• Title, Summary, Keyword: breast cancer care

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The 1998, 1999 Patterns of Care Study for Breast Irradiation after Mastectomy in Korea (1998, 1999년도 우리나라에서 시행된 근치적 유방 전절제술 후 방사선치료 현황 조사)

  • Keum,, Ki-Chang;Shim, Su-Jung;Lee, Ik-Jae;Park, Won;Lee, Sang-Wook;Shin, Hyun-Soo;Chung, Eun-Ji;Chie, Eui-Kyu;Kim, Il-Han;Oh, Do-Hoon;Ha, Sung-Whan;Lee, Hyung-Sik;Ahn, Sung-Ja
    • Radiation Oncology Journal
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    • v.25 no.1
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    • pp.7-15
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    • 2007
  • [ $\underline{Purpose}$ ]: To determine the patterns of evaluation and treatment in patients with breast cancer after mastectomy and treated with radiotherapy. A nationwide study was performed with the goal of improving radiotherapy treatment. $\underline{Materials\;and\;Methods}$: A web- based database system for the Korean Patterns of Care Study (PCS) for 6 common cancers was developed. Randomly selected records of 286 eligible patients treated between 1998 and 1999 from 17 hospitals were reviewed. $\underline{Results}$: The ages of the study patients ranged from 20 to 80 years (median age 44 years). The pathologic T stage by the AJCC was T1 in 9.7% of the cases, T2 in 59.2% of the cases, T3 in 25.6% of the cases, and T4 in 5.3% of the cases. For analysis of nodal involvement, N0 was 7.3%, N1 was 14%, N2 was 38.8%, and N3 was 38.5% of the cases. The AJCC stage was stage I in 0.7% of the cases, stage IIa in 3.8% of the cases, stage IIb in 9.8% of the cases, stage IIIa in 43% of the cases, stage IIIb in 2.8% of the cases, and IIIc in 38.5% of the cases. There were various sequences of chemotherapy and radiotherapy after mastectomy. Mastectomy and chemotherapy followed by radiotherapy was the most commonly performed sequence in 47% of the cases. Mastectomy, chemotherapy, and radiotherapy followed by additional chemotherapy was performed in 35% of the cases, and neoadjuvant chemoradiotherapy was performed in 12.5% of the cases. The radiotherapy volume was chest wall only in 5.6% of the cases. The volume was chest wall and supraclavicular fossa (SCL) in 20.3% of the cases; chest wall, SCL and internal mammary lymph node (IMN) in 27.6% of the cases; chest wall, SCL and posterior axillary lymph node in 25.9% of the cases; chest wall, SCL, IMN, and posterior axillary lymph node in 19.9% of the cases. Two patients received IMN only. The method of chest wall irradiation was tangential field in 57.3% of the cases and electron beam in 42% of the cases. A bolus for the chest wall was used in 54.8% of the tangential field cases and 52.5% of the electron beam cases. The radiation dose to the chest wall was $45{\sim}59.4\;Gy$ (median 50.4 Gy), to the SCL was $45{\sim}59.4\;Gy$ (median 50.4 Gy), and to the PAB was $4.8{\sim}38.8\;Gy$, (median 9 Gy) $\underline{Conclusion}$: Different and various treatment methods were used for radiotherapy of the breast cancer patients after mastectomy in each hospital. Most of treatment methods varied in the irradiation of the chest wall. A separate analysis for the details of radiotherapy planning also needs to be followed and the outcome of treatment is needed in order to evaluate the different processes.

Dynamics and Liver Disease Specific Aspects of Quality of Life Among Patients with Chronic Liver Disease in Yunnan, China

  • Che, Yan-Hua;You, Jing;Chongsuvivatwong, Virasakdi;Li, Li;Sriplung, Hucha;Yan, Yuan-Zhi;Ma, Si-Jia;Zhang, Xiaoli;Shen, Ting;Chen, He-Min;Rao, Shao-Feng;Zhang, Ru-Yi
    • Asian Pacific Journal of Cancer Prevention
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    • v.15 no.12
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    • pp.4765-4771
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    • 2014
  • Background: Patients with chronic liver diseases (CLD) may have compromised health related quality of life (HRQoL). Hepatitis B virus (HBV) infection has long been the leading cause of CLD including liver cancer and cirrhosis. Knowledge on different symptom profiles of CLD should help in development of comprehensive treatment and patient care plans. Objective: To access the facets of HRQoL in chronic liver diseases throughout their spectrum of severity. Materials and Methods: A cross-sectional study was conducted in the First Affiliated Hospital of Kunming Medical University in Yunnan Province of China. Both out- and inpatients undergoing treatment protocols for different HBV related liver disease states were consecutively collected from December 2012 to June 2013. ANOVA was used to compare the mean scores of EQ-5D and chronic liver disease questionnaire (CLDQ) among 5 disease groups. The relationship between demographic variables predicting global CLDQ scores and the domains of CLDQ was analysed. Results: A total of 1040 patients including 520 without complications, 91 with compensated cirrhosis, 198 with decompensated cirrhosis, 131 with HCC and 100 with liver failure were recruited. All domains of CLDQ, the means of EQ-5D value and EQ VAS exhibited significant decline with worsening of disease severity from uncomplicated HBV to liver failure. The multivariate regression demonstrated the reduction of mean scores of CLDQ domain at advanced stage. Patients with liver failure and HCC had more HRQoL impairment than other disease states. No effect of patient gender was found. Patient age was associated with 'fatigue' and 'worry' domains (p=0.006; p=0.004) but not with other domains and global scores of CLDQ and ED-5D. Conclusions: The HRQoL in chronic hepatitis B patients is greatly affected by disease states. Care for HBV-related diseases should consider not only the outcomes of treatment strategies but also improvement in patient wellbeing.

Estimation of Cancer Mortality among Koreans with Reference to $Ky{\breve{o}}ngsangnam-do$ Area (한국인 암사망률의 추정에 관한 연구 - 경상남도지역을 중심으로 -)

  • Lee, Moo-Song;Park, Tae-Soo;Ahn, Yoon-Ok
    • Journal of Preventive Medicine and Public Health
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    • v.25 no.2
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    • pp.115-126
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    • 1992
  • To estimate the cancer mortality rates among Koreans, a mortality survey was carried out in the province of $Ky{\breve{o}}ngsangnam-do$. The study population are the beneficiaries of Korea Medical Insurance Corporation(KMIC), $Ky{\breve{o}}ngsangnam-do$ area, among which the 3,867 deaths occurred from January, 1989 to December, 1990, were reviewed to confirm the cancer deaths. These were based upon the death certificates and medical utilization records before dying which were available through the computerized databases on medical care utility of KMIC. The survey was conducted along three steps. At first, the death certificates were examined, as a second step medical utilization records were reviewed, and finally direct contacts to the family members of the deceased were done. As a result, 990 deaths were found due to cancer. Using them, age and sex specific cancer(all sites and several sites) mortality rates were estimated. Overall cancer mortality rate in the area was estimated 138.7 per 100,000 person-years in males, and 65.7 in females, respectively. And the orders of site-specific cancer mortality rates were the cancers of stomach, liver, lung, esophagus, and cancers of the hematopoietic system among males, In females, followed by gastric cancer, cancers of lung and liver are the 2nd and 3rd in rank, respectively and cancers of breast and uterine cervix are the 4th and the 5th in rank.

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Study on Computerized Treatment Plan of Field-in-Field Intensity Modulated Radiation Therapy and Conventional Radiation Therapy according to PBC Algorithm and AAA on Breast Cancer Tangential Beam (유방암 접선조사에서 PBC 알고리즘과 AAA에 따른 Field-in-Field Intensity Modulated Radiation Therapy와 Conventional Radiation Therapy 전산화 치료계획에 대한 고찰)

  • Yeom, Mi-Suk;Bae, Seong-Soo;Kim, Dae-Sup;Back, Geum-Mun
    • The Journal of Korean Society for Radiation Therapy
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    • v.24 no.1
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    • pp.11-14
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    • 2012
  • Purpose: Anisotropic Analytical Algorithm (AAA) provides more accurate dose calculation regarding impact on scatter and tissue inhomogeneity in comparison to Pencil Beam Convolution (PBC) algorithm. This study tries to analyze the difference of dose distribution according to PBC algorithm and dose calculation algorithm of AAA on breast cancer tangential plan. Materials and Methods: Computerized medical care plan using Eclipse treatment planning system (version 8.9, VARIAN, USA) has been established for the 10 breast cancer patients using 6 MV energy of Linac (CL-6EX, VARIAN, USA). After treatment plan of Conventional Radiation Therapy plan (Conventional plan) and Field-in-Field Intensity Modulated Radiation Therapy plan (FiF plan) using PBC algorithm has been established, MU has been fixed, implemented dose calculation after changing it to AAA, and compared and analyzed treatment plan using Dose Volume Histogram (DVH). Results: Firstly, as a result of evaluating PBC algorithm of Conventional plan and the difference according to AAA, the average difference of CI value on target volume has been highly estimated by 0.295 on PBC algorithm and as a result of evaluating dose of lung, $V_{47Gy}$ and $V_{45Gy}$ has been highly evaluated by 5.83% and 4.04% each, Mean dose, $V_{20Gy}$, $V_{5Gy}$, $V_{3Gy}$ has been highly evaluated 0.6%, 0.29%, 6.35%, 10.23% each on AAA. Secondly, in case of FiF plan, the average difference of CI value on target volume has been highly evaluated on PBC algorithm by 0.165, and dose on ipsilateral lung, $V_{47Gy}$, $V_{45Gy}$, Mean dose has been highly evaluated 6.17%, 3.80%, 0.15% each on PBC algorithm, $V_{20Gy}$, $V_{5Gy}$, $V_{3Gy}$ has been highly evaluated 0.14%, 4.07%, 4.35% each on AAA. Conclusion: When calculating with AAA on breast cancer tangential plan, compared to PBC algorithm, Conformity on target volume of Conventional plan, FiF plan has been less evaluated by 0.295, 0.165 each. For the reason that dose of high dose region of ipsilateral lung has been showed little amount, and dose of low dose region has been showed much amount, features according to dose calculation algorithm need to be considered when we evaluate dose for the lungs.

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Analysis of Set-up Errors during CT-scan, Simulation, and Treatment Process in Breast Cancer Patients (유방암 환자의 모의치료, CT 스캔 및 치료 과정에서 발생되는 준비 오차 분석)

  • Lee, Re-Na
    • Radiation Oncology Journal
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    • v.23 no.3
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    • pp.169-175
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    • 2005
  • Purpose: Although computed tomography (CT) simulators are commonly used in radiation therapy department, many Institution still use conventional CT for treatments. In this study the setup errors that occur during simulation, CT scan (diagnostic CT scanner), and treatment were evaluated for the twenty one breast cancer patients. Materials and Methods: Errors were determined by calculating the differences in isocenter location, SSD, CLD, and locations of surgical clips implanted during surgery. The anatomic structures on simulation film and DRR image were compared to determine the movement of isocenter between simulation and CT scan. The isocetner point determined from the radio-opaque wires placed on patient's surface during CT scan was moved to new position if there was anatomic mismatch between the two images Results: In 7/21 patients, anatomic structures on DRR Image were different from the simulation Image thus new isocenter points were placed for treatment planning. The standard deviations of the diagnostic CT setup errors relative to the simulator setup in lateral, longitudinal, and anterior-posterior directions were 2.3, 1.6, and 1.6 mm, respectively. The average variation and standard deviation of SSD from AP field were 1.9 mm and 2.3 mm and from tangential fields were 2.8 mm and 3.7 mm. The variation of the CLD for the 21 patients ranged from 0 to 6 mm between simulation and DRR and 0 to 5 mm between simulation and treatment. The group systematic errors analyzed based on clip locations were 1.7 mm in lateral direction, 2.1 mm in AP direction, and 1.7 mm in SI direction. Conclusion: These results represent that there was no significant differences when SSD, CLD, clips' locations and isocenter locations were considered. Therefore, it is concluded that when a diagnostic CT scanner is used to acquire an image, the set-up variation is acceptable compared to using CT simulator for the treatment of breast cancer. However, the patient has to be positioned with care during CT scan in order to reduce the setup error between simulation and CT scan.

A Study on the Preference of Art Media of Cancer Patients: Multidisciplinary Approach of Art Therapy (통원 암 환자의 미술 매체 선호도 연구: 미술 치료요법의 다학제간 접근)

  • Lee, Yun-Hee;Kim, Jee-Eun
    • Journal of the Korea Convergence Society
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    • v.11 no.10
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    • pp.171-179
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    • 2020
  • This study was attempted to identify the media preferences and the reasons of cancer patients. The data collection was conducted on 76 people. and they are 6 men, 70 women with 38 breast cancer patients, and 38 patients with other cancers. For measuring tools, self-written questionnaires and Mandala paintings were used for single-time art therapy. The data analysis compared the results of technical statistics, independence verification and chi verification using the SPSS WIN ver.25.0 with the Mandala painting. There were no significant differences in media preference by age and duration of the disease, and there were significant differences in media preference by disease. In the Mandala painting, the characteristics of the medium and the factors of specific disease showed that there were reasons and effects of preference media choice. This study is meaningful in that it concentrated on the art therapy access and support in terms of the cancer outpatients, which have been concentrated on inpatients so that they shed light to the support and intervention needed by the outpatients, and can be used as basic data for the development of art therapy programs to help stabilize the mind of cancer patients in the future.

Survival of isolated human preantral follicles after vitrification: Analyses of morphology and Fas ligand and caspase-3 mRNA expression

  • Wiweko, Budi;Soebijanto, Soegiharto;Boediono, Arief;Mansyur, Muchtaruddin;Siregar, Nuryati C;Suryandari, Dwi Anita;Aulia, Ahmad;Djuwantono, Tono;Affandi, Biran
    • Clinical and Experimental Reproductive Medicine
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    • v.46 no.4
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    • pp.152-165
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    • 2019
  • Objective: This study aimed to examine the effect of vitrification on apoptosis and survival in human preantral follicles after thawing. Methods: This experimental study was conducted at an acute tertiary care hospital from March 2012 to April 2013. Ovaries were sliced into 5 × 5 × 1-mm pieces and divided into the following three groups: preantral follicle isolation, ovarian tissue vitrification-warming followed by follicle isolation, and immunohistochemistry of fresh ovarian tissue. For statistical analyses, the Student t-test, chi-square test, Kruskal-Wallis test, and Kaplan-Meier survival analysis were used. Results: A total of 161 preantral follicles (70% secondary) were collected from ovarian cortex tissue of six women between 30 and 37 years of age who underwent oophorectomy due to cervical cancer or breast cancer. There were no significant differences in the follicular morphology of fresh preantral follicles and vitrified follicles after thawing. The mean Fas ligand (FasL) mRNA expression level was 0.43 ± 0.20 (relative to β-actin) in fresh preantral follicles versus 0.51 ± 0.20 in vitrified follicles (p= 0.22). The mean caspase-3 mRNA expression level in fresh preantral follicles was 0.56 ± 0.49 vs. 0.27 ± 0.21 in vitrified follicles (p= 0.233). One vitrified-thawed secondary follicle grew and developed to an antral follicle within 6 days of culture. Conclusion: Vitrification did not affect preantral follicle morphology or mRNA expression of the apoptosis markers FasL and caspase-3. Further studies are required to establish whether vitrification affects the outcomes of in vitro culture and the maturation of preantral follicles.

Exploring Reproductive Health Education Needs in Infertile Women in Iran: A Qualitative Study

  • Khakbazan, Zohreh;Maasoumi, Raziyeh;Rakhshaee, Zahra;Nedjat, Saharnaz
    • Journal of Preventive Medicine and Public Health
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    • v.53 no.5
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    • pp.353-361
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    • 2020
  • Objectives: An inadequate understanding of infertility can affect individuals' self-efficacy and ability to perform self-care; thus, reproductive health education is an important part of infertility treatment. The present qualitative study aimed to explore the experiences and educational needs of infertile women with regard to reproductive health. Methods: In this qualitative study, we utilized a content analysis approach. Purposive sampling was performed to ensure maximum diversity. In total, 23 individual interviews were conducted with 20 Iranian women with infertility and 3 key informants between July 2018 and February 2019 in northern Iran. Data were collected through in-depth, semi-structured interviews. Data analysis was performed using a conventional content analysis approach. Results: Reproductive health education needs were identified by analyzing interview data from 4 main categories: familiarity with the fertility process and preparation for pregnancy, recognition of infertility and expectations around seeking treatment, recognition of preventive actions associated with reproductive health, and correction of false beliefs. Recognizing the causes of infertility and understanding the different approaches to infertility treatment are among the most important educational needs of infertile women. The potential for neglect of health-related issues due to concerns about fertility and the maternal experience necessitates education about preventive measures for cervical cancer, breast cancer, and sexually transmitted infections. Correcting misconceptions, including those related to contraceptives and traditional medicine, can also help promote reproductive health. Conclusions: In infertile women, the educational needs associated with reproductive health are multifaceted. Satisfying these needs can help achieve optimal treatment results and promote reproductive health.

A Study on The Health Status of Island Community People in Island (도서지역 주민의 건강상태에 관한 연구)

  • Shin, Kyung Rim
    • Korean Journal of Adult Nursing
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    • v.12 no.2
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    • pp.296-310
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    • 2000
  • During the past 10 years, concern for community people's health has increased together with the changes. Public health policies and studies for community people's health, however, have influenced those in childmaternal health care to want more general coverage and studies of health and wellness. Particularly, the study of community people's health in the extent an island area is almost rare as that personal and the material benefits in this area are lacking of community people's work is large, and the basic elements of living, such as diet and elimination, are irregular due to the schedule of the tide. Thus, there are many potential health problems. In this regard, the study attempted to understand the health problems of island community people and to provide a basis for developing health promotion and health education programs. In collecting data for the study, face to face interviews were made through a structured questionnaire from October 1 to December 30, 1996. Collected data were analyzed with the SAS statistics program, descriptive statistics, t-test and ANOVA. Subjects' health status was examined by classifying into such categories as their health perception, complaints of health problem, related lifestyle, psychosocial health staus, the result of examination is as follows; 1. For subjects' health perception, 26.9% of the subject answered not sick, but not so healthy'; 30.9% thought they were healthy, while 22.9% answered that they were not healthy. 2. For the health problem complaints many complained of pains in their muscles and skeletal system, especially knee joint pain. Women's health problems related with breast and the reproductive system included 52.3% of cases doing breast self examination, while 56.55% received the cervical cancer screening test. In men's health problems, 44.2% of subjects answered that they have moderate to severe BPH(Benign Prostatic Hypertrophy) symptom. 3. There were statistically a significant difference in the degree of physical health according to marital status(p=0.0028), occupation(p=0.0442), income(p=0.0357). 4. For stress status, 17.2% was to need the intervention, 50.2% was to need observation. 5. The mean score of self-esteem was 27.7 showing a relatively high score. 6. For the rate of smoking, 37.7% used to smoke, while 28% used to take alcohol. 7. The rate of substance abuse was 45.9% of subjects. 8. Most of subjects' health behaviors included most of the acupuncture (52%). 9. The rate of subjects receiving comprehensive medical testing was 34.36% while 34.78% did after care managing behavior. 10. For the obesity grade, 53% is normal weight, low-weight 32.8%, obesity 33%. 11. For nutrition status, 78.7% illy balanced to need intervention of nutritional education. 12. For 78.7% of subjects, muscle strength and 40.7% of stretching were not good enough to need health education on physical exercises. Therefore, based on the results, appropriate health education programs need to be developed to promote health of community people on an island.

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The Prevalence of Cancer in Kangwha County (강화지역 암의 유병률)

  • Yi, Sang-Wook;Lee, Kang-Hee;Kim, Suk-Il;Kang, Hyung-Gon;Jee, Sun-Ha;Ohrr, Hee-Choul
    • Journal of Preventive Medicine and Public Health
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    • v.32 no.3
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    • pp.333-342
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    • 1999
  • Objectives: Most descriptive studies of cancer have focused either or cancer incidence or mortality. Cancer prevalence has rarely been estimated. Cancer prevalence data can be used as a measure of the economic and social burden of cancer and are also useful for health care planning. This study attempts to estimate cancer prevalence in Kangwha county. Methods: This investigation is based on data of Kangwha cancer registry. The data include all cases of cancer diagnosed from 1983 through 1992. We define 'prevalent cases' as cancer patients who is alive as of January 1, 1993. For each five-year age group, the number of 'known prevalent cases' is added to the number of 'estimated prevalent cases'. Prevalence is calculated by dividing these sums by the populations of Kangwha County on December 31, 1992(derived from Kangwha Statistics Annual). Results: Crude prevalence of cancel among males and females are 536.7 and 601.1 per 100,000 respectively. Gastric cancer is the most common malignant neoplasm(213.2 per 100,000, crude prevalence) among males. It is followed by lung cancer(45.1 per 100,000), liver cancer(32.8 per 100,000), rectal cancer(25.4 per 100,000) and colon cancer(25.4 per 100,000). Cervical cancer is the most common cancer(201.9 per 100,000, crude prevalence) and is fellowed by gastric cancer(91.5 per 100,000), thyroid cancer(64.8 per 100,000), breast cancer(57.2 per 100,000) and rectal cancer(32.7 per 100,000) among females. Conclusions: We tried to estimate cancer prevalence based on the Kangwha cancer registry for the first time in Korea. The estimation of cancer prevalence based on a population-based cancer registry will be more correct and useful as the data accumulate. We will make another estimation in the near future.

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