한국인유전성유방/난소암고위험군에서난소암의 유병률

이지현,배영태,안세현,김성원,조영업,정성후,장명철,한세환,강은영,박보영,박수경,이희대,정준,이병길,황기태,김현아,김은규,백남선,윤찬석,한국유방암학회,이민혁 한국유방암학회 2011 Journal of breast cancer Vol.14 No.-

Purpose: Few studies have reported ovarian cancer risks in Korean patients with the BRCA1/2 mutation. We investigated the prevalence of ovarian cancer in Korean women at high risk for hereditary breast-ovarian cancer (HBOC) syndrome and reviewed the clinicopathological factors of ovarian cancer. Methods: Female subjects who were enrolled in the Korean Hereditary Breast Cancer study were included.The questionnaire included a personal and family history of cancer. The BRCA1/2 mutation and CA-125 level were tested at the time of enrollment. A transvaginal ultrasonogram (TVUS) was recommended for subjects with an elevated CA-125 level. Results: A total of 1,689 patients were included.No ovarian cancer was newly diagnosed by CA-125 level or TVUS during the enrollment. The prevalence of ovarian cancer was 1.71% in BRCA1/2 mutation carriers and 0.39% in non-carriers. Among 11 patients with ovarian cancer, five had the BRCA1 mutation and one had the BRCA2 mutation. The most common histopathological type was serous cystadenocarcinoma.No difference in clinicopathological findings between BRCA1/2 mutation carriers and non-carriers was observed. Conclusion: The prevalence of ovarian cancer was 58-fold elevated in women at high-risk for HBOC syndrome and 146-fold elevated in the BRCA1 subgroup, compared with the Korean general population. Further investigation with a long-term follow-up is required to evaluate BRCA1/2 gene penetrance.

침윤성 유방암의 보존술 이후 발생하는 국소 재발의 위험인자

이온복,이종원,김희정,임우성,박은화,이정선,손병호,공경엽,안승도,안세현 한국유방암학회 2009 Journal of breast cancer Vol.12 No.4

Purpose: Twenty-year follow-up results of two pioneering randomized controlled trials have demonstrated equal patient survival after mastectomy and breast conservation therapy. The use of breast conservation therapy has undoubtedly provided substantial progress towards a better quality of life for women with breast cancer. Outcomes of breast conservation therapy performed at Asan medical center were retrospectively reviewed and analyses were performed to determine significant risk factors of local recurrence. Methods: A total of 578 women with stage I, stage II or stage III breast cancer were treated with conservative surgery and radiation therapy between January 1997 and December 2002. Outcomes of local recurrence and survival were recorded. Results: During a median follow-up of 54.1 months, 21 patients (3.6%) developed local recurrence as first event and 10 patients (1.7%) developed regional recurrence and 19 patients (3.3%) developed systemic recurrence. Univariate analysis of the prognostic factors determined that age (p=0.005), nuclear grade (p=0.013), estrogen receptor negativity (p=0.008), lymphovascular invasion (p=0.009), progesterone receptor negativity (p=0.016) and lack of hormone therapy (p=0.005) were statistically significant factors associated only with locoregional recurrence. Results of multivariate analysis determined that lymphovascular invasion (p=0.045) strongly independent predictors for local recurrence. Conclusion: Age, nuclear grade, estrogen receptor negativity, lymphovascular invasion, progesterone receptor negativity and lack of hormone therapy were associated with local recurrence after Breast conserving surgery. The lymphovascular invasion was the strongest independent risk factors for local recurrence.

세침흡인을 통한 저에코성 종괴의 소멸

이동석,이종기,김지화 한국유방암학회 2004 한국유방암학회지 Vol.7 No.1

T1 및 T2 유방암의 유방보존수술 후에 동측 유방 내 국소재발의 위험 요인 분석

김지훈,한원식,문형곤,고은영,이종원,김은규,박인애,하성환,지의규,오승근,윤여규,김성원,황기태,노동영 한국유방암학회 2009 Journal of breast cancer Vol.12 No.4

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 HR 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.

유방암 환자의 F-18 FDG PET/CT 영상에서 우연히 관찰되는 갑상샘의 미만성 섭취 증가의 임상적 의의

정영진,임석태,김동욱,정환정,윤현조,정성후,손명희 한국유방암학회 2009 Journal of breast cancer Vol.12 No.4

Purpose: This study was to investigate the clinical significance of diffusely increased F-18 FDG uptake in the thyroid gland as an incidental finding on F-18 FDG PET/CT imaging in patients with breast carcinoma. Methods: One hundred four patients with breast carcinoma who had no prior history of thyroid disease were enrolled. All patients underwent F-18 FDG PET/CT, ultrasound and thyroid function test (TFTTSH, FT4, and T3), anti-TPO antibody test within 2 weeks. Also we checked estrogen (ER) and progesterone receptors (PR). We classified all patients into subgroups according to the existence and degree of F-18 FDG uptake in the thyroid gland, and evaluated the difference between subgroups. Results: Of the 104 patients, 42 (40.4%) subjects showed diffusely increased thyroid uptakes. There was no significant difference in rate of abnormality in TFT and thyroid US, and existence of anti-TPO antibody and ER/PR between two groups. Of 42 patient who showed diffuse uptake, 12 (28.5%), 13 (31.0%), and 17 (40.5%) subjects demonstrated hypointense, isointense, and hyperintense thyroid uptake compared with activity of mediastinal blood pool. Thirteen (76.4%) of 17 subjects in the hyperintense thyroid uptake group revealed abnormality in various tests (US, TFT, and anti-TPO antibody). The rate of abnormality in this group was significantly different with the other two groups (p=0.002). Conclusion: Our data suggested that the rate of diffuse thyroid uptakes on F-18 FDG PET/CT imaging of patients with breast carcinoma was higher than healthy subjects. In case of someone who had no prior thyroid disease showed diffuse thyroid uptakes more than activity of mediastinal blood pool on F-18 FDG PET/CT imaging, it should be considered further evaluation about the thyroid gland.

유방 전절제술 후 즉시 유방 재건술을 시행 받은 유방암 환자의 치료 성적

남상근,박세호,이동원,송승용,박형석,김승일,박병우,유대현 한국유방암학회 2014 Journal of Breast Disease Vol.2 No.2

Purpose: This study aimed to investigate clinical outcomes of breast cancer patients who underwent mastectomy with or without immediate breast reconstruction. Methods: Of 1,847 patients undergoing total mastectomy, 371 (20.1%) underwent immediate reconstruction between January 2005 and December 2011. Clinicopathological characteristics and survival were compared by performing univariate and multivariate analysis. Results: The proportion of reconstruction had been gradually increasing since 2009. Reconstruction group showed younger age at diagnosis and lower cancer stages. Adjuvant chemotherapy and radiation therapy were more frequently administered in the mastectomy alone group. During a median follow-up period of 57 months, locoregional relapse-free survival (LRRFS) was similar regardless of type of surgery. However the reconstruction group showed a more favorable overall survival (OS). Multivariate analysis for LRRFS revealed no statistical significance but the OS was higher in the reconstruction group. In the mastectomy alone group, two-thirds died of breast cancer, while all patients in the reconstruction group died of breast cancer. Stage-matched breast cancer specific survival was similar between both groups. Conclusion: Immediate breast reconstruction is oncologically safe after mastectomy for breast cancer. Considering the quality of life, the patient should be preoperatively counseled by a multidisciplinary team regarding possible immediate reconstruction.

유방암 치료를 위한 분자표적

박우찬,김이수,김태현,박병우,박호용,송병주,이재복,전창완,최운정 한국유방암학회 2009 Journal of breast cancer Vol.12 No.4

Advances in molecular biology have made it possible to understand the tumor biology of breast cancer at the molecular level and have revealed molecular targets for the therapy of breast cancer. Nowadays, targeting agents are used as mono-therapy or as combined therapy with other anticancer drugs for the treatment of breast cancer. Much more efforts is also being made in the development of better therapeutic agents targeting molecules having an important role in tumor biology. In this article, promising molecules for targeted therapy are reviewed for their roles in the pathophysiology and the treatment of breast cancer. We also introduce and summarize new preclinical agents, developed or on developing, with preliminary results from clinical trials. Given the progress currently being made, targeted therapy could become a main strategy for the treatment of breast cancer in the near future.

유방암에서 HER2 유전자 증폭 분석에 대한 은제자리부합법과 형광제자리부합법의 비교

김태정,김태은,정은선,임현우,송병주,정상설,이아원,최영진,이교영 한국유방암학회 2009 Journal of breast cancer Vol.12 No.4

Purpose: We want to validate the use of the silver-enhanced in situ hybridization (SISH) technique as comparised with fluorescence in situ hybridization (FISH) technique for assessing the HER2 gene amplification of breast carcinoma. Methods: Tissue microarray (TMA) blocks from 58 breast cancer specimens were prepared and the concordance between HER2 gene amplification in breast cancer was determined by the FISH (PathVysion, Abbott/Vysis) technique and the automated silver in situ hybridization (SISH, INFORMTM, Ventana) technique. For comparison, all the specimens were stained by immunohistochemistry (Ventana-PATHWAY4B5). Evaluation was performed by two pathologists and with following the instructions of the manufacturers and the guidelines of the American Society of Clinical Oncology/College of American Pathologists. Results: The results of SISH and FISH were identical in all 58 cases; 17 cases showed HER2 amplification, and on the other hand, 41 cases didn’t show HER2 amplification. Five weakly positive (2+) cases in immunohistochemistry staining revealed one HER2 amplification and four no HER2 amplification on both SISH and FISH. The SISH results of the HER2/CEP17 ratio were well correlated with the FISH results of the HER2/CEP17 ratio (correlation coefficient r=0.745, Linear regression r2=0.555, p<0.001). Conclusion: The results of the SISH technique for assessing the HER2 status of excised breast carcinoma is comparable to the result obtained by FISH. However, SISH has the advantage of having permanent end result that can be visualized by an ordinary light microscope and less laborious preparation and time is needed than is required by FISH. SISH seems to be more feasible than FISH for assessing HER2 amplification of breast cancer.

동일 T 병기 유방암에서 유방의 부피가 예후에 미치는 영향

이중재,전영산,강수환,이수정 한국유방암학회 2009 Journal of breast cancer Vol.12 No.4

Purpose: The aim of this study was to evaluate the prognostic significance of the breast volume in primary breast cancer patients with the same T stage. Methods: The study population consisted of 358 patients with T1 and T2 primary breast cancer, who underwent preoperative mammography and surgery in our institution from March 1992 to December 2006. The patients were divided into three groups based on the calculated breast volume as the following: Group A: <285 cc (n=117), Group B: 285-460 cc (n=121) and Group C: ≥460 cc (n=120). Overall survival (OS) and disease free survival (DFS) of the patients in the three groups in each T stage were analyzed. Results: The mean age was 46.3 years (age range, 22-85 years) and the mean calculated breast volume was 403.1 cc (volume range, 94-1,231 cc). As the age of patients was increased, the breast volume was increased (r=0.184, p<0.001). With a mean follow up period of 80.8 months, there was no significant difference in DFS or OS among patients in Groups A, B, and C (p>0.05). For patients with T1 stage disease, Group A patients showed the highest DFS and OS, and patients in Group C showed the lowest DFS and OS; however, the difference was not statistically significant (p>0.05). For patients with T2 disease, patients in Group C showed the highest DFS and OS, though the difference with the two other groups did not have statistical significance (p>0.05). Conclusion: The breast volume was not a significant predictor of DFS and OS for patients with T1 and T2 breast cancer. However it should be noted that this was the first study to evaluate the correlation between breast volume and survival in breast cancer patients.

유방암의 수신자판단특성곡선(ROC) 분석에 의한 정량적 Tc-99m Tetrofosmin Scintimammography의 진단적 정확도

박상현,박흥규,한상훈,이영돈,정민,이태훈,오재환,이정남,이운기,박연호,민승기,백정흠,김종호,황경훈 한국유방암학회 2004 한국유방암학회지 Vol.7 No.1