical trial. More often, clinical trials are designed to be multicentric and involve several institutions, sometimes small ones that benefit from the experience and quality control of the bigger centers. The most important task for a physician facing new proposals is to honestly consider the evidence of whether or not the method is safe and better than previous techniques. If evidence is not provided, the physician should consider joining a clinical trial and should never apply the procedure only becaus","PeriodicalId":414717,"journal":{"name":"Journal of Korean Breast Cancer Society","volume":"33 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2002-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"133941219","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2002-09-01DOI: 10.4048/JKBCS.2002.5.3.209
K. Yoo, A. Shin
{"title":"Epidemiological Characteristics of Breast Cancer in Korea","authors":"K. Yoo, A. Shin","doi":"10.4048/JKBCS.2002.5.3.209","DOIUrl":"https://doi.org/10.4048/JKBCS.2002.5.3.209","url":null,"abstract":"","PeriodicalId":414717,"journal":{"name":"Journal of Korean Breast Cancer Society","volume":"53 5-6","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2002-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"114010372","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2002-09-01DOI: 10.4048/JKBCS.2002.5.3.212
W. Park
Historically the endocrine therapy of breast cancer originated from a novel concept proposed by George Thomas Beaston, a surgeon in Glasgow. In 1896, he published a paper about the successful treatment of a premenopausal woman with recurrent breast cancer by bilateral oophorectomy. Actually, the principal hormone of the ovary, estrogen, was identified in 1923. Thereafter, many efforts were made to prevent estrogen production by means of radiation to ovaries, bilateral adrenalectomy, or hypophysectomy. Endocrine therapy experienced a step change in the 1960's when the estrogen receptor (ER) was discovered. This led to the elucidation of the mechanisms of estrogen action and established ER as a new target of endocrine therapy. Tamoxifen, the first selective ER modulator (SERM), has been the gold standard in the endocrine therapy of breast cancer since the drug had first been approved in the 1970s for the treatment of advanced breast cancer in the UK and the USA. Over the last 8 years, tamoxifen has been considered to be the main means of reducing mortality from breast cancer in western countries.(1) The impact of endocrine therapy for breast cancer was confirmed by the 1995 Oxford overview.(2) Recently, new endocrine agents with various action mechanisms, such as the third-generation of aromatase inhibitors, and ER downregulators, revealed equivalent or better results in the treatment of breast cancer as tamoxifen. The 7th International Conference on Adjuvant Therapy of Primary Breast Cancer held at St. Gallen, Switzerland, also recognized the increased role of endocrine therapy in properly selected patients groups, especially in younger patients with ER-positive tumors.(3) At present, numerous trials are ongoing to determine optimal endocrine therapy for breast cancer. In addition, recent advances in research upon estrogen and ER function at the molecular level have provided new strategies and a better understanding of endocrine therapy for breast cancer. Accordingly, in this review, we have attempted to summarize the basic concepts of Current Understanding of Endocrine Therapy for Breast Cancer
{"title":"Current Understanding of Endocrine Therapy for Breast Cancer","authors":"W. Park","doi":"10.4048/JKBCS.2002.5.3.212","DOIUrl":"https://doi.org/10.4048/JKBCS.2002.5.3.212","url":null,"abstract":"Historically the endocrine therapy of breast cancer originated from a novel concept proposed by George Thomas Beaston, a surgeon in Glasgow. In 1896, he published a paper about the successful treatment of a premenopausal woman with recurrent breast cancer by bilateral oophorectomy. Actually, the principal hormone of the ovary, estrogen, was identified in 1923. Thereafter, many efforts were made to prevent estrogen production by means of radiation to ovaries, bilateral adrenalectomy, or hypophysectomy. Endocrine therapy experienced a step change in the 1960's when the estrogen receptor (ER) was discovered. This led to the elucidation of the mechanisms of estrogen action and established ER as a new target of endocrine therapy. Tamoxifen, the first selective ER modulator (SERM), has been the gold standard in the endocrine therapy of breast cancer since the drug had first been approved in the 1970s for the treatment of advanced breast cancer in the UK and the USA. Over the last 8 years, tamoxifen has been considered to be the main means of reducing mortality from breast cancer in western countries.(1) The impact of endocrine therapy for breast cancer was confirmed by the 1995 Oxford overview.(2) Recently, new endocrine agents with various action mechanisms, such as the third-generation of aromatase inhibitors, and ER downregulators, revealed equivalent or better results in the treatment of breast cancer as tamoxifen. The 7th International Conference on Adjuvant Therapy of Primary Breast Cancer held at St. Gallen, Switzerland, also recognized the increased role of endocrine therapy in properly selected patients groups, especially in younger patients with ER-positive tumors.(3) At present, numerous trials are ongoing to determine optimal endocrine therapy for breast cancer. In addition, recent advances in research upon estrogen and ER function at the molecular level have provided new strategies and a better understanding of endocrine therapy for breast cancer. Accordingly, in this review, we have attempted to summarize the basic concepts of Current Understanding of Endocrine Therapy for Breast Cancer","PeriodicalId":414717,"journal":{"name":"Journal of Korean Breast Cancer Society","volume":"22 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2002-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"124811940","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2002-06-01DOI: 10.4048/JKBCS.2002.5.2.168
Jong Min Park, S. Jin, M. Kim, H. Yim, C. Park, K. I. Chung, H. Park
Purpose: Sentinel lymph node (SLN) biopsy is a useful method for assessing axillary nodal status and selecting axillary dissection in breast cancer patients. The goals of our study were to evaluate the detection rate of SLN and determine the accuracy of SLN biopsy in predicting axillary nodal status using technetium radiolabeled sulfur colloid and isosulfan blue dye. Method.: Between January and August 2001, 55 breast cancer patients with clinically node negative results underwent SLN biopsy from the Department of Surgery at Ajou University Hospital. Both technetium radiolabeled sulfur colloid and isosulfan blue dye were used to guide SLN biopsy. SLN biopsy was always followed by a complete axillary dissection. The histopathology of SLNs determined from frozen sectioning and serial sectioning was compared with that of the nonsentinel nodes evaluated with routine Hematoxylin and Eosin stain. ResuIts: The overall SLN detection rate was 85.4% (47 of 55 patients). The staging accuracy of SLN biopsy was 97.9% (46 of 47 patients), the sensitivity 92.3% (12/13), the false negative rate 7.7% (1/13), and the negative predictive value 97.1% (34 of 35). Conclusion: Our study was a pilot study for SLN biopsy. SLN biopsy was more effective when a combination of technetium radiolabeled sulfur colloid and isosulfan blue dye were used. The results of our study support the hypothesis that SLN biopsy is an accurate predictor of axillary nodal status. SLN biopsy may be applicable to early breast cancer patients and thereby allow the omission of routine axillary dissection in selected cases.
{"title":"Sentinel Lymph Node Biopsy Using Technetium-99m Antimony Sulfide Colloid and Isosulfan Blue Dye in Breast Cancer Patients","authors":"Jong Min Park, S. Jin, M. Kim, H. Yim, C. Park, K. I. Chung, H. Park","doi":"10.4048/JKBCS.2002.5.2.168","DOIUrl":"https://doi.org/10.4048/JKBCS.2002.5.2.168","url":null,"abstract":"Purpose: Sentinel lymph node (SLN) biopsy is a useful method for assessing axillary nodal status and selecting axillary dissection in breast cancer patients. The goals of our study were to evaluate the detection rate of SLN and determine the accuracy of SLN biopsy in predicting axillary nodal status using technetium radiolabeled sulfur colloid and isosulfan blue dye. Method.: Between January and August 2001, 55 breast cancer patients with clinically node negative results underwent SLN biopsy from the Department of Surgery at Ajou University Hospital. Both technetium radiolabeled sulfur colloid and isosulfan blue dye were used to guide SLN biopsy. SLN biopsy was always followed by a complete axillary dissection. The histopathology of SLNs determined from frozen sectioning and serial sectioning was compared with that of the nonsentinel nodes evaluated with routine Hematoxylin and Eosin stain. ResuIts: The overall SLN detection rate was 85.4% (47 of 55 patients). The staging accuracy of SLN biopsy was 97.9% (46 of 47 patients), the sensitivity 92.3% (12/13), the false negative rate 7.7% (1/13), and the negative predictive value 97.1% (34 of 35). Conclusion: Our study was a pilot study for SLN biopsy. SLN biopsy was more effective when a combination of technetium radiolabeled sulfur colloid and isosulfan blue dye were used. The results of our study support the hypothesis that SLN biopsy is an accurate predictor of axillary nodal status. SLN biopsy may be applicable to early breast cancer patients and thereby allow the omission of routine axillary dissection in selected cases.","PeriodicalId":414717,"journal":{"name":"Journal of Korean Breast Cancer Society","volume":"26 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2002-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"123728349","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2002-06-01DOI: 10.4048/JKBCS.2002.5.2.102
B. Seo, Y. Oh, K. Cho, Young Hen Lee, Hyung Joon Noh, Ji Yung Lee, J. Lee, Bo-Kyung Je, E. Choi, N. Lee, Jung Hyuk Kim, J. Bae, S. Kim
Purpose: Real-time compound imaging obtains multiple coplanar tomographic ultrasound images and combines them into a single compound image, reducing acoustic artifacts and noise. The purpose of this study is to determine if real-time compound imaging improves evaluation of breast cancer compared to conventional sonography. Methods: From May 2000 to July 2001, we scanned the same axial plane with conventional sonography and real-time compound imaging in 520 patients with solid breast nodules. Twenty-eight cancers in 25 patients which were confirmed pathologically were included in this study. Twenty-five of 28 cases were invasive ductal carcinoma and the remaining three were ductal carcinoma in situ. Each image pair consisted of a conventional ultrasound and a real-time compound image with a stationary probe, to maintain an identical projection. The evaluating points were 1) contrast between cancer and normal breast tissue, 2) depiction of margin, 3) clarity of internal echotexture, 4) clarity of posterior echo pattern, and 5) clarity of internal microcalcifi-
{"title":"Does Real-time Compound Imaging Improve Evaluation of Breast Cancer Compared to Conventional Sonography?","authors":"B. Seo, Y. Oh, K. Cho, Young Hen Lee, Hyung Joon Noh, Ji Yung Lee, J. Lee, Bo-Kyung Je, E. Choi, N. Lee, Jung Hyuk Kim, J. Bae, S. Kim","doi":"10.4048/JKBCS.2002.5.2.102","DOIUrl":"https://doi.org/10.4048/JKBCS.2002.5.2.102","url":null,"abstract":"Purpose: Real-time compound imaging obtains multiple coplanar tomographic ultrasound images and combines them into a single compound image, reducing acoustic artifacts and noise. The purpose of this study is to determine if real-time compound imaging improves evaluation of breast cancer compared to conventional sonography. Methods: From May 2000 to July 2001, we scanned the same axial plane with conventional sonography and real-time compound imaging in 520 patients with solid breast nodules. Twenty-eight cancers in 25 patients which were confirmed pathologically were included in this study. Twenty-five of 28 cases were invasive ductal carcinoma and the remaining three were ductal carcinoma in situ. Each image pair consisted of a conventional ultrasound and a real-time compound image with a stationary probe, to maintain an identical projection. The evaluating points were 1) contrast between cancer and normal breast tissue, 2) depiction of margin, 3) clarity of internal echotexture, 4) clarity of posterior echo pattern, and 5) clarity of internal microcalcifi-","PeriodicalId":414717,"journal":{"name":"Journal of Korean Breast Cancer Society","volume":"5 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2002-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"126784818","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2002-06-01DOI: 10.4048/JKBCS.2002.5.2.91
Young Rahn Lee, B. Seo, K. B. Chung, K. Cho, J. Lee, Young Hen Lee, Hyung Joon Noh, Seung Hwa Lee, O. Woo, Bo-Kyung Je, Kyoung Rae Kim, Jung Hyuk Kim, J. Bae, Insun Kim
Purpose: The incidence of breast cancer is continuously increasing in Korea, and the age of the initially detected breast cancer is younger than western people. The purpose of this study was to compare radiological, pathological, and clinical findings of breast cancers according to age and then contribute to the basis of screening program of breast cancer. Methods: Retrospectively, the 325 patients who had pathologically confirmed breast cancer were included in this study. The patients were classified into 6 groups according to age, 20∼29, 30∼39, 40∼49, 50∼59, 60∼69, and more than 70 years. We evaluated the radiological findings of 325 cases of mammography and 144 cases of breast ultrasonography, classified as four types; mass, microcalcification, others, and non-detected lesion, and then analyzed radiological findings according to age. We evaluated pathological and clinical findings according to age and compared with radiological findings. We used Mantel-Haenszel's χ test and trend test for comparison according to age. Results: The incidence of breast cancer was 61 cases (19%) in 30∼39 years, 122 (38%) in 40∼49 years, 92 (28%) in 50∼59 years. Most of breast cancer was invasive ductal carcinoma, 258 (79%) and in situ carcinoma was 32 (10%). Most of in situ carcinoma was detected in 20∼59 years, 31/32 (97%). Mammography showed mass in 237 (73%), microcalcification in 45 (14%), other finding in 13 (4%), and non-detected lesion in 30 (9%). Twenty-one (47%) of 45 cases with microcalcification were in situ carcinoma and most of in situ carcinoma was presented as microcalcification on mammography, 21/32 (66%). In twenty-eight of 30 cases (93%) with non-detected lesion on mammography, breast cancer was detected on ultrasonography. In terms of clinical findings, there was no symptom in 12/32 (38%) with in situ carcinoma and 57/258 (22%) with invasive ductal carcinoma. Conclusion: The incidence of breast cancer is abruptly increasing from 4th decades and there is no significant difference in radiological and clinical findings according to age. But, most of in situ carcinoma was detected in 20∼59 years and presented as microcalcification on mammography. Thus, Screening mammography should be considered from 4th decades. (Journal of Korean Breast Cancer Society 2002;5:91-101)
{"title":"A Comparative Study of Breast Cancer of Korean Women according to Age in Radiological, Pathological, and Clinical Findings","authors":"Young Rahn Lee, B. Seo, K. B. Chung, K. Cho, J. Lee, Young Hen Lee, Hyung Joon Noh, Seung Hwa Lee, O. Woo, Bo-Kyung Je, Kyoung Rae Kim, Jung Hyuk Kim, J. Bae, Insun Kim","doi":"10.4048/JKBCS.2002.5.2.91","DOIUrl":"https://doi.org/10.4048/JKBCS.2002.5.2.91","url":null,"abstract":"Purpose: The incidence of breast cancer is continuously increasing in Korea, and the age of the initially detected breast cancer is younger than western people. The purpose of this study was to compare radiological, pathological, and clinical findings of breast cancers according to age and then contribute to the basis of screening program of breast cancer. Methods: Retrospectively, the 325 patients who had pathologically confirmed breast cancer were included in this study. The patients were classified into 6 groups according to age, 20∼29, 30∼39, 40∼49, 50∼59, 60∼69, and more than 70 years. We evaluated the radiological findings of 325 cases of mammography and 144 cases of breast ultrasonography, classified as four types; mass, microcalcification, others, and non-detected lesion, and then analyzed radiological findings according to age. We evaluated pathological and clinical findings according to age and compared with radiological findings. We used Mantel-Haenszel's χ test and trend test for comparison according to age. Results: The incidence of breast cancer was 61 cases (19%) in 30∼39 years, 122 (38%) in 40∼49 years, 92 (28%) in 50∼59 years. Most of breast cancer was invasive ductal carcinoma, 258 (79%) and in situ carcinoma was 32 (10%). Most of in situ carcinoma was detected in 20∼59 years, 31/32 (97%). Mammography showed mass in 237 (73%), microcalcification in 45 (14%), other finding in 13 (4%), and non-detected lesion in 30 (9%). Twenty-one (47%) of 45 cases with microcalcification were in situ carcinoma and most of in situ carcinoma was presented as microcalcification on mammography, 21/32 (66%). In twenty-eight of 30 cases (93%) with non-detected lesion on mammography, breast cancer was detected on ultrasonography. In terms of clinical findings, there was no symptom in 12/32 (38%) with in situ carcinoma and 57/258 (22%) with invasive ductal carcinoma. Conclusion: The incidence of breast cancer is abruptly increasing from 4th decades and there is no significant difference in radiological and clinical findings according to age. But, most of in situ carcinoma was detected in 20∼59 years and presented as microcalcification on mammography. Thus, Screening mammography should be considered from 4th decades. (Journal of Korean Breast Cancer Society 2002;5:91-101)","PeriodicalId":414717,"journal":{"name":"Journal of Korean Breast Cancer Society","volume":"82 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2002-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"127610946","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2002-06-01DOI: 10.4048/JKBCS.2002.5.2.147
B. Son, K. Lee, C. Kim, H. Yoon, S. Ahn
Purpose: In the WHO classification of breast carcinoma, invasive ductal carcinoma with predominant intraductal component (IDC with PIC) has been defined as carcinomas in which the component of ductal carcinoma in situ amounts to four times more than the invasive element in area. This study was designed to evaluate the clinicopathological significance of IDC with PIC. Methods: Five hundred and seventy nine patients with breast cancer (154 IDC with PIC and 425 with T1 invasive ductal carcinomas) treated with mastectomy or breast conserving surgery between 1989 and 1998 at the Asan Medical Center were divided into two study groups (IDC with PIC and T1 IDC) and compared the clinicopathological characteristics and survival of both groups. Results: By comparison with the T1 IDC, the IDC with PIC has several distinct features including younger mean age of occurrence (45.3 years vs 48.3 years, P=0.002), larger mean tumor size (3.5 cm vs 1.6 cm, P<0.001), lower incidence of axillary lymph node metastasis (15.7% vs 31.3%, P< 0.001) and estrogen receptor positivity (45.7% vs 59.2%, P=0.03), higher incidence of low histologic grade (78.7% vs 61.7%, P=0.002) and cancer detection rate by screening without symptom (21.6% vs 11.5%, P=0.003) or clinical manifestation of nipple discharge (17.3% vs 4.3%, P<0.001) and microcalcification with or without mass on mammography (58.7% vs 30.2%, P<0.001). There were no significant difference in the cumulative 5-year overall and disease-free survival rates (93.1% vs 90.1%, P=0.78; 89.5% vs 86%, P=0.23). In the IDC with PIC group, tumors larger than 2 cm in size were more frequently metastasized to axillary lymph nodes than tumors smaller than 2 cm, but this finding was not significant (P=0.07). Conclusion: Invasive ductal carcinoma with predominant intraductal component showed less invasive and more low-grade malignant characteristics than T1 invasive ductal carcinoma. Survival was not statistically different. (Journal of Korean Breast Cancer Society 2002;5:147-153)
目的:WHO对乳腺癌的分类中，浸润性导管癌(invasive ductal carcinoma with dominant intrductal component, IDC with PIC)被定义为原位导管癌成分大于浸润性导管成分4倍的肿瘤。本研究旨在评估IDC合并PIC的临床病理意义。方法:将1989 ~ 1998年峨山医院行乳房切除术或保乳手术的579例乳腺癌患者(IDC合并PIC患者154例，T1期浸润性导管癌患者425例)分为IDC合并PIC组和T1期浸润性导管癌组，比较两组患者的临床病理特征和生存率。结果:与T1型IDC相比，PIC型IDC的平均发病年龄较低(45.3岁vs 48.3岁，P=0.002)，肿瘤平均体积较大(3.5 cm vs 1.6 cm, P<0.001)，腋窝淋巴结转移发生率较低(15.7% vs 31.3%， P<0.001)，雌激素受体阳性发生率较低(45.7% vs 59.2%， P=0.03)，低组织学分级发生率较高(78.7% vs 61.7%， P=0.002)，无症状筛查的癌症检出率较高(21.6% vs 11.5%)。P=0.003)或乳头溢液的临床表现(17.3% vs 4.3%， P<0.001)和乳房x光检查伴有或不伴有肿块的微钙化(58.7% vs 30.2%， P<0.001)。累积5年总生存率和无病生存率无显著差异(93.1% vs 90.1%， P=0.78;89.5% vs 86%， P=0.23)。在IDC合并PIC组中，大于2cm的肿瘤比小于2cm的肿瘤更容易转移到腋窝淋巴结，但这一发现无统计学意义(P=0.07)。结论:以导管内成分为主的浸润性导管癌较T1浸润性导管癌侵袭性小，恶性程度低。生存率无统计学差异。(韩国乳腺癌学会杂志2002;5:147-153)
{"title":"Clinical Significance of Invasive Ductal Carcinoma with Predominant Intraductal Component in Breast Cancer -Comparison with T1 Invasive Ductal Carcinoma-","authors":"B. Son, K. Lee, C. Kim, H. Yoon, S. Ahn","doi":"10.4048/JKBCS.2002.5.2.147","DOIUrl":"https://doi.org/10.4048/JKBCS.2002.5.2.147","url":null,"abstract":"Purpose: In the WHO classification of breast carcinoma, invasive ductal carcinoma with predominant intraductal component (IDC with PIC) has been defined as carcinomas in which the component of ductal carcinoma in situ amounts to four times more than the invasive element in area. This study was designed to evaluate the clinicopathological significance of IDC with PIC. Methods: Five hundred and seventy nine patients with breast cancer (154 IDC with PIC and 425 with T1 invasive ductal carcinomas) treated with mastectomy or breast conserving surgery between 1989 and 1998 at the Asan Medical Center were divided into two study groups (IDC with PIC and T1 IDC) and compared the clinicopathological characteristics and survival of both groups. Results: By comparison with the T1 IDC, the IDC with PIC has several distinct features including younger mean age of occurrence (45.3 years vs 48.3 years, P=0.002), larger mean tumor size (3.5 cm vs 1.6 cm, P<0.001), lower incidence of axillary lymph node metastasis (15.7% vs 31.3%, P< 0.001) and estrogen receptor positivity (45.7% vs 59.2%, P=0.03), higher incidence of low histologic grade (78.7% vs 61.7%, P=0.002) and cancer detection rate by screening without symptom (21.6% vs 11.5%, P=0.003) or clinical manifestation of nipple discharge (17.3% vs 4.3%, P<0.001) and microcalcification with or without mass on mammography (58.7% vs 30.2%, P<0.001). There were no significant difference in the cumulative 5-year overall and disease-free survival rates (93.1% vs 90.1%, P=0.78; 89.5% vs 86%, P=0.23). In the IDC with PIC group, tumors larger than 2 cm in size were more frequently metastasized to axillary lymph nodes than tumors smaller than 2 cm, but this finding was not significant (P=0.07). Conclusion: Invasive ductal carcinoma with predominant intraductal component showed less invasive and more low-grade malignant characteristics than T1 invasive ductal carcinoma. Survival was not statistically different. (Journal of Korean Breast Cancer Society 2002;5:147-153)","PeriodicalId":414717,"journal":{"name":"Journal of Korean Breast Cancer Society","volume":"151 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2002-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"131919853","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2002-06-01DOI: 10.4048/JKBCS.2002.5.2.118
Sørensen Oh, M. Kang, W. Moon, H. Choi
Purpose: The insulin-like growth factor-I receptor (IGF-IR) is a member of the transmembrane tyrosine kinase family that regulates various biological processes. These processes include maintaining optimal cell growth, establishing and maintaining the transformed phenotype, tumorigenesis for several types of cells and antiapoptosis. This study investigated the immunohistochemical expression of IGF-IR in relation with the expression of the estrogen receptor (ER), the progesteron receptor (PR), proliferative activity (Ki-67) as well as with the other conventional clinicopathlogicat parameters in breast cancer. Methods: This study was performed on paraffin sections from 64 invasive ductal breast carcinoma specimens by immunohistochemistry using rabbit polyclonal antibodies to the IGF-I receptor. Results: IGF-IR expression was detected in 56 (87.5%) cases. The immunohistochemical stains for the IGF-IR were scored according to a semi quantitative scoring system. IGF-IR staining was positively correlated with the ER status, but not significantly with the PR, lymph node status, tumor size, histologicaI grade, and proliferative activity. The Ki-67 labeling index showed a significant correlation with the tumor grade and ER status. ConcIusion: The IGF-IR may play a role in estrogen-mediated growth and the pathogenesis of breast cancer.
{"title":"Correlation between Expression of Insulin-like Growth Factor-I Receptor and Clinicopathologic Prognostic Factors in Invasive Ductal Carcinoma of the Breast","authors":"Sørensen Oh, M. Kang, W. Moon, H. Choi","doi":"10.4048/JKBCS.2002.5.2.118","DOIUrl":"https://doi.org/10.4048/JKBCS.2002.5.2.118","url":null,"abstract":"Purpose: The insulin-like growth factor-I receptor (IGF-IR) is a member of the transmembrane tyrosine kinase family that regulates various biological processes. These processes include maintaining optimal cell growth, establishing and maintaining the transformed phenotype, tumorigenesis for several types of cells and antiapoptosis. This study investigated the immunohistochemical expression of IGF-IR in relation with the expression of the estrogen receptor (ER), the progesteron receptor (PR), proliferative activity (Ki-67) as well as with the other conventional clinicopathlogicat parameters in breast cancer. Methods: This study was performed on paraffin sections from 64 invasive ductal breast carcinoma specimens by immunohistochemistry using rabbit polyclonal antibodies to the IGF-I receptor. Results: IGF-IR expression was detected in 56 (87.5%) cases. The immunohistochemical stains for the IGF-IR were scored according to a semi quantitative scoring system. IGF-IR staining was positively correlated with the ER status, but not significantly with the PR, lymph node status, tumor size, histologicaI grade, and proliferative activity. The Ki-67 labeling index showed a significant correlation with the tumor grade and ER status. ConcIusion: The IGF-IR may play a role in estrogen-mediated growth and the pathogenesis of breast cancer.","PeriodicalId":414717,"journal":{"name":"Journal of Korean Breast Cancer Society","volume":"5 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2002-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"128645154","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
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