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1.
Nutr Cancer ; 76(1): 42-54, 2024.
Artigo em Inglês | MEDLINE | ID: mdl-37943034

RESUMO

We aimed to examine the association between dietary isoflavone intake and the risk of breast cancer recurrence and summarize evidence on the role of dietary isoflavone intake in breast cancer prognosis. This prospective study included 592 breast cancer survivors who completed a dietary assessment. Hazard ratios (HRs) and 95% confidence intervals (CIs) were estimated using Cox proportional hazards models. Of the studies published until May 31, 2023, that were searched in PUBMED and EMBASE databases, 14 studies were selected. Adjusted HRs were combined using fixed- or random-effects models. During the median follow-up of 4.3 years, 47 recurrences were identified. The HR (95% CI) for recurrence comparing the highest versus the lowest tertile of isoflavones intake was 1.29 (0.60-2.78). In a meta-analysis of previously published data and ours, dietary isoflavone intake was associated with a better breast cancer prognosis. The combined HRs (95% CIs) comparing the extreme categories were 0.81 (0.67-0.98) for recurrence and 0.85 (0.76-0.96) for all-cause mortality. A nonlinear inverse association was observed between isoflavone intake and the risk of recurrence and all-cause mortality. Our study suggests that dietary isoflavone intake is associated with a favorable prognosis in breast cancer survivors and warrants further investigation.


Assuntos
Neoplasias da Mama , Isoflavonas , Humanos , Feminino , Estudos Prospectivos , Modelos de Riscos Proporcionais , Sobreviventes , Fatores de Risco
2.
Ann Surg ; 275(5): 985-991, 2022 05 01.
Artigo em Inglês | MEDLINE | ID: mdl-32941285

RESUMO

OBJECTIVE: The aim of this study was to present the results of early experience of robot-assisted nipple sparing mastectomy (RANSM). BACKGROUND: RANSM improves cosmetic outcomes over conventional nipple-sparing mastectomy. However, data on the feasibility and safety of the RANSM are limited. METHODS: Patients who underwent RANSM with immediate breast reconstruction as part of the Korea Robot-endoscopy Minimal Access Breast Surgery Study Group (KoREa-BSG) from November 2016 to January 2020 were enrolled. clinicopathologic characteristics, perioperative complications, and operation time were collected. RESULTS: Overall, 73 women underwent 82 RANSM procedures conducted by 11 breast surgeons at 8 institutions. The median patient age was 45.5 years old (20-66 years), and 52 (63.4%) patients were premenopausal. Invasive breast cancer was noted in 55 cases (40 cases were stage i, 11 cases were stage ii, and 4 cases were stage iii, respectively) and ductal carcinoma in-situ was recorded in 20 cases. Of those, 3 patients with BRCA1/2 mutation carriers underwent contralateral risk-reducing RANSM. The median length of hospitalization was 12.0 days (5.0-24.0 days). The incision location was the mid-axillary line and the median incision length was 50.0 mm (30.0-60.0 mm). Median total operation time, median total mastectomy time, and median reconstruction time was 307.0 minutes (163.0-796.0 minutes), 189.5 minutes (97.5-325.0 minutes), and 119.5 minutes (45.0-689.0 minutes). Only 2 cases (2.5%) required reoperation. Nipple ischemia was found in 9 cases (10.9%) but only 1 case (1.2%) required nipple excision given that 8 cases (9.7%) resolved spontaneously. Skin ischemia was observed in 5 cases (6.1%) and only 2 (2.4%) cases needed skin excision whereas 3 cases (3.6%) resolved spontaneously. There was no conversion to open surgery orcases of mortality. The mean time for mastectomy among surgeons who performed more than 10 cases was 182.3 minutes (± 53.7, minutes) and 195.4 minutes (± 50.4, minutes). CONCLUSION: This was the first report of RANSM conducted in the KoREa-BSG. RANSM is technically feasible and acceptable with a short learning curve. Further prospective research to evaluate surgical and oncologic outcomes is needed.


Assuntos
Neoplasias da Mama , Mamoplastia , Robótica , Neoplasias da Mama/patologia , Neoplasias da Mama/cirurgia , Endoscopia/métodos , Feminino , Humanos , Masculino , Mamoplastia/métodos , Mastectomia/métodos , Pessoa de Meia-Idade , Mamilos/cirurgia
3.
Lipids Health Dis ; 21(1): 66, 2022 Aug 02.
Artigo em Inglês | MEDLINE | ID: mdl-35918691

RESUMO

BACKGROUND: The role of lipid metabolism in obesity and cancer manifestations cannot be underestimated, but whether alterations in lipid metabolism can manipulate the vasculature to promote obesity among breast cancer (BC) survivors is yet to be clearly understood. This study quantified plasma lipid and particle sizes using high-throughput proton (1H) nuclear magnetic resonance (NMR) and tested their associations with obesity among breast cancer (BC) survivors. METHODS: A total of 348 (225 premenopausal and 123 postmenopausal) BC survivors enrolled from five hospitals in Korea were included. We assessed thirty-four plasma lipid biomarkers using 1H NMR, and obesity status was defined as a body mass index (BMI) of 25 kg/m2 or greater. Generalized linear and logistic regression models were applied to estimate the least-square means of BMI (kg/m2) and odds ratio (OR)s of obesity, respectively, and the corresponding 95% confidence interval (CI)s across plasma lipid levels. RESULTS: Mean (SD) values of BMI was 23.3 (3.2) kg/m2 and 90 (25.9%) had BMI of ≥ 25 kg/m2. BMI levels increased with increasing total triglycerides (TG), TG in lipoproteins and very-low-density lipoprotein (VLDL) subfractions. However, BMI levels decreased with increasing tertiles of high-density lipoprotein (HDL)-cholesterol (C) and HDL particle size (HDL-p). Similar associations were observed in the logistic regression models. The increasing and decreasing BMI trends with TG and HDL profiles respectively were predominantly limited to premenopausal BC survivors. CONCLUSIONS: Increasing levels of plasma total TG and TG in lipoproteins were associated with increasing levels of BMI among premenopausal BC survivors. High HDL-C levels and large HDL-p were inversely associated with obesity among premenopausal BC survivors. Due to the cross-sectional design of this study, longitudinal studies are necessary to examine the association between obesity and lipid profile among BC survivors.


Assuntos
Neoplasias da Mama , Sobreviventes de Câncer , Índice de Massa Corporal , Neoplasias da Mama/patologia , HDL-Colesterol , Estudos Transversais , Feminino , Humanos , Lipoproteínas , Lipoproteínas LDL , Obesidade/complicações , Triglicerídeos
4.
Eur J Cancer Care (Engl) ; 30(5): e13447, 2021 Sep.
Artigo em Inglês | MEDLINE | ID: mdl-33774893

RESUMO

OBJECTIVE: We investigated the contribution of supplement use to total nutrient intake, the prevalence of inadequate nutrient intake and the factors associated with supplement use among breast cancer survivors. METHODS: A total of 701 Korean breast cancer survivors were included. We calculated the contribution of dietary supplements to total nutrient intake and the proportion of the population below the estimated average requirements (EARs) or exceeding the tolerable upper intake levels (ULs). Stepwise logistic regression was used to identify factors associated with dietary supplement use. RESULTS: A total of 66.5% of the survivors used dietary supplements, with multivitamins and minerals being the most commonly consumed ones. The per cent contribution of supplement to the total intake was the highest for vitamin C. 28.2%-55.4% of the non-users consumed below the EAR of riboflavin, folate and calcium; 6.1%, 4.9% and 6.5% of the supplement users consumed above the UL of vitamins A and C, and iron, respectively. Supplement users had higher education levels or longer survival time. CONCLUSION: 66.5% of Korean breast cancer survivors used dietary supplements. A higher education level or prolonged survival time was associated with higher use of dietary supplements.


Assuntos
Neoplasias da Mama , Sobreviventes de Câncer , Estudos Transversais , Dieta , Suplementos Nutricionais , Ingestão de Alimentos , Feminino , Humanos , Sobreviventes
5.
Adv Exp Med Biol ; 1187: 591-599, 2021.
Artigo em Inglês | MEDLINE | ID: mdl-33983601

RESUMO

The status of the axillary lymph nodes is one of the most important prognostic factors for patients with breast cancer. For over 100 years, axillary lymph node dissection was the standard approach to obtain and manage axillar lymph node, but now, sentinel lymph node biopsy has become a standard approach with less morbidity and equal accuracy in clinical node-negative patients. In addition, numerous studies are on the way to omit axillary lymph node dissection in specific patient subgroups. The recent trials like the ACOSOG Z0011 showed the evidence that omitting an ALND in patients with low burden nodal disease is safe in patients receiving whole-breast radiation. To reduce the use of ALND is the goal to consider when selecting an axillary management strategy.


Assuntos
Neoplasias da Mama , Linfonodos , Axila , Neoplasias da Mama/cirurgia , Humanos , Excisão de Linfonodo , Linfonodos/cirurgia , Biópsia de Linfonodo Sentinela
6.
Surg Innov ; 28(1): 41-47, 2021 Feb.
Artigo em Inglês | MEDLINE | ID: mdl-32757879

RESUMO

Background. The hybrid ultrasonic advanced bipolar device (HUB) that integrates ultrasonic energy and advanced bipolar energy was recently developed and applied to thyroid surgery. The purpose of this study was to compare the efficacy and safety of HUB and ultrasonic coagulating shears for open thyroidectomy. Methods. A total of 200 patients were enrolled from April to September 2017 in this prospective, randomized, multicenter study. Patients were randomly assigned to an ultrasonic group (n = 101) or a hybrid group (n = 99). Results. Operation times were similar in the 2 study groups, that is, 54.2 ± 25.2 minutes in the ultrasonic group and 50.2 ± 21.6 minutes in the hybrid group. Postoperative surgical results and morbidities were no different in the 2 groups. However, the total amount of bleeding was significantly less in the hybrid group (13.0 ± 17.7 mg vs 8.6 ± 11.5 mg; P = .042). Conclusions. Our study showed that there was no significant difference between the 2 groups in postoperative surgical results and morbidity. The total bleeding amount was significantly less in the hybrid group. The study shows that HUB is comparable to the ultrasonic coagulating shears in terms of efficacy and safety during thyroid surgery.


Assuntos
Eletrocoagulação , Tireoidectomia , Terapia por Ultrassom , Humanos , Estudos Prospectivos , Tireoidectomia/métodos , Ultrassom
7.
Breast Cancer Res Treat ; 179(2): 491-498, 2020 Jan.
Artigo em Inglês | MEDLINE | ID: mdl-31673880

RESUMO

PURPOSE: To examine whether depression, anxiety disorder, and their co-occurrence would increase the risk of mortality in patients with breast cancer, and whether antidepressant treatment would reduce the same. METHODS: Data were retrieved from the database of the Korean National Health Insurance Service. Of 145,251 patients diagnosed with breast cancer between 2007 and 2014, 20,870 patients diagnosed with depression or anxiety disorder one year before breast cancer diagnosis were excluded. Thus, data of 124,381 patients were included in this study. RESULTS: Depression and anxiety disorder were associated with an increased risk of mortality [Hazard Ratio (HR) 1.26, 95% CI 1.18-1.36; HR 1.14, 95% CI 1.08-1.22, respectively] and their co-occurrence further increased the risk (HR = 1.38, 95% CI 1.24-1.54). Antidepressant treatment was related to a reduced risk of mortality. Compared to patients without any psychiatric comorbidity with no antidepressant treatment, the mortality risk increased in patients with either psychiatric comorbidity or both, but the risk seemed to attenuate with antidepressant treatments. CONCLUSION: The current findings suggest that psychiatric comorbidities are markers of increased mortality risk in patients with breast cancer, and antidepressant treatment may attenuate the risk. This underscores the need for screening and treating depression and anxiety disorders to improve survival in patients with breast cancer.


Assuntos
Transtornos de Ansiedade/epidemiologia , Transtornos de Ansiedade/etiologia , Neoplasias da Mama/complicações , Neoplasias da Mama/epidemiologia , Transtorno Depressivo/epidemiologia , Transtorno Depressivo/etiologia , Antidepressivos/efeitos adversos , Antidepressivos/uso terapêutico , Transtornos de Ansiedade/tratamento farmacológico , Neoplasias da Mama/mortalidade , Comorbidade , Transtorno Depressivo/tratamento farmacológico , Feminino , Humanos , Prognóstico , Modelos de Riscos Proporcionais , Vigilância em Saúde Pública , Sistema de Registros , República da Coreia , Fatores de Risco
8.
Qual Life Res ; 29(2): 421-429, 2020 Feb.
Artigo em Inglês | MEDLINE | ID: mdl-31628647

RESUMO

PURPOSE: The aim of this study was to examine profiles of depressive symptoms and the association with anxiety and quality of life (QOL) in breast cancer survivors. METHODS: A cross-sectional multicenter survey involving 5 hospitals in Korea was implemented between February 2015 and January 2017. A self-report survey included the Patient Health Questionnaire-9, Short Form 36, and State and Trait Anxiety Scale. Data from 347 patients were analyzed. RESULTS: Latent profile analysis identified five profiles of depressive symptoms: (1) "no depression" (63.98%); (2) "mild depression with sleep problems" (16.43%); (3) "mild depression" (8.65%); (4) "moderate depression with anhedonia" (7.78%); and (5) "moderately severe depression" (3.17%). Results from Fisher's exact test and analysis of variance (ANOVA) to examine whether sociodemographic and clinical characteristics distinguish the classes indicated that marital status, income and education as well as C-reactive protein distinguished a few classes. Multivariate analysis of covariance and analysis of covariance results indicated that both types of anxiety as well as several dimensions of QOL differed between the identified classes. CONCLUSIONS: The current results suggest that although identified classes were characterized overall by severity of depression, a few classes also reflected pronounced individual symptom patterns, warranting tailored interventions for these symptom patterns, along with overall severity of depression.


Assuntos
Transtornos de Ansiedade/etiologia , Neoplasias da Mama/psicologia , Depressão/etiologia , Qualidade de Vida/psicologia , Sobreviventes de Câncer , Estudos Transversais , Feminino , Humanos , Pessoa de Meia-Idade , Inquéritos e Questionários
9.
Medicina (Kaunas) ; 55(11)2019 Nov 18.
Artigo em Inglês | MEDLINE | ID: mdl-31752241

RESUMO

Background and Objectives: ZBTB48 is a telomere-associated factor that has been renamed as telomeric zinc finger-associated protein (TZAP). It binds preferentially to long telomeres, competing with telomeric repeat factors 1 and 2. Materials and Methods: We analyzed the TZAP mutation in 128 breast carcinomas (BCs). In addition, its association with telomere length was investigated. Results: The TZAP mutation (c.1272 G > A, L424L) was found in 7.8% (10/128) of the BCs and was associated with the N0 stage. BCs with the TZAP mutation had longer telomeres than those without this mutation. Survival analysis showed that the TZAP mutation resulted in poorer overall survival. Conclusions: These results suggest that the TZAP mutation is a possible prognostic marker in BC.


Assuntos
Neoplasias da Mama/complicações , Proteínas de Ligação a DNA/genética , Mutação/genética , Fatores de Transcrição/genética , Adulto , Neoplasias da Mama/genética , Distribuição de Qui-Quadrado , Feminino , Humanos , Pessoa de Meia-Idade , Reação em Cadeia da Polimerase/métodos , Prognóstico , Estatísticas não Paramétricas , Telômero/genética , Telômero/patologia
11.
Dermatol Surg ; 40(5): 562-8, 2014 May.
Artigo em Inglês | MEDLINE | ID: mdl-24712703

RESUMO

BACKGROUND: Regulation of inflammation during the wound healing process reduces scar formation at the injury site. OBJECTIVE: To evaluate the effect of intralesional injection of low-dose steroid with pulsed dye laser on healing of early postoperative thyroidectomy scars. MATERIALS AND METHODS: Twenty Korean women with thyroidectomy scars were enrolled. All were treated with an intralesional injection of low-dose steroid (2 mg/mL) and 595-nm pulsed dye laser starting within 4 weeks of suture removal. The Vancouver Scar Scale (VSS), Global Assessment Score (GAS), and Patient Satisfaction Score were used in this evaluation. RESULTS: Average VSS scores were significantly lower after treatment. The GAS also indicated better cosmetic outcomes after steroid injection in the laser treatment group than after laser treatment only. CONCLUSION: Early postoperative intralesional injection of low-dose steroid and pulsed dye laser treatment is effective and safe.


Assuntos
Anti-Inflamatórios/uso terapêutico , Cicatriz/prevenção & controle , Inflamação/prevenção & controle , Lasers de Corante/uso terapêutico , Triancinolona/uso terapêutico , Adulto , Animais , Anti-Inflamatórios/administração & dosagem , Cicatriz/etiologia , Feminino , Humanos , Inflamação/patologia , Injeções Intralesionais , Camundongos , Pessoa de Meia-Idade , República da Coreia , Tireoidectomia/efeitos adversos , Fatores de Tempo , Triancinolona/administração & dosagem , Cicatrização , Adulto Jovem
12.
Epidemiol Health ; 46: e2024026, 2024.
Artigo em Inglês | MEDLINE | ID: mdl-38317529

RESUMO

OBJECTIVES: This study investigated whether adherence to the overall lifestyle recommendations in the American Cancer Society (ACS) guidelines on nutrition and physical activity for cancer survivors was associated with inflammation in breast cancer survivors. METHODS: The study included 409 women who had undergone breast cancer surgery at least 1 year before enrollment. A generalized linear model was used to estimate the least square means and 95% confidence intervals of plasma levels of inflammatory markers according to lifestyle factors defined in terms of adherence to the ACS guidelines. RESULTS: Higher overall adherence scores were associated with lower levels of high-sensitivity C-reactive protein (hs-CRP) (p for trend=0.015) and higher levels of adiponectin (p for trend=0.009). Similar significant associations of hs-CRP (p for trend= 0.004) and adiponectin (p for trend=0.010) levels were observed with the score for the body mass index (BMI) component of the adherence score. A higher diet component score was associated with a higher adiponectin level (p for trend=0.020), but there was no significant association for the physical activity component score. CONCLUSIONS: The present study's findings suggest that maintaining a healthy lifestyle according to the ACS guidelines was associated with beneficial effects on inflammatory marker levels, especially hs-CRP and adiponectin, among breast cancer survivors. Among the 3 components of lifestyle guidelines, the BMI component exhibited the most similar tendency to the overall adherence score in relation to inflammatory indicators. Further prospective and intervention studies are needed to investigate longitudinal associations between lifestyle factors and inflammatory markers among breast cancer survivors.


Assuntos
American Cancer Society , Biomarcadores , Neoplasias da Mama , Sobreviventes de Câncer , Exercício Físico , Inflamação , Humanos , Feminino , Sobreviventes de Câncer/estatística & dados numéricos , Neoplasias da Mama/sangue , Pessoa de Meia-Idade , Exercício Físico/fisiologia , Inflamação/sangue , Biomarcadores/sangue , Estados Unidos/epidemiologia , Adulto , Proteína C-Reativa/análise , Fidelidade a Diretrizes/estatística & dados numéricos , Idoso , Cooperação do Paciente/estatística & dados numéricos , Adiponectina/sangue
13.
Asia Pac J Clin Oncol ; 19(1): 113-125, 2023 Feb.
Artigo em Inglês | MEDLINE | ID: mdl-35590398

RESUMO

AIM: This study examined the associations of body mass index (BMI) and weight change with inflammatory markers among breast cancer survivors in Korea. METHODS: A total of 495 women were included who had been diagnosed with primary breast cancer and survived for at least 6 months since the surgery. Information on the body weight and height of the participants was collected both at the study enrollment and diagnosis. The plasma levels of inflammatory markers were measured, including high-sensitivity C-reactive protein, interleukin (IL)-6, IL-8, tumor necrosis factor-α, and adiponectin. A summary z-score was calculated by summing up the z-scores of each biomarker. The least-square means and 95% confidence intervals (CIs) were calculated using a generalized linear model and odds ratios (ORs) and 95% CIs for the elevated levels of inflammatory markers with a multivariate logistic regression model. RESULTS: Participants with a BMI ≥27.5 kg/m2 at the study enrollment and at diagnosis were significantly associated with elevated summary z-scores compared to those with a BMI < 23 kg/m2 ; the ORs (95% CIs) were 5.42 (2.15-13.71) for current BMI and 3.66 (1.68-7.98) for BMI at diagnosis, respectively. Additionally, a weight loss > 5% since diagnosis was associated with a lower prevalence of high summary z-scores; the OR (95% CI) was .20 (.08-.52) compared to a stable weight. CONCLUSIONS: A high BMI at diagnosis and current BMI with a greater degree were associated with unfavorable levels of inflammatory markers among breast cancer survivors. Additionally, weight loss since diagnosis was inversely associated with these markers.


Assuntos
Neoplasias da Mama , Sobreviventes de Câncer , Feminino , Humanos , Índice de Massa Corporal , Proteína C-Reativa , Adiponectina , Citocinas , Neoplasias da Mama/complicações , Obesidade/complicações , Obesidade/epidemiologia , Redução de Peso
14.
Cancer Res Treat ; 55(2): 580-591, 2023 Apr.
Artigo em Inglês | MEDLINE | ID: mdl-36596730

RESUMO

PURPOSE: This study aimed to evaluate the incidence and prognosis of second non-breast primary cancer (SNBPC) among Korean survivors of breast cancer. Materials and Methods: Data from the Korean National Health Insurance Service were searched to identify women who received curative surgery for initial breast cancer (IBC) between 2003 and 2008 (n=64,340). Among them, patients with the following characteristics were excluded: other cancer diagnosis before IBC (n=10,866), radiotherapy before IBC (n=349), absence of data on sex or age (n=371), or male (n=248). Accordingly, data of 52,506 women until December 2017 were analyzed. SNBPC was defined as a newly diagnosed SNBPC that occurred 5 years or more after IBC diagnosis. RESULTS: The median follow-up time of all patients was 12.13 years. SNBPC was developed in 3,084 (5.87%) women after a median of 7.61 years following IBC diagnosis. The 10-year incidence of SNBPC was 5.78% (95% confidence interval [CI], 5.56 to 6.00). Higher SNBPC incidence was found in survivors with the following factors: old age at IBC diagnosis, low household income, and receiving combined chemotherapy with endocrine therapy, whereas receiving radiotherapy was related to a lower incidence of SNBPC (hazard ratio, 0.89; p < 0.01). Among the patients with SNBPC, the 5-year survival rate was 62.28% (95% CI, 65.53 to 69.02). CONCLUSION: Approximately 5% of breast cancer survivors developed SNBPC within 10 years after IBC diagnosis. The risk of SNBPC was associated with patient's age at IBC diagnosis, income level, and a receipt of systemic treatments.


Assuntos
Neoplasias da Mama , Feminino , Humanos , Masculino , Neoplasias da Mama/epidemiologia , Neoplasias da Mama/terapia , Mama , Prognóstico , Sobreviventes , República da Coreia/epidemiologia
15.
Korean J Clin Oncol ; 17(1): 52-55, 2021 Jun.
Artigo em Inglês | MEDLINE | ID: mdl-36945207

RESUMO

Descending necrotizing mediastinitis (DNM) is a life-threatening complication secondary to oropharyngeal abscesses, cervical esophageal perforation, or neck infections spreading along the fascial planes into the mediastinum. Post-thyroidectomy surgical site infection is a highly unusual complication that is typically localized around the incision, but may be propagated into the mediastinum, causing DNM. We encountered a case of this rare complication after thyroidectomy. The patient was a 33-year-old woman who was admitted to our center for left hemithyroidectomy. The surgery was performed without any intraoperative events. However, she later developed fever, hypotension, and tachycardia. Imaging revealed deep neck emphysema and focal pneumomediastinum with infiltration in the anterior neck and mediastinum with abscess formation. Additional imaging at 7 days postoperatively revealed reduced fluid collection deep in the neck with minimal changes in fluid collection in the mediastinum. Esophageal perforation was excluded via an esophagogram, which lead to the conclusion that the infection may have been caused by open thyroidectomy. The patient was treated with prompt medical and surgical intervention. After treatment, she was discharged from the hospital with no further complications. We present our case report as well as a literature review of the diagnosis and treatment of this disease.

16.
J Breast Cancer ; 24(2): 164-174, 2021 Apr.
Artigo em Inglês | MEDLINE | ID: mdl-33818022

RESUMO

PURPOSE: In this trial, we investigated the efficacy and safety of adjuvant letrozole for hormone receptor (HR)-positive breast cancer. Here, we report the clinical outcome in postmenopausal women with HR-positive breast cancer treated with adjuvant letrozole according to estrogen receptor (ER) expression levels. METHODS: In this multi-institutional, open-label, observational study, postmenopausal patients with HR-positive breast cancer received adjuvant letrozole (2.5 mg/daily) for 5 years unless they experienced disease progression or unacceptable toxicity or withdrew their consent. The patients were stratified into the following 3 groups according to ER expression levels using a modified Allred score (AS): low, intermediate, and high (AS 3-4, 5-6, and 7-8, respectively). ER expression was centrally reviewed. The primary objective was the 5-year disease-free survival (DFS) rate. RESULTS: Between April 25, 2010, and February 5, 2014, 440 patients were enrolled. With a median follow-up of 62.0 months, the 5-year DFS rate in all patients was 94.2% (95% confidence interval [CI], 91.8-96.6). The 5-year DFS and recurrence-free survival (RFS) rates did not differ according to ER expression; the 5-year DFS rates were 94.3% and 94.1%in the low-to-intermediate and high expression groups, respectively (p = 0.6), and the corresponding 5-year RFS rates were 95.7% and 95.4%, respectively (p = 0.7). Furthermore, 25 patients discontinued letrozole because of drug toxicity. CONCLUSION: Treatment with adjuvant letrozole showed very favorable treatment outcomes and good tolerability among Korean postmenopausal women with ER-positive breast cancer, independent of ER expression. TRIAL REGISTRATION: ClinicalTrials.gov Identifier: NCT01069211.

17.
AJR Am J Roentgenol ; 193(6): 1731-7, 2009 Dec.
Artigo em Inglês | MEDLINE | ID: mdl-19933672

RESUMO

OBJECTIVE: The purpose of this study was to prospectively evaluate the role of axillary lymph node classification by sonography in breast cancer patients by node-to-node correlation with surgical histology and sentinel node biopsy results. SUBJECTS AND METHODS: Between June 2006 and December 2006, preoperative axillary sonography was performed in 191 consecutive breast cancer patients (median age, 46 years; age range, 24-79 years) who had been scheduled to undergo breast cancer surgery with sentinel node biopsy. The axillary lymph node that had the thickest cortex or that was closest to the primary tumor was prospectively classified and then removed through sonographically guided needle localization. Correspondence about and histologic results for the needle-localized nodes and the radioactive sentinel nodes were analyzed. The rate of malignancy, according to the sonographic classification, and the area under a receiver operating characteristic curve were analyzed. RESULTS: Of the 191 needle-localized nodes, 41 (21%) had metastases and 150 (79%) did not have metastases. When a cutoff point of a cortical thickness of 2.5 mm was used, sonographic classification showed 85% (35/41) sensitivity, 78% (117/150) specificity, and an area under the curve of 0.861 (95% CI, 0.796-0.926). Of the 54 patients with metastases at sentinel node biopsy or axillary lymph node dissection, 13 (24%) had false-negative results of sonographically guided needle localization. Unsuccessful lymphatic mapping because of absent radiotracer uptake during sentinel node biopsy was found in 4% (7/191), whereas all needle-localized nodes with a cortical thickness of more than 2.5 mm were confirmed as metastases. CONCLUSION: Sonographic classification of axillary lymph nodes is effective for predicting the presence of metastases to avoid sentinel node biopsy or to reduce unsuccessful lymphatic mapping during sentinel node biopsy.


Assuntos
Neoplasias da Mama/patologia , Linfonodos/diagnóstico por imagem , Metástase Linfática/diagnóstico por imagem , Ultrassonografia de Intervenção , Adulto , Idoso , Axila , Biópsia/métodos , Neoplasias da Mama/diagnóstico por imagem , Feminino , Humanos , Linfonodos/cirurgia , Pessoa de Meia-Idade , Estudos Prospectivos , Curva ROC , Biópsia de Linfonodo Sentinela
18.
J Korean Med Sci ; 24(1): 92-6, 2009 Feb.
Artigo em Inglês | MEDLINE | ID: mdl-19270819

RESUMO

This randomized prospective study investigated the effect of fibrin glue use on drainage duration and overall drain output after lumpectomy and axillary dissection in breast cancer patients. A total of 100 patients undergoing breast lumpectomy and axillary dissection were randomized to a fibrin glue group (N=50; glue sprayed onto the axillary dissection site) or a control group (N=50). Outcome measures were drainage duration, overall drain output, and incidence of seroma. Overall, the fibrin glue and control groups were similar in terms of drainage duration, overall drain output, and incidence of seroma. However, subgroup analysis showed that fibrin glue use resulted in a shorter drainage duration (3.5 vs. 4.7 days; p=0.0006) and overall drain output (196 vs. 278 mL; p=0.0255) in patients undergoing level II or III axillary dissection. Fibrin glue use reduced drainage duration and overall drain output in breast cancer patients undergoing a lumpectomy and level II or III axillary dissection.


Assuntos
Neoplasias da Mama/cirurgia , Adesivo Tecidual de Fibrina/uso terapêutico , Excisão de Linfonodo , Mastectomia Segmentar , Adesivos Teciduais/uso terapêutico , Adulto , Axila , Neoplasias da Mama/patologia , Drenagem , Feminino , Humanos , Pessoa de Meia-Idade , Estudos Prospectivos , Seroma/epidemiologia , Seroma/etiologia , Índice de Gravidade de Doença , Fatores de Tempo
19.
Genes Chromosomes Cancer ; 47(6): 490-9, 2008 Jun.
Artigo em Inglês | MEDLINE | ID: mdl-18314908

RESUMO

Triple-negative breast cancer (TNBC) is defined by a lack of expression of estrogen, progesterone, and HER2 receptors, and genetically most of them fall into the basal subgroup of breast cancer. The important issue of TNBC is poorer clinical outcome and absence of effective targeted therapy. In this study, we sought to identify DNA copy number alterations and expression of relevant genes characteristic of TNBC to discover potential therapeutic targets. Frozen tissues from 114 breast cancers were analyzed using high-resolution array comparative genomic hybridization. The classification into subtype was determined by estrogen and progesterone receptor expression, and by the presence or absence of gain on the ERBB2 containing clone. The ACE algorithm was used for calling gain and loss of clones. Twenty-eight cases (25%) were classified as TNBC. Recurrent gains (> or =25%) unique to TNBC were 9p24-p21, 10p15-p13, 12p13, 13q31-q34, 18q12, 18q21-q23, and 21q22. Two published gene expression array data sets comparing basal subtype versus other subtype breast cancers were used for searching candidate genes. Of the genes upregulated in the basal subtype, 45 of 686 genes in one data set and 59 of 1,428 in the second data set were found to be located in the gained regions. Of these candidate genes, gain of NFIB (9p24.1) was specific for TNBC in a validation set by real-time PCR. In conclusion, we have identified recurrently gained regions characteristic of TNBC, and found that NFIB copy number and expression is increased in TNBC across the data sets. This article contains Supplementary Material available at http://www.interscience.wiley.com/jpages/1045-2257/suppmat.


Assuntos
Neoplasias da Mama/genética , Carcinoma Ductal de Mama/genética , Amplificação de Genes , Dosagem de Genes , Regulação Neoplásica da Expressão Gênica , Adulto , Idoso , Algoritmos , Neoplasias da Mama/classificação , Neoplasias da Mama/mortalidade , Carcinoma Ductal de Mama/classificação , Carcinoma Ductal de Mama/mortalidade , Sistemas Computacionais , DNA de Neoplasias/genética , Feminino , Perfilação da Expressão Gênica , Genes erbB-2 , Humanos , Pessoa de Meia-Idade , Proteínas de Neoplasias/biossíntese , Proteínas de Neoplasias/genética , Hibridização de Ácido Nucleico , Análise de Sequência com Séries de Oligonucleotídeos , Reação em Cadeia da Polimerase , Receptores de Estrogênio/genética , Receptores de Progesterona/genética
20.
Ann Clin Lab Sci ; 49(2): 171-174, 2019 Mar.
Artigo em Inglês | MEDLINE | ID: mdl-31028060

RESUMO

BACKGROUND: Human mammary tumor virus (HMTV) is 90-95% homologous to mouse mammary tumor virus, one of the causal agents of murine mammary tumors. Although HMTV has been frequently detected in human breast cancers, its clinical and prognostic value remains unknown. METHODS: In the present study, we analyzed HMTV infection using polymerase chain reaction (PCR) in 128 breast cancers. RESULTS: HMTV was found in 9.4% (12/128) of breast cancers and was significantly associated with breast pain (66.7% vs. 11.7%, p=0.007). It had a tendency to be detected more frequently in breast cancer patients with lower BMI<25, although this result was not statistically significant (18.8% vs. 5.4%, p=0.103). Kaplan-Meier survival analysis showed no prognostic value of HMTV in breast cancer (χ2=0.148, p=0.700). For the first time, we investigated the clinical and prognostic value of HMTV in Korean patients with breast cancer. CONCLUSION: Although our study revealed that HMTV infection does not have important clinical significance in breast cancer, the possibility remains that it may be a prominent causative agent of the disease.


Assuntos
Povo Asiático , Betaretrovirus/fisiologia , Neoplasias da Mama/virologia , Idoso , Idoso de 80 Anos ou mais , Neoplasias da Mama/patologia , Feminino , Humanos , Estimativa de Kaplan-Meier , Pessoa de Meia-Idade , Prognóstico , Análise de Sobrevida
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