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Rha, Sun Young,Sohn, Joohyuk,Kim, Gun Min,Kim, Hye Ryun,Lee, Jiyeon LIPPINCOTT WILLIAMS AND WILKINS 2018 Cancer nursing Vol.41 No.2
<P>Implications for Practice: Delayed nausea control may be improved by adhering to guideline-consistent antiemetics and using p.r.n. antiemetics. Delayed nausea control would contribute to patients' functioning and QOL.</P>
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Choi, Seo Hee,Kim, Jun Won,Choi, Jinhyun,Sohn, Joohyuk,Kim, Seung Il,Park, Seho,Park, Hyung Seok,Jeong, Joon,Suh, Chang-Ok,Keum, Ki Chang,Kim, Yong Bae,Lee, Ik Jae Elsevier 2018 Clinical breast cancer Vol.18 No.2
<P><B>Abstract</B></P> <P><B>Background</B></P> <P>The aim of this study was to assess the outcomes of patients with de novo stage IV breast cancer after locoregional treatment (LRT) of primary site.</P> <P><B>Patients and Methods</B></P> <P>We studied 245 patients diagnosed with de novo stage IV breast cancer. LRT of the primary tumor (+ systemic therapy) was performed in 82 (34%) patients (surgery, 27; surgery + radiotherapy (RT), 46; and RT, 9). Among those undergoing surgery, 64 (88%) patients underwent mastectomy, and 9 (12%) patients underwent breast-conserving surgery (BCS). Local recurrence-free survival (LRFS) and overall survival (OS) were investigated, and propensity score matching was used to balance patient distributions.</P> <P><B>Results</B></P> <P>The 5-year LRFS and OS rates were 27% and 50%, respectively. Advanced T stage (T4), liver or brain metastasis, ≥ 5 metastatic sites, and absence of hormone therapy were significant adverse factors for LRFS, whereas T4 stage and absence of hormone therapy were significant for OS. The LRT group demonstrated significantly more favorable outcomes (5-year LRFS, 61%; 5-year OS, 71%), especially after surgery. After matching, survival rates remained significantly higher for patients who received LRT (5-year LRFS, 62% vs. 20%; <I>P</I> < .001; 5-year OS, 73% vs. 45%; <I>P</I> = .02). BCS + RT was superior to mastectomy ± RT, which can be attributed to more patients with a low tumor burden undergoing BCS + RT. Outcomes were better with post-mastectomy RT in selected patients (≥ N2, ≥ T3, or T2N1).</P> <P><B>Conclusions</B></P> <P>Upfront LRT including RT is an important option together with systemic therapies for de novo stage IV breast cancer.</P>
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Moon, Hui-Sung,Kwon, Kiho,Kim, Seung-Il,Han, Hyunju,Sohn, Joohyuk,Lee, Soohyeon,Jung, Hyo-Il Royal Society of Chemistry 2011 Lab on a chip Vol.11 No.6
<P>Circulating tumor cells (CTCs) are highly correlated with the invasive behavior of cancer, so their isolations and quantifications are important for biomedical applications such as cancer prognosis and measuring the responses to drug treatments. In this paper, we present the development of a microfluidic device for the separation of CTCs from blood cells based on the physical properties of cells. For use as a CTC model, we successfully separated human breast cancer cells (MCF-7) from a spiked blood cell sample by combining multi-orifice flow fractionation (MOFF) and dielectrophoretic (DEP) cell separation technique. Hydrodynamic separation takes advantage of the massive and high-throughput filtration of blood cells as it can accommodate a very high flow rate. DEP separation plays a role in precise post-processing to enhance the efficiency of the separation. The serial combination of these two different sorting techniques enabled high-speed continuous flow-through separation without labeling. We observed up to a 162-fold increase in MCF-7 cells at a 126 µL min<SUP>−1</SUP> flow rate. Red and white blood cells were efficiently removed with separation efficiencies of 99.24% and 94.23% respectively. Therefore, we suggest that our system could be used for separation and detection of CTCs from blood cells for biomedical applications.</P> <P>Graphic Abstract</P><P>We developed a microfluidic device for separating CTCs from blood by combining multi-orifice flow fractionation (MOFF) and dielectrophoresis (DEP) which enables high-speed continuous flow-through separation without any labeling. <IMG SRC='http://pubs.rsc.org/services/images/RSCpubs.ePlatform.Service.FreeContent.ImageService.svc/ImageService/image/GA?id=c0lc00345j'> </P>
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Kim, Ji-Yeon,Im, Seock-Ah,Jung, Kyung Hae,Ro, Jungsil,Sohn, Joohyuk,Kim, Jee Hyun,Park, Yeon Hee,Kim, Tae-Yong,Kim, Sung-Bae,Lee, Keun Seok,Kim, Gun Min,Kim, Se Hyun,Kim, Seonwoo,Ahn, Jin Seok,Lee, Ky Elsevier 2018 European journal of cancer Vol.103 No.-
<P><B>Abstract</B></P> <P><B>Background</B></P> <P>We investigated the efficacy and safety of fulvestrant plus goserelin (F + G) versus anastrozole plus goserelin (A + G) in comparison with goserelin (G) alone in premenopausal women with hormone receptor-positive (HR+), human epidermal growth factor receptor 2-negative (HER2-), tamoxifen-pretreated metastatic breast cancer (MBC).</P> <P><B>Patients and methods</B></P> <P>In this multicentre, open-label, randomised phase II study, premenopausal women aged ≥18 years with HR+, HER2–, tamoxifen-pretreated MBC were randomly assigned (1:1:1) to F + G, A + G or G alone. The primary end-point was time to progression (TTP). Secondary end-points included overall survival, overall response rate, clinical benefit rate and toxicity.</P> <P><B>Results</B></P> <P>Of 138 eligible patients, 44 were randomly assigned to receive F + G, 47 to A + G and 47 to G alone. The median follow-up duration was 32.2 months (interquartile range: 23.69–40.86) and the median age was 43.0 years (range 23.0–55.0). The median TTP was 16.3 months (95% confidence interval [CI] 7.5–25.1) for F + G, 14.5 months (95% CI 11.0–18.0) for A + G and 13.5 months (95% CI 10.3–16.8) for G alone. Compared with G alone, the hazard ratios were 0.608 for F + G (95% CI, 0.370–0.998; p = 0.049) and 0.982 for A + G (95% CI, 0.624–1.546; p = 0.937). In terms of visceral metastasis, a stratification factor, there were no TTP differences according to treatment arm. Grade III or IV toxicities were rarely observed. Of the common adverse events, grade I arthralgia and joint stiffness were more frequently observed in the F + G than in the A + G or G-alone groups (p < 0.05, respectively).</P> <P><B>Conclusions</B></P> <P>F + G provides a promising new option for the treatment of premenopausal women with HR+, HER2-, tamoxifen-pretreated MBC.</P> <P><B>Trial registration</B></P> <P>ClinicalTrials.gov number NCT01266213 and Korean Cancer Study Group (KCSG) Breast cancer protocol number BR10-04.</P> <P><B>Highlights</B></P> <P> <UL> <LI> In premenopausal women with hormone receptor-positive metastatic breast cancer, hormone treatment similar to that used in postmenopausal women is the standard treatment option after tamoxifen treatment failure. </LI> <LI> In this study, fulvestrant plus goserelin (G) has better clinical outcome than G alone in premenopausal women, especially those younger than 40 years. </LI> <LI> Aromatase inhibitor with G is not superior to G alone in tamoxifen-pretreated premenopausal women. </LI> </UL> </P>
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Park, Seho,Koo, Ja Seung,Kim, Gun Min,Sohn, Joohyuk,Kim, Seung Il,Cho, Young Up,Park, Byeong-Woo,Park, Vivian Youngjean,Yoon, Jung Hyun,Moon, Hee Jung,Kim, Min Jung,Kim, Eun-Kyung Korean Cancer Association 2018 Cancer Research and Treatment Vol.50 No.3
<P><B>Purpose</B></P><P>Sentinel lymph node biopsy (SLNB) can be performed when node-positive disease is converted to node-negative status after neoadjuvant chemotherapy (NCT). Tattooing nodes might improve accuracy but supportive data are limited. This study aimed to investigate the feasibility of charcoal tattooing metastatic axillary lymph node (ALN) at presentation followed by SLNB after NCT in breast cancers.</P><P><B>Materials and Methods</B></P><P>Twenty patientswith cytology-proven node metastases prospectively underwent charcoal tattooing at diagnosis. SLNB using dual tracers and axillary surgery after NCT were then performed. The detection rate of tattooed node and diagnostic performance of SLNB were analyzed.</P><P><B>Results</B></P><P>All patients underwent charcoal tattooingwithout significant morbidity. Sentinel and tattooed nodes could be detected during surgery after NCT. Nodal pathologic complete response was achieved in 10 patients. Overall sensitivity, false-negative rate (FNR), negative predictive value, and accuracy of hot/blue SLNB were 80.0%, 20.0%, 83.3%, and 90.0%, respectively. Retrieving more nodes and favorable nodal response were associated with improved performance. The best accuracy was observed when excised tattooed node was calculated together (FNR, 0.0%). Cold/non-blue tattooed nodes of five patients were removed during non-sentinel axillary surgery but clinicopathological parameters did not differ compared to patients with hot/blue tattooed node detected during SLNB, suggesting the importance of the tattooing procedure itself to improve performance.</P><P><B>Conclusion</B></P><P>Charcoal tattooing of cytology-confirmed metastatic ALN at presentation is technically feasible and does not limit SLNB after NCT. The tattooing procedure without additional preoperative localization is advantageous for improving the diagnostic performance of SLNB in this setting.</P>
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Next-generation sequencing of BRCA1/2 in breast cancer patients
Hyung Seok Park,Seo-Jin Park,Jee Ye Kim,Sanghwa Kim,Jaegyu Ryu,Joohyuk Sohn,Seho Park,Gun Min Kim,In Sik Hwang,Jong-Rak Choi,Seung Il Kim 대한외과학회 2017 Annals of Surgical Treatment and Research(ASRT) Vol.92 No.5
Purpose: We evaluated the clinical role of rapid next-generation sequencing (NGS) for identifying BRCA1/2 mutations compared to traditional Sanger sequencing. Methods: Twenty-four paired samples from 12 patients were analyzed in this prospective study to compare the performance of NGS to the Sanger method. Both NGS and Sanger sequencing were performed in 2 different laboratories using blood samples from patients with breast cancer. We then analyzed the accuracy of NGS in terms of variant calling and determining concordance rates of BRCA1/2 mutation detection. Results: The overall concordance rate of BRCA1/2 mutation identification was 100%. Variants of unknown significance (VUS) were reported in two cases of BRCA1 and 3 cases of BRCA2 after Sanger sequencing, whereas NGS reported only 1 case of BRCA1 VUS, likely due to differences in reference databases used for mutation identification. The median turnaround time of Sanger sequencing was 22 days (range, 14–26 days), while the median time of NGS was only 6 days (range, 3–21 days). Conclusion: NGS yielded comparably accurate results to Sanger sequencing and in a much shorter time with respect to BRCA1/2 mutation identification. The shorter turnaround time and higher accuracy of NGS may help clinicians make more timely and informed decisions regarding surgery or neoadjuvant chemotherapy in patients with breast cancer.
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Kim, Min Jung,Kim, Eun-Kyung,Kwak, Jin Young,Park, Byeong-Woo,Kim, Seung-Il,Sohn, Joohyuk,Oh, Ki Keun American Roentgen Ray Society, etc.] 2009 American Journal of Roentgenology Vol.192 No.1
<P>OBJECTIVE: This study was designed to assess the diagnostic indexes of sonographic surveillance with mammography for the detection of metachronous contralateral breast cancer. MATERIALS AND METHODS: Between January 2003 and December 2003, 1,706 breast sonographic examinations were performed by three radiologists in 1,256 Asian women with a history of surgery for breast cancer in one breast as an adjunct screening test to mammography in an academic medical center. We evaluated the biopsy recommendation rate, a diagnostic index, of the combination of whole-breast sonography and mammography for the detection of contralateral metachronous breast cancers and the positive predictive value (PPV) of this biopsy recommendation rate. RESULTS: Based on 1,706 examinations in 1,256 women, the biopsy recommendation rate was 3.5% per patient and 2.6% per examination. The PPV of the biopsy recommendation rate was 41.0% with 18 breast cancers diagnosed (cancer detection rate, 1.4% per patient and 1.1% per examination). Among these cancers, two were detected on sonography alone. One false-negative cancer was found on the next sonographic examination but could not be seen on the next mammographic examination. CONCLUSION: With a false-negative rate of only 0.06% and a PPV of 41.0% for the biopsy recommendation rate, our results suggest that annual sonography could be a useful adjunctive tool to mammography for the detection of metachronous contralateral cancers.</P>
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US surveillance of regional lymph node recurrence after breast cancer surgery.
Moon, Hee Jung,Kim, Min Jung,Kim, Eun-Kyung,Park, Byeong-Woo,Youk, Ji Hyun,Kwak, Jin Young,Sohn, Joohyuk,Kim, Seung-Il Radiological Society of North America 2009 Radiology Vol.252 No.3
<P>PURPOSE: To determine the diagnostic indexes of lymph node ultrasonography (US) of the axillary and supraclavicular regions for detecting lymph node recurrence (LNR) after breast cancer surgery and assess the effect of lymph node evaluation on prognosis during bilateral breast US. MATERIALS AND METHODS: Institutional review board approved this retrospective study and waived informed consent. Between January 2003 and December 2004, 3982 lymph node US examinations, including bilateral axillary and supraclavicular areas, were performed in 1817 women (mean age, 49.9 years; range, 22-86 years) after breast cancer surgery, nine of whom had palpable lesions. Final diagnosis was based on cytopathologic results, clinical follow-up, and imaging studies for at least 12 months after breast US. Diagnostic indexes of US for detecting LNR were assessed. The frequency of distant metastases between patients with ipsilateral LNR and those without was compared. Three-year mortality rates of patients with ipsilateral LNR only and those with distant metastases were evaluated. RESULTS: Of 1817 patients, 54 had suspicious LNR at US (28 at first, 20 at second, five at third, and one at fourth US examination). Thirty-nine of 1817 patients (2.1%), including nine with palpable lesions, had LNR, 11 of whom had ipsilateral LNR only. At first lymph node US, LNR was detected in 17 patients; at second, in 10; at third, in two; and at fourth, in one. Nine had false-negative results. The respective sensitivity, specificity, accuracy, positive predictive value, and negative predictive value of lymph node US for detecting LNR per woman was 76.9% (30 of 39), 98.7% (1754 of 1778), 98.2% (1784 of 1817), 55.6% (30 of 54), and 99.5% (1754 of 1763); those of first lymph node US were 85.0% (17 of 20), 99.4% (1786 of 1797), 99.2% (1803 of 1817), 60.7% (17 of 28), and 99.8% (1786 of 1789); and those of total US examinations were 78.0% (32 of 41), 99.4% (3917 of 3941), 99.2% (3949 of 3982), 57.1% (32 of 56), and 99.8% (3917 of 3926). Distant metastases were found more frequently in patients with ipsilateral LNR (62%) than in those without (2.3%) (P < .0001). The 3-year mortality rate of patients with ipsilateral LNR only was significantly lower than that in patients with distant metastases (P = .03). CONCLUSION: Ipsilateral LNR is a predictor of distant metastasis, and lymph node evaluation during breast US is useful for early detection of LNR in asymptomatic patients.</P>
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