Comparative Accuracy of Preoperative Tumor Size Assessment on Breast Ultrasonography and Magnetic Resonance Imaging in Young Breast Cancer Patients

강상율,최은정,변정희,Ahn Ha Rim,윤현조,정성후 대한외과초음파학회 2020 대한외과초음파학회지 Vol.7 No.1

Purpose: Breast cancer in young women deserves special consideration, such as dense breast, more aggressive progression, and oncoplastic surgery. Magnetic resonance imaging (MRI) is a more recent modality than ultrasonography (US), but the role of MRI in patients with a dense breast is still controversial. This comparative study analyzed the relationship between the preoperative radiological and the postoperative pathological tumor size for young breast cancer patients. Methods: All breast cancers diagnosed in patients 45 years or younger from January 2016 to December 2018 were reviewed. Tumor size measurements obtained on breast US and MRI were compared for accuracy with those obtained in the final pathology results. Patients with only microcalcification on imaging modalities and those who had undergone neoadjuvant chemotherapy were excluded. Results: A total of 103 breast cancer patients were included in this study. Of the 103 breast cancers with both imaging modalities performed, 86 (83.5%) were infiltrating ductal carcinomas and 17 (16.5%) were ductal carcinoma in situ. The mean tumor size measured on MRI was significantly greater than that measured on pathology (18.5 ± 11.0 mm vs. 16.6 ± 8.5 mm), whereas the sizes measured on US was not significantly different from that measured on pathology (16.5 ± 9.5 mm vs. 16.6 ± 8.5 mm). The tumor size measured on MRI was greater than that measured on US. Conclusion: Measurements taken by US were more accurate in measuring the tumor size in patients 45 years of age or younger than MRI.

Breast Cancer Statistics in Korea in 2017: Data from a Breast Cancer Registry

강상율,김유석,김지선,김현열,김희정,박성민,배수연,윤광현,이새별,이세경,정규원,한재홍,윤현조,Korean Breast Cancer Society 한국유방암학회 2020 Journal of breast cancer Vol.23 No.2

This article describes the breast cancer statistics in Korea, including the incidence, type of surgical procedure, stage, and molecular subtype, using the Korean Breast Cancer Society (KBCS) and Korea Central Cancer Registry data. There were a total of 26,534 new breast cancer diagnoses in 2017 in Korea, of which 4,139 were carcinoma in situ cases and 22,395 were invasive cancer cases. The age standardized rate of breast cancer was 75.3 per 100,000 women in 2017 (63.0 of invasive carcinoma and 12.3 of carcinoma in situ), and it has been steadily increasing across all age groups. Breast cancer occurred most commonly in the 40–49 age group. Compared to 2016, breast conserving surgery (BCS) has increased, and 67.4% of patients were treated with BCS in 2017. The proportions of stage 0 and stage I have continued to increase, accounting for 60.7%. The most common subtype of breast cancer was hormone receptor (HR) positive and human epidermal growth factor receptor-2 (HER2) negative type comprising 65.9% of the cases, whereas HR negative and HER2 positive type was the rarest comprising 10.2% of the cases. The 5-year relative survival rate of breast cancer patients had increased by 14.0% from 79.2% in 1993–1995 to 93.2% in 2013–2017. It is essential to actively enter breast cancer data into the KBCS registry to improve our understanding.

Basic Findings Regarding Breast Cancer in Korea in 2015: Data from a Breast Cancer Registry

강상율,김유석,김지선,김현열,이세경,정규원,윤현조,Korean Breast Cancer Society 한국유방암학회 2018 Journal of breast cancer Vol.21 No.1

The Korean Breast Cancer Society (KBCS) has established a nationwide breast cancer database using an online registration program in 1996. The present study aimed to analyze the basic findings and trends of breast cancer in Korea in 2015 using the data provided by the Korea Central Cancer Registry and the KBCS. In 2015, a total of 22,550 patients were newly diagnosed with breast cancer, of which 3,331 were carcinoma in situ cases and 19,219 were invasive cancer cases. The incidence rate of breast cancer in Korea has steadily increased since the nationwide database was established, and the crude rate and agestandardized rate including that of carcinoma in situ, were 88.1 and 66.0 cases per 100,000 women, respectively. In terms of age, the incidence of breast cancer was the highest in the 40–49-year-old age group (7,889 patients, 35.0%). With regard to surgical procedure, breast-conserving surgery was frequently performed (62.3%). However, the rate of mastectomy has been gradually increasing since 2012, that is, from 32.3% in 2014 to 36.1% in 2015. The rate of early breast cancer has continued to increase, and that of stages III and IV breast cancer was only 9.1% at the time of diagnosis. However, the 5-year survival rate of patients with carcinoma in situ from 2011 to 2015 was 92.3%, which was 14.4% higher than that from 1993 to 1995 (77.9%). Analysis of data from the nationwide registry of breast cancer will not only help to understand the characteristics of breast cancer in individuals in Korea, but will also significantly contribute to the treatment and research of breast cancer. Therefore, a high quality database for breast cancer in Korea must be established by further initiating registration project and establishing an objective legal basis.

Breast Cancer Statistics in Korea, 2018

강상율,이새별,김유석,김지선,김현율,김희정,박성민,배수연,윤광현,이세경,정규원,한재홍,윤현조,Korean Breast Cancer Society 한국유방암학회 2021 Journal of breast cancer Vol.24 No.2

Breast cancer is the most common malignancy in Korean women, and its incidence continues to increase. The Korean Breast Cancer Society (KBCS) established a nationwide breast cancer database through its online enrollment program in 1996. This study aimed to analyze the clinical characteristics of breast cancer in Korea, and to assess the pattern of changes in breast cancer management in 2018. We analyzed the KBCS and Korea Central Cancer Registry (KCCR) databases in 2018. In 2018, 28,157 patients were newly diagnosed with breast cancer, of whom 4,510 had noninvasive breast cancer and 23,647 had invasive breast cancer. The age-standardized rate of breast cancer in 2018 was 79.0 per 100,000 women (65.6 invasive, 13.4 noninvasive). The median age of female patients diagnosed with breast cancer in 2018 was 52 years, and the incidence of breast cancer was the highest in the 40–49-years age group (9,432 patients, 33.6%). The proportion of patients with stage 0 and stage I breast cancer continued to increase, accounting for 63.8% of cases, and breast-conserving surgery was performed more often than mastectomy (66.2% vs. 33.0%). The most common subtypes of breast cancer were hormone receptor [HR]-positive and human epidermal growth factor receptor-2 (HER2)-negative types (65.9% of cases), while the HR-negative and HER2-positive types accounted for 9.2% of cases. According to the KCCR data, from 2014 to 2018, the 5-year relative survival rate of patients with breast cancer was 93.3%, which was 14.0% higher than that from 1993 to 1995 (79.3%). The clinical characteristics of breast cancer in Korea have been changing, and national databases can improve our understanding of the disease characteristics of Korean women. Therefore, updating the KBCS registry is important for the effective management of breast cancer in Korea.

유방 관상피내암에서 초음파와 MRI의 종양 크기 예측 정확도 비교

강상율,안하림,변정희,윤현조,정성후 한국유방암학회 2021 Journal of Breast Disease Vol.9 No.2

Purpose: The purpose of this study was to compare the accuracy of preoperative breast tumor size measured by ultrasonography (US) and magnetic resonance imaging (MRI) in patients with ductal carcinoma in situ (DCIS). Methods: Medical records of 74 patients postoperatively diagnosed with DCIS were retrospectively analyzed. Tumor size measurements obtained using the two imaging modalities were compared for accuracy with those obtained during the final pathologic examination. Patients with only microcalcification on imaging were excluded. Results: For all patients, Lin’s concordance correlation coefficient (CCC) of MRI was 0.725, which was more accurate than 0.670 of US. In subgroup analysis, CCC of US was 0.757, more accurate than 0.697 of MRI in premenopausal DCIS patients. Background parenchymal enhancement (BPE) was the only risk factor deteriorating the accuracy of US and MRI examinations. Moderate and marked BPE was associated with the inaccurate tumor size estimations in both US and MRI (odds ratio [OR]:2.23, 95% confidence interval [CI]=1.12−3.52, p=0.001 in US, OR:8.16, 95% CI=1.17−15.2, p=0.031 in MRI). Conclusion: MRI was more accurate for measuring tumor size in patients with DCIS. Moderate and marked BPE was a risk factor that prevented accurate measurement of preoperative tumor size. In premenopausal patients, US would help measure tumor size accurately.

미세기포를 이용한 퇴적물 정화

강상율(Sang Yul Kang),김형준(Hyoung Jun Kim),김충일(Tschung Il Kim),박현주(Hyun Ju Park),나춘기(Choon Ki Na),한무영(Moo Young Han) 대한환경공학회 2016 대한환경공학회지 Vol.38 No.8

본 연구는 미세기포를 이용하여 하천 및 호수의 퇴적물 내 영양염류 제어 가능성을 살펴보고자 하였다. 이를 위해 실제 호수에서 퇴적물을 채취하여 용출 특성 실험 및 기포를 이용한 퇴적물 및 영양염류 제거 실험을 수행하였다. 연구에 사용된 퇴적물의 입도분석 결과, 점토와 실트(<0.075 mm)비율은 약 7.7%, 모래(0.075~4.75 mm)는 약 67.8%, 자갈은(≥4.75 mm) 약 24.5%로 나타났다. 총질소(T-N), 총인 (T-P), 강열감량은 각각 2,790~3,260 mg/kg, 261~311 mg/kg, 4.1~9.6%로 나타났다. 퇴적물의 입도별 T-N과 T-P을 분석한 결과, 입도가 클수록 퇴적물의 T-N와 T-P 함량은 감소하는 경향을 나타냈다. 이는 입도가 클수록 비표면적이 작아져 흡착되는 오염물질량이 줄어들기 때문으로 판단된다. 기포의 특성에 따른 퇴적물의 제거효율을 분석한 결과, 압력 6기압, 순환률 30%, 응집제 주입량 15 ppm의 조건으로 실험을 수행하였을 때 퇴적물의 제거율이 19.9%로 가장 높게 나타났다. 이 때의 T-N, T-P의 제거효율도 21.4, 22.6%로 가장 높게 나타났다. 운전조건을 고정시키고 기포 주입횟수를 증가시키면서 T-N과 T-P의 제거효율을 살펴본 결과, 주입횟수 2회까지 T-N과 T-P의 제거효율은 높았으나, 3회부터는 제거효율이 낮아짐에 따라 주입횟수가 증가하더라도 제거효율에는 큰 변화를 보이지 않았다. 그리고 미세입자가 제거된 퇴적물의 영양염류 용출량은 미세입자를 제거하지 않은 퇴적물의 용출량보다 약 20.1~64.3% 정도 감소함을 알 수 있었다. 이를 통해 미세기포를 퇴적물에 반복적으로 주입하는 방안은 퇴적물 및 퇴적물에서의 영양염류 용출을 제어하는 효과적인 방안으로써 가능성이 있음을 확인할 수 있었다. This study was conducted on the sediment remediation using micro-bubble to remove fine particles. For this study, characteristics of contamination and release in sediment were analyzed. And then, the characteristics of bubbles on removal efficiency was investigated at various operation conditions. In particle size distribution of the sediment used for the study, the proportion of clay and silt (<0.075 mm) was about 7.7%, sand (0.075~4.75 mm) was about 67.8%, and gravel (≥4.75) was 24.5%. Total nitrogen (TN) and total phosphorus (TP) of the sediment were 2,790~3,260, 261~311 mg/kg respectively. Ignition loss and water content were 4.1~9.6, 32.9~53.2% respectively. In analysis of removal efficiency according to operation conditions of microbubble, it was the highest when operation condition is pressure 6 atm, pressurized water ratio 30%, and coagulant dosage 15 ppm. At the time, the sediment’s removal efficiency was 19.9%. Accordingly removal efficiency of TN and TP were 21.4, 22.6% respectively. Finally a research was found that fine particles in sediment were almost removed by micro-bubble, which led to decrease nutrients’ release at about 20.1~64.3% in comparison to sediment including lots of fine particles.

갑상선 유두암에서 전이 림프절 비율의 예후 인자적 가치

강상율(Sang Yull Kang),김선광(Seon Kwang Kim),윤현조(Hyun Jo Youn),정성후(Sung Hoo Jung) 대한갑상선-내분비외과학회 2015 The Koreran journal of Endocrine Surgery Vol.15 No.3

Purpose: Metastatic lymph node ratio (MLNR) is known as an important prognostic factor in many solid carcinomas; however, the role of MLNR in papillary thyroid carcinoma (PTC) is unclear. The purpose of this study was to determine whether MLNR has prognostic significance for recurrence in patients with pathological N1a PTC. Methods: A retrospective analysis was conducted of 1,198 patients with PTC who underwent total thyroidectomy with central neck dissection between 2006 and 2011. Only patients with central lymph node metastasis were included in this study. Patients with lateral neck lymph node metastasis or extrathyroidal involvement were excluded. Finally, this study included 282 patients with N1a patients. MLNR was defined as the number of metastatic lymph nodes divided by the number of removed lymph nodes. Results: Median age was 47.3 years (17∼73 years). There were 209 female patients and 41 male patients, respectively. Median follow-up period was 53 months (36∼114 months). Median value of MLNR was 0.36 (0.04∼1.000). Of 250 patients, 20 patients (8.0%) developed recurrent disease. MLNR independently predicted PTC recurrence (odds ratio [OR], 6.385; 95% confidence interval [CI], 2.523-16.158; P < 0.001). In receiver operating characteristic curve analysis, 0.47 was significantly meaningful for recurrence when three or more lymph nodes were collected. Conclusion: MLNR is an independent predictor of PTC recurrence in patients with pathological N1a PTC. Therefore, N1a patients with MLNR > 0.47 should be monitored closely for recurrence.

미세기포를 이용한 퇴적물 정화

강상율 ( Sang Yul Kang ),박현주 ( Hyun Ju Park ),김충일 ( Tschung-il Klm ),한무영 ( Moo Young Han ) 한국물환경학회(구 한국수질보전학회) 2015 한국물환경학회·대한상하수도학회 공동 춘계학술발표회 Vol.2015 No.-

Problems with Military Service

Sang Yul Kang(강상율) 대한외과학회 2014 대한외과학회 학술대회 초록집 Vol.2014 No.11

Risk factor for contralateral occult carcinoma in patients with unilateral papillary thyroid carcinoma

안하림,강상율,윤현조,정성후 대한종양외과학회 2020 Korean Journal of Clinical Oncology Vol.16 No.1

Purpose: The extent of surgery necessary in patients with unilateral papillary thyroid carcinoma (PTC) on preoperative radiologic imaging is still in doubt. In this study, we aimed to define risk factors that could be indicators for malignant nodules in the contralateral thyroid lobe. Methods: We included 438 patients who underwent total thyroidectomy between January 2011 and December 2014 at our institution. In this study, patients were divided into two groups according to the presence of contralateral occult carcinoma identified by postoperative pathological examination. We analyzed the clinicopathologic factors including characteristics of coexistent nodules in the contralateral lobe based on preoperative radiological imaging. Results: A total of 96 patients (21.9%) had PTC in the contralateral lobe. There were no significant differences between patients with or without contralateral occult carcinoma with respect to gender, age, primary tumor size, central lymph node metastasis, extrathyroidal extension and stage. The presence of Hashimoto’s thyroiditis was an independent predictive factor for contralateral occult carcinoma (P=0.01). Conclusion: A risk factor for contralateral occult carcinoma in unilateral PTC patients is Hashimoto’s thyroiditis. Therefore, more caution is needed when determining optimal surgical methods for PTC patients with Hashimoto’s thyroiditis.