• Korean Journal of Clinical Pharmacy
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• v.23 no.3
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• pp.213-222
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• 2013

Purpose: The aim of this study was to investigate the current state of antidepressant prescriptions in breast cancer patients and factors affecting the prescription of antidepressants. Methods: This study targeted female breast cancer patients who were prescribed antidepressants by a psychiatrist at least once between August 2010 and July 2011 at the Asan Medical Center in Seoul. The prescription history of each study subject was investigated to analyze the current state of antidepressant prescriptions in breast cancer patients. Results: The analysis of the prescription histories of 136 subjects in the antidepressant group determined that escitalopram, mirtazapine, and trazodone were the three most commonly prescribed medications with an average of 1.54 antidepressants prescribed per patient. A logistic regression analysis showed a statistically significant increase in antidepressant prescriptions in patients who were divorced or widowed, had sleep disturbances, or had undergone oncologic surgery for the breast cancer (p<0.050). In contrast, the prescription rate was lower for patients with tumour sizes greater than 50 mm (p<0.050). Conclusion: The sociodemographic factor of marital status, clinical factors of sleep disorders and tumour size, and a treatment-specific factor of the use of surgical therapy were identified as affecting the prescription of antidepressants in female breast cancer patients.

• The Journal of Korean Obstetrics and Gynecology
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• v.29 no.1
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• pp.78-91
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• 2016

Objectives: Breast cancer patients in Korea need to care about symptoms with complementary medicine including acupuncture. We reviewed the randomized controlled studies using acupuncture in breast cancer patients to establish a basic knowledge of clinical practice guidelines. Methods: We searched the following databases through July 2015: the Cochrane Central Register of Controlled Trials, Ovid-Medline, Ovid-EMBASE, the Allied and Complementary Medicine Databases and OASIS. The articles of RCTs using acupuncture in breast cancer for all symptoms were selected and analyzed. The acupoints, treatment period, inclusion criteria of participants, follow-up period and effectiveness were extracted. Results: Three hundred fifty five records after duplicate were screened, and 14 RCTs were selected. RCTs of Hot flush, pain, fatigue were reviewed. The adverse symptoms using medical treatment in breast cancer patients were targets of acupuncture in RCTs. The acupuncture treatment was decreased the hot flush, pain and fatigue. However, the effect was not confirmed due to various study design. Conclusions: The analysis of the research would be conjugated to establish a basic knowledge of clinical practice guidelines. Well designed studies in Korea are needed to confirm the efficacy and safety of acupuncture in patients with breast cancer.

• Journal of radiological science and technology
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• v.41 no.6
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• pp.561-566
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• 2018

Field-in-Field Technique is applied to the radiation therapy of breast cancer patients, and it is possible to compensate the difference in breast thickness and deliver uniform dose in the breast. However, there are several fields in the treatment field that result in a more complex dose delivery than a single field dose delivery. If the patient's respiration is irregular during the delivery of the dose by several fields and the change of respiration occurs, the dose distribution in the breast changes. Therefore, based on the computed tomography images of breast cancer patients, a human model was created by using a 3D printer (Builder Extreme 1000) to describe the volume in the same manner. A computerized tomography (CT) of the human body model was performed and a treatment plan of 260 cGy / fx was established using a 6-MV field-in-field technique using a computerized treatment planning system (Eclipse 13.6, Varian, USA). The distribution of the dose in the breast according to the change of the respiration was measured using a moving phantom at 0.1 cm, 0.3 cm, 0.5 cm amplitude, using a MOSOXIDE Silicon Field Effect Transistor (MOSFET, Best Medical, Canada) Were measured and compared. The distribution of dose in the breast according to the change of respiration showed similar value within ${\pm}2%$ in the movement up to 0.3 cm compared to the treatment plan. In this experiment, we found that the dose distribution in the breast due to the change of respiration when the change of respiration was increased was not much different from the treatment plan.

• The Journal of Internal Korean Medicine
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• v.40 no.3
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• pp.343-355
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• 2019

Objectives: Traditional oriental medicine is used in treating breast cancer-related lymphedema to alleviate symptoms. Upper limb lymphedema is a symptom that is frequently observed in patients with breast cancer, and it impairs their quality of life. This systematic review aimed to summarize the current available evidence to evaluate the effect of traditional oriental medicine on upper limb lymphedema in breast cancer patients. Methods: The review evaluated randomized controlled trials (RCTs) measuring the effect of herbal medicine, acupuncture, and moxibustion on upper limb lymphedema in breast cancer patients within four electronic databases. The Cochrane risk of bias (ROB) tool was used to assess the quality of the RCTs. Results: In total, 23 RCTs met the inclusion criteria. Among them, 22 studies reported that the rate of severity of lymphedema improved after treatment in the traditional treatment group using herbal medicine, acupuncture, or moxibustion better than in the conventional medicine group. The methodological quality of the RCTs was insufficient with an unclear and high ROB. Conclusions: Traditional oriental medicine may have a potential to improve lymphedema in patients with breast cancer. To confirm the clinical recommendation, further research with a rigorous study design is required to support the effects of traditional oriental medicine.

• The Journal of Korean Obstetrics and Gynecology
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• v.32 no.3
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• pp.102-115
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• 2019

Objectives: The purpose of this study is to confirm the effectiveness and safety of acupuncture for treating breast cancer-related lymphedema (BCRL), thus providing a clinical basis for acupuncture treatment and helping to develop clinical practice guideline through consideration of used meridians and acupoints. Methods: Clinical studies applying acupuncture on breast cancer-related lymphedema were searched through 7 databases such as The Cochrane Library Central, Embase, Pubmed and CAJ. Interventions and results of the selected clinical studies were analyzed. Results: 8 Clinical studies were finally included according to inclusion and exclusion criteria. There were 6 randomized controlled studies and 2 single-arm pilot studies. All of those studies were searched in The Cochrane Library Central, Embase, Pubmed and CAJ and written in English and Chinese. Treatment group applied acupuncture as a Korean medicine intervention. Interventions of control group were made with non-treatment, upper limb exercise, and oral administration of capillary stabilizer or diuretics. Outcome measurements varied from paper to paper but every study measured reduction in arm circumference. Among 8 studies, 6 studies reported statistically significant reduction in arm circumference in treatment group and there were no serious adverse effects. Conclusions: This study suggested that acupuncture has few side effects as well as statistically significant effects on many aspects in treating breast cancer-related lymphedema. However the results should be taken cautiously as more clinical studies are needed.

• Journal of The Korean Society of Integrative Medicine
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• v.9 no.4
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• pp.19-28
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• 2021

Purpose : The purpose of this study was to apply manual lymphatic drainage (MLD) and high-frequency diathermy (HFD) to patients with axillary web syndrome (AWS), one of the side effects of breast cancer surgery, and to treat upper extremity pain, volume, function of the upper extremity, (joint range of motion; ROM, disabilities of the arm, shoulder and hand; DASH) and quality of life before and after treatment. It is to determine the effect of treatment by checking the level change. Methods : This study is a case series. A total of 5 patients diagnosed with AWS after breast cancer surgery voluntarily participated in this study. The intervention program consisted of stretching, MLD and HFD. It was conducted 3 times a week for 30 minutes for 4 weeks. In order to compare the effects of pain (numeric pain rating scale; NPRS), volume, upper limb function (ROM, DASH) and quality of life (the European organization for research and treatment of cancer quality of life questionnaire-breast, EORTC QLQ-BR23) evaluations were compared before and after 4 weeks of intervention. All measured variables were analyzed and expressed as mean, standard deviation and percentage. Results : The shoulder NPRS level of the subjects in all case groups decreased, the volume decreased and the shoulder flexion, abduction ROM increased. It showed improvement in DASH and quality of life, QLQ-BR23. Conclusion : After breast cancer surgery, we confirmed the possibility that MLD and HFD treatments could be effective in improving pain, decreasing volume, increasing upper extremity function, and quality of life for patients who have difficulties with AWS. The possibility has been confirmed, and additional research is needed by increasing the number of participants in the experiment in the future.

• Journal of The Korean Society of Integrative Medicine
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• v.9 no.1
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• pp.49-57
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• 2021

Purpose: The purpose of this study was to investigate the effect of manual lymphatic drainage (MLD) methods on muscle tone, pain, and depression in patients with breast cancer. Methods: The study had a two-group pretest-posttest design. A total of 24 patients with breast cancer voluntarily participated in the study. Subjects were randomly assigned to the MLD (n=12) and control (n=12) groups. Measurements of muscle tone, pain, and depression were taken prior to starting the intervention and after completing the 4 week program. The muscle tone, pain, and depression were measured using noninvasive muscle tone measuring equipment, the short-form McGill pain questionnaire, and the Beck depression inventory, respectively. The intervention was performed for 20 minutes a day, three times a week, for four weeks. A paired t-test was used to compare pretest and posttest values within each group, and an independent t-test was used to compare to pretest and posttest changes between the groups. Results: Comparison of the effects within the groups revealed significant reductions in muscle tone, pain, and depression in the MLD group after 4 weeks (p<.05), whereas the control group showed no differences. Comparison of the effects between the groups revealed significantly better reductions in muscle tone, pain, and depression in the MLD group than in the control group after 4 weeks (p<.05). Conclusion: These results suggest that MLD is an effective method for reducing muscle tone, pain, and depression in patients with breast cancer.

• Korean Journal of Clinical Pharmacy
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• v.31 no.2
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• pp.115-124
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• 2021

Background: With an increase in the number of breast cancer survivors, greater importance is attached to health-related quality of life, particularly pain and symptom control. This study aimed to identify the factors that are associated with pain in cancer patients based on the patterns of prescribing opioid, non-opioid, and adjuvant analgesics. Methods: This analysis included new patients who had developed breast cancer between 2003 and 2012. The degree of pain was analyzed based on the socio-demographic (age, income quintile, number of hospitalizations, and duration of disease), indicator (Body Mass Index; BMI, Charlson Comorbidity Index; CCI, Cumulative Analgesic Consumption Score; CACS), operation (mastectomy, lymph node dissection), and therapy (chemotherapy, radiation therapy), as well as complication-related variable (lymphedema). Results: As for the patterns of prescribing analgesics by stages, non-opioid and opioid analgesics constituted 30.7 and 69.3%, respectively. The mean value and variance of CACS were 5.596 and 12.567, respectively. The factors that significantly affected the degree of pain were age (≥50; IRR: 1.848, 95% CI 1.564-2.184, p=0.000), income quintile (IRR: 0.964, 95% CI 0.938-0.991, p=0.008), BMI (≥ 25; IRR: 1.479, 95% CI 1.222-1.795, p=0.000), CCI (≥ 4; IRR: 1.649, 95% CI 1.344-2.036, p=0.000), and lymphedema (yes; IRR: 1.267, 95% CI 1.006-1.610, p=0.047). Conclusions: It is necessary to develop systematic and comprehensive pain control measures to improve the quality of life for breast cancer survivors, especially for those who are 50 years or older, lie in the lower-income quintile, have BMI of ≥25 and CCI score ≥ 4, or have lymphedema.

• Clinical Pain
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• v.20 no.1
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• pp.25-29
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• 2021

Upper limb morbidity including shoulder pain, lymphedema, adhesive capsulitis, myofascial pain syndrome, and limited range of motions (LROMs) occurs frequently in breast cancer patients. Especially restricted upper limb motion aggravated by chronic lymphedema results in functional limitation and impaired activities of daily living (ADL). However, conventional rehabilitation therapy including complex decongestive therapy and stretching exercise is insufficient for managing advanced breast cancer patients with complex upper limb morbidity. Here, we report a case of breast cancer-related chronic lymphedema in a 62-years old female with severe LROM in all joints of the affected upper extremity that caused severe disability in ADL. Significant improvements in range of motion and upper extremity function were observed after serial extracorporeal shock wave therapy (ESWT), combined with conventional rehabilitation therapy. Therefore, ESWT might be recommended for managing the extensive limited joint motion which causes functional decline in a patient of chronic lymphedema with trophic skin change.

• PNF and Movement
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• v.21 no.1
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• pp.53-61
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• 2023

Purpose: The study aims to examine the effects of the proprioceptive neuromuscular facilitation pattern exercise and scrambler therapy on pain, range of motion (ROM), and shoulder dysfunction in breast cancer patients. Methods: In total, 30 breast cancer patients were recruited and randomized to group I (n = 10), group II (n = 10), and group III (n = 10). Pain was measured using a visual analogue scale, ROM was measured using a goniometer, and shoulder dysfunction was measured using a shoulder pain and disability index. Group I practiced the proprioceptive neuromuscular facilitation pattern exercise and underwent scrambler therapy, group II underwent scrambler therapy only, and group III practiced the proprioceptive neuromuscular facilitation pattern exercise only. Results: A within-groups comparison showed that all groups demonstrated significant differences in pain, ROM, and shoulder dysfunction after the experiment (p<0.05). Further, according to a comparison of the three groups, group I showed a more significant difference in effectiveness than groups II and III in terms of pain, ROM, and shoulder dysfunction before and after the experiment (p<0.05). Conclusion: This study showed that the proprioceptive neuromuscular facilitation pattern exercise and scrambler therapy are effective in treating pain, ROM issues, and shoulder dysfunction in breast cancer patients.