Assessment of Quality of Life and Safety in Postmenopausal Breast Cancer Patients Receiving Letrozole as an Early Adjuvant Treatment / 한국유방암학회지

PURPOSE: There are few reports from Asian countries about the long-term results of aromatase inhibitor adjuvant treatment for breast cancer. This observational study aimed to evaluate the long-term effects of letrozole in postmenopausal Korean women with operable breast cancer. METHODS: Self-reported quality of life (QoL) scores were serially assessed for 3 years during adjuvant letrozole treatment using the Korean version of the Functional Assessment of Cancer Therapy-Breast questionnaires (version 3). Changes in bone mineral density (BMD) and serum cholesterol levels were also examined. RESULTS: All 897 patients received the documented informed consent form and completed a baseline questionnaire before treatment. Adjuvant chemotherapy was administered to 684 (76.3%) subjects, and 410 (45.7%) and 396 (44.1%) patients had stage I and II breast cancer, respectively. Each patient completed questionnaires at 3, 6, 12, 18, 24, 30, and 36 months after enrollment. Of 897 patients, 749 (83.5%) completed the study. The dropout rate was 16.5%. The serial trial outcome index, the sum of the physical and functional well-being subscales, increased gradually and significantly from baseline during letrozole treatment (p<0.001). The mean serum cholesterol level increased significantly from 199 to 205 after 36 months (p=0.042). The mean BMD significantly decreased from −0.39 at baseline to −0.87 after 36 months (p<0.001). CONCLUSION: QoL gradually improved during letrozole treatment. BMD and serum cholesterol level changes were similar to those in Western countries, indicating that adjuvant letrozole treatment is well tolerated in Korean women, with minimal ethnic variation.

Minimally Invasive Excision of Benign Breast Tumor Using Ultrasound Guided Vacuum-Assisted Mammotome

PURPOSE: Current epidemiologic study indicates that the incidence of breast cancer has increased in Korea. However, significantly more women will develop benign breast disease during their adult lives. Even though benign breast disease is not life threatening, it can cause patient discomfort, anxiety, and fear. This study evaluates the safety, efficacy, and patient acceptance of an ultrasound guided vacuum-assisted mammotome (UVAM) in percutaneous total removal of benign breast lesions. METHODS: From Aug. 2002 to Feb. 2003, 106 sonographically benign breast lesions (up to 2.5 cm in size) of 86 patients underwent total removal under local anesthesia using 11-guage or 8-guage UVAM needles. Ultrasonographic follow-up evaluation was performed at 14 days post operation to assess the residual lesions and complications. RESULTS: UVAM allows total removal of benign breast lesions that are up to 2.5 cm in size and no residual lesions were found in follow-up breast sonogram for any of the patients. Forty-one patients (47.7%) were younger than 40. The pathologists classified the majority of removed lesions as fibroadenoma (52.9%) or fibrocystic changes (34.9%). Most complications were mild or moderate. Among the complications such as hematoma, pain, and skin dimpling, hematoma was most common and resolved spontaneously without additional intervention. All of the patients were satisfied with this procedure. CONCLUSION: Percutaneous excision of benign breast lesions using UVAM is feasible, safe, and yields high patient satisfaction. Long-term efficacy is being evaluated in an ongoing study.