Reconstructing hope with the breast: A meta-synthesis of the meaning of breast reconstruction in women breast cancer survivors

Ahn, Jeonghee,Suh, Eunyoung E. 한국간호과학회 2021 한국간호과학회 학술대회 Vol.2021 No.10

Aim(s): Breast cancer is the most frequent cancer in women worldwide. Nowadays breast reconstruction is broadly recommended to increase the quality of life and to reduce psychological distress by improving body image. However, little is known about what breast reconstruction ultimately means for women with breast cancer. This study aimed to examine the meaning of breast reconstruction in women breast cancer survivors by synthesizing qualitative research on the lived experience of the women who had undergone breast reconstruction. Method(s): A literature search using a combination of the keywords ‘breast reconstruction’ and ‘qualitative research’ was conducted in PubMed, CINAHL, EMbase, PsycInfo, ProQuest, and SCOPUS. Peer-reviewed journal articles, published in the last two decades from 2001 to 2020, were included in this research. A total of 22 qualitative studies were yielded and subjected to critical appraisal to ensure the integrity of findings. Meta-synthesis process developed by Sandelowski and Barroso was used to integrate findings across the studies. Result(s): Four core themes were identified: (1) restoring the disfigured body, (2) rebuilding the feminine self, (3) reconnecting the self to significant others, and (4) recovering from the psychological trauma due to breast cancer. Women with breast cancer regarded breast reconstruction as a healing process to returning the normal life as well as a surgical procedure to reshape the damaged body. Breast reconstruction enabled breast cancer survivors to regain the societal image of women, to reunion intimate relationships, and as a result, overcome stigma from breast cancer. Conclusion(s): This meta-synthesis develops an integrated interpretation and explanation of the meaning of breast reconstruction in women breast cancer survivors. This study provides insights and improves understanding of the holistic view on breast reconstruction for women with breast cancer. This may allow health professionals to provide appropriate and supportive counseling intervention for breast cancer patients.

Partial Breast Reconstruction Using Various Oncoplastic Techniques for Centrally Located Breast Cancer

박효천,김홍열,김민철,이정우,정호윤,조병채,박호용,양정덕 대한성형외과학회 2014 Archives of Plastic Surgery Vol.41 No.5

Background: As the breast cancer incidence has increased, breast-conserving surgery hasreplaced total mastectomy as the predominant procedure. However, centrally located breastcancers pose significant challenges to successful breast-conserving surgeries. Therefore, weperformed partial mastectomy and oncoplastic procedures on centrally located breast canceras a means of partial breast reconstruction. The authors examined and evaluated thefunctional and aesthetic usefulness of this reconstruction method. Methods: From January 2007 to June 2011, 35 patients with centrally located breast cancerswho underwent various oncoplastic procedures based on the breast size and resection volume. The oncoplastic procedures performed included volume displacement surgical techniques suchas purse-string suture, linear suture, and reduction mammaplasty. Other oncoplastic proceduresincluded volume replacement procedures with an adipofascial, thoracoepigastric, intercostalartery perforator, thoracodorsal artery perforator, or latissimus dorsi flap. Results: Mean patient age was 49 years, and mean follow-up period was 11 months. In cases ofsmall to moderate-sized breasts and resection volumes <50 g, volume displacement procedureswere performed. In cases of resection volumes >50 g, volume replacement procedures wereperformed. In cases of larger breasts and smaller resection volumes, glandular reshaping wasperformed. Finally, in cases of larger breasts and larger resection volumes, reductionmammaplasty was performed. This reconstruction method also elicits a high patient satisfactionrate with no significant complications. Conclusions: In centrally located breast cancer, oncoplastic surgery considering breast sizeand resection volume is safe and provides appropriate aesthetic outcomes. Therefore, ourmethod is advisable for breast cancer patients who elect to conserve their breasts and retain anatural breast shape.

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.

Basic Facts of Breast Cancer in Korea in 2014: The 10-Year Overall Survival Progress

박은화,민선영,김지선,윤찬석,정규원,남석진,오세정,이시연,박병우,임우성,허민희,Korean Breast Cancer Society 한국유방암학회 2017 Journal of breast cancer Vol.20 No.1

We, the Korean Breast Cancer Society (KBCS), present the facts and the trends of breast cancer in Korea in 2014. Data on the total number of newly diagnosed patients was obtained from the Korea Central Cancer Registry database, other data were collected from the KBCS online registry database, and the overall survival data of patients were updated from Statistics Korea. A total of 21,484 female patients were newly diagnosed with breast cancer in 2014. The crude incidence rate and the age-standardized incidence rate (ASR) of breast cancer in female patients, including carcinoma in situ, were 83.4 cases and 63.9 cases per 100,000 women, respectively. The ASR showed an annual increase of 6.1% from 1999 to 2014; however, although the increase of the ASR had slowed since 2008, the incidence rate itself continuously increased. The proportion of early breast cancer increased consistently, and the pathological features changed accordingly. While breast-conserving surgery was mainly performed, the proportion of total mastectomy was slightly increased. The total number of breast reconstruction surgeries increased rapidly. The 5-year and 10-year overall survival rates for all stages of breast cancer patients were 91.2% and 84.8%, respectively. The overall survival rate of Korean patients with breast cancer was extremely high, compared with other developed countries. Thus, we consider that the clinical characteristics of breast cancer have changed over the past decade. A nationwide registry data will contribute to a better understanding of the characteristics of breast cancer in Korea.

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.

Changing Patterns in the Clinical Characteristics of Korean Breast Cancer from 1996-2010 Using an Online Nationwide Breast Cancer Database

고범석,Woo-Chul Noh,강성수,박병우,Eun Young Kang,Nam-Sun Paik,Jung-Hyun Yang,Sei Hyun Ahn 한국유방암학회 2012 Journal of breast cancer Vol.15 No.4

Purpose: Breast cancer is one of the most frequent malignancies in Korean women, and its incidence is increasing at a rapid rate. Since 1996, the Korean Breast Cancer Society has collected nationwide breast cancer data using an online registration program and analyzed the data biennial. The purpose of this study was to evaluate the characteristics of Korean breast cancer and to analyze changes in these characteristics over the period of time. Methods: Data were collected from 41 medical schools (74 hospitals), 24 general hospitals, and 6 private clinics. Data on the total number, gender, and age of newly-diagnosed breast cancer patients were collected through a questionnaire. Additional data were collected and analyzed from the online database. Results: In 2010, 16,398 patients in Korea were newly diagnosed with breast cancer. The crude incidence rate of female breast cancer was 67.2 cases per 100,000, and the median age at diagnosis was 49 years. The incidence of breast cancer was highest in patients aged between 40 and 49 years. Since 1996, there has been a significant increase in the proportion of early-stage cancers (detected in stage 1 or 2), the percentage of estrogen receptor-positive cancers, and in the proportion of patients receiving breast-conserving surgery. Conclusion: The incidence and clinical characteristics of Korean breast cancer are slowly changing to the patterns of Western countries. To understand changing patterns in the characteristics of Korean breast cancer, the nationwide data should be continuously analyzed.

Detection of Human Papillomavirus in Korean Breast Cancer Patients by Real-Time Polymerase Chain Reaction and Meta-Analysis of Human Papillomavirus and Breast Cancer

Jinhyuk Choi,김정율,이혜승,최유진,김하연,이진환,장혜윤,김애리 대한병리학회 2016 Journal of Pathology and Translational Medicine Vol.50 No.6

Background: Human papillomavirus (HPV) is a well-established oncogenic virus of cervical, anogenital, and oropharyngeal cancer. Various subtypes of HPV have been detected in 0% to 60% of breast cancers. The roles of HPV in the carcinogenesis of breast cancer remain controversial. This study was performed to determine the prevalence of HPV-positive breast cancer in Korean patients and to evaluate the possibility of carcinogenic effect of HPV on breast. Methods: Meta-analysis was performed in 22 case-control studies for HPV infection in breast cancer. A total of 123 breast cancers, nine intraductal papillomas and 13 nipple tissues of patients with proven cervical HPV infection were tested by real-time polymerase chain reaction to detect 28 subtypes of HPV. Breast cancers were composed of 106 formalin-fixed and paraffin embedded (FFPE) breast cancer samples and 17 touch imprint cytology samples of breast cancers. Results: The overall odds ratio between breast cancer and HPV infection was 5.43 (95% confidence interval, 3.24 to 9.12) with I2 = 34.5% in meta-analysis of published studies with case-control setting and it was statistically significant. HPV was detected in 22 cases of breast cancers (17.9%) and two cases of intaductal papillomas (22.2%). However, these cases had weak positivity. Conclusions: These results failed to serve as significant evidence to support the relationship between HPV and breast cancer. Further study with larger epidemiologic population is merited to determine the relationship between HPV and breast cancer.

A Case Report of Breast Sparganosis in a Patient with Ipsilateral Breast Cancer: MRI and Ultrasonographic Findings

이유진,추기석,배영태,김지연 대한영상의학회 2010 대한영상의학회지 Vol.63 No.6

Sparganosis of the breast is a quite rare parasitic infection of humans and presents as soft tissue masses that mimic breast malignancy or benign tumor, such as fibroadenoma. We present here a case of histologically confirmed breast sparganosis in the upper inner quadrant of the right breast with coexisting breast cancer in the ipsilateral breast upper outer quadrant. Ultrasonography of breast sparganosis showed a well defined, tubular hypoechoic mass with discrete multilayered wall and tubule-in tubule appearance, surrounded by heterogenous hyperechoic areas in the subcutaneous fat layer of the breast. MRI revealed an elongated tubular structure with persistent and progressive enhancement. This is the second report concerned with the MRI and ultrasonographic findings of breast sparganosis and the first report of breast sparganosis in a patient with ipsilateral breast cancer.

Contralateral Breast Management Related to Breast Reconstruction in Korean Females

양정덕,이정훈,정호윤,조병채,박호용,정진향 한국유방암학회 2010 Journal of breast cancer Vol.13 No.2

Purpose: The final purpose of post mastectomy reconstruction is a balanced, symmetrical, pleasing appearance for both breasts. However, in cases where women have an unattractive breast, which may be small, ptotic or huge, remodeling of the contralateral breast may be desirable. Surgical options available for the contralateral breast included breast augmentation using implants, mastopexy, and reduction mammoplasty. Methods: All patients who underwent unilateral breast reconstruction at Kyungpook National University Hospital from September of 2006 to February of 2008 were included in this study. The methods of reconstruction included transverse rectus abdominis musculocutaneous flap, latissimus dorsi flap, and the use of implants. Contralateral procedures to achieve symmetry included augmentation,mastopexy, and reduction. Results: A total of 57 patients were evaluated, including 45 immediate, and 12 delayed reconstructions. Twenty-six of these patients underwent contralateral breast management (augmentation [12], mastopexy [11], and reduction [3]). The average age was 44.9 years and the mean follow up interval was 13 months. Most of the patients were satisfied with the symmetry, clothed appearance, nude appearance, aesthetics, and consistency. Sixtysix percent (8 of 12) of delayed reconstruction patients had a symmetry procedure performed on the opposite breast, compared with 40 percent (18 of 45) of the immediate-reconstruction patients. No complications were observed on the contralateral breasts undergoing symmetrization. Conclusion: Contralateral management in breast reconstruction can provide symmetry with the reconstructed breast contour and aesthetically satisfactory results in a safe manner. Immediate symmetrization procedure also can avoid secondary operations and offer psychological benefits without delaying adjuvant therapy.

Molecular Portrait of the Normal Human Breast Tissue and Its Influence on Breast Carcinogenesis

Madalin Marius Margan,Andreea Adriana Jitariu,Anca Maria Cimpean,Cristian Nica,Marius Raica 한국유방암학회 2016 Journal of breast cancer Vol.19 No.2

Normal human breast tissue consists of epithelial and nonepithelial cells with different molecular profiles and differentiation grades. This molecular heterogeneity is known to yield abnormal clones that may contribute to the development of breast carcinomas. Stem cells that are found in developing and mature breast tissue are either positive or negative for cytokeratin 19 depending on their subtype. These cells are able to generate carcinogenesis along with mature cells. However, scientific data remains controversial regarding the monoclonal or polyclonal origin of breast carcinomas. The majority of breast carcinomas originate from epithelial cells that normally express BRCA1. The consecutive loss of the BRCA1 gene leads to various abnormalities in epithelial cells. Normal breast epithelial cells also express hypoxia inducible factor (HIF) 1α and HIF-2α that are associated with a high metastatic rate and a poor prognosis for malignant lesions. The nuclear expression of estrogen receptor (ER) and progesterone receptor (PR) in normal human breast tissue is maintained in malignant tissue as well. Several controversies regarding the ability of ER and PR status to predict breast cancer outcome remain. Both ER and PR act as modulators of cell activity in normal human breast tissue. Ki-67 positivity is strongly correlated with tumor grade although its specific role in applied therapy requires further studies. Human epidermal growth factor receptor 2 (HER2) oncoprotein is less expressed in normal human breast specimens but is highly expressed in certain malignant lesions of the breast. Unlike HER2, epidermal growth factor receptor expression is similar in both normal and malignant tissues. Molecular heterogeneity is not only found in breast carcinomas but also in normal breast tissue. Therefore, the molecular mapping of normal human breast tissue might represent a key research area to fully elucidate the mechanisms of breast carcinogenesis.