• The Journal of Internal Korean Medicine
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• v.25 no.3
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• pp.451-460
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• 2004

Objective : 황금의 유방암세포주에 대한 항암효과 및 기전에 대한 연구는 아직 미흡하며, 특히 에스트로젠리셉터를 가지지않은 유방암세포주인 MDA-MB-231에 대한 효과 및 기전에 대한 연구는 아직 발표된바 없어, 이에 대한 연구가 진행되었다. Methods : 인간 유방암세포주 MDA-MB-231 MTT assay를 이용 성장방해비율을 조사하였으며. FACS analysis를 이용 cell cycle analysis를 시행하였고, Western Blot Analysis 및 Annexin V analysis를 시행하였다. Results : MDA-MB-231에 대한 황금의 IC50는 180 ug/ml 이었으며 최대 세포성장억제효과는 $500{\mu}g/ml$로 한약재중 비교적 강한 세포독성을 보여 주었다. 유세포분석 에서 황금 $500{\mu}g/ml$의 농도를 72시간 투여한 경우 세포사멸(Sub Gl) 분율이 대조군의 1.7%에 비해 21%로 높아 현저한 용량의존적인 세포사멸현상을 보여주었으며, 세포사멸을 보다 명확히 규명할 수 있는 Annexin V analysis에서도 황금 $200{\mu}g/ml$농도일때 48시간에서 17%의 뚜렷한 세포사멸효과를 나타내었다. 한편 세포사멸촉진인자인 Bax, 세포사멸실행단백질인자인 caspase 3의 활성과 PARP의 분할은 세포사멸이 세포주기정지와 더불어 세포사멸의 과정에 p53이 관여함을 알 수 있다. 앞으로의 연구는 p53발현이 다른 세포주와 각 단백질의 억제제를 통해 인과적인 관련성을 즘 더 명확히 할 필요가 있어야 할 것으로 생각되어진다. Conclusion : 유방암의 예후에 있어 호르몬치료에 부적절함으로 인해 예후가 나쁜 에스트로젠리셉터 발현이 없는 유방암에 대해서도 황금이 탁월한 항암효과를 보여주고 있으며, 임상적으로 황금단독, 다른 항암약재와의 배합, 그리고 기존의 항암화학요법이나 방사선요법과의 병용투여를 통한 초기 및 진행된 유방암의 치료에 대한 새로운 접근의 실마리를 제공할 것으로 생각된다.

• Journal of Korea Multimedia Society
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• v.16 no.5
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• pp.558-565
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• 2013

Mammography, the process of using X-ray to examine the woman breast, is the one of the effective tools for detecting breast cancer at an early state. In screening mammogram, Computer-Aided Detection(CAD) system helps radiologist to diagnose cases by detecting malignant masses. A mass is an important lesion in the breast that can indicate a cancer. Due to various shapes and unclear boundaries of the masses, detecting breast masses is considered a challenging task. To this end, CAD system detects a lot of regions of interest including normal tissues. Thus it is important to develop the well-organized classifier. In this paper, we propose an enhanced sparse representation (SR) based classifier using Fisher discrimination dictionary learning. Experimental results show that the proposed method outperforms the existing support vector machine (SVM) classifier.

• Journal of Korea Multimedia Society
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• v.8 no.4
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• pp.482-491
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• 2005

In this paper, we proposed the microcalcification detection algorithm which is based on wavelet transform and automatic thresholding method in the X-ray mammographic images. Digital X-ray imaging system is essential equipment in the field diagnosis and is widely used in the various fields such as chest, fracture of a bone, and dental correction. Especially, digital X-ray mammographic imaging is known as the most important method to diagnose the breast cancer, many researches to develop the imaging system are processing in country. In this paper, we proposed a microcalcifications detection algorithm necessary in the early phase of breast cancer diagnosis and showed that a algorithm could effectively detect microcalfication and could aid diagnosis-radiologist.

• Radiation Oncology Journal
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• v.19 no.1
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• pp.27-33
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• 2001

Purpose : To evaluate interim results in terms of failure, cosmetic results and survival after breast conserving operation and radiation therapy in early breast cancer. Material and Methods : From January 1992 through December 1997, seventy two patients with early stage 0, I and II breast cancer were treated with conservative surgery plus radiotherapy at Keimyung University Dongsan Medical Center. Age distribution was 25 to 77 years old with median age of 43. According to TNM stage, five patients had stage 0, thirty three were stage I, twenty five were IIa, and nine were IIb. Most patients underwent excision of all gross tumor and ipsilateral axillary dissection. Breast was irradiated through medial and lateral tangential fields of 6 MV photons to 50.4 Gy in 28 fractions over 5.5 weeks. We delivered a boost irradiation dose of 10 to 16 Gy in 1 to 2 weeks to excision site. Adjuvant chemotherapy was administered in forty one patients with CMF (cyclophosphamide, methotrexate, 5-fluorouracil) regimens of 6 cycles concurrently or before radiation. Cosmetic results were assessed by questionnaire to patients grading of excellent, good, fair, poor. Follow-up periods were 22 to 91 months with median 40 months. Results : Five year disease free survival rate (5YDFS) was $95.8\%$. According to stage, 5YDFS was $100\%,\;96.9\%,\;96\%\;and\;88.9\%$ in stage 0, I, IIa and IIb, respectively. Two patients had distant metastasis and one had local and distant failure. One patient with distant failure had bone and liver metastasis at 14 months after treatment and the other had lung and both supraclavicular metastasis at 21 months after treatment. Patient with local and distant failure had local recurrence on other quadrant in same breast and then salvaged with total mastectomy and chemotherapy but she died due to brain metastasis at 55 months. Complications were radiation pneumonitis in five patients (four patients of asymptomatic, one patients of symptomatic) and hand or arm edema(4 patients). Fifty nine patients answered our cosmetic result questionnaire and cosmetic results were good to excellent in fifty one patients $(86\%)$. Conclusion : We considered that conservative surgery and radiation for the treatment of early stage invasive breast cancer was safe and had excellent survival and cosmetic results. We need to assess about prognostic factors with longer follow up and with large number of patients.

• Journal of the Korean Society of Radiology
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• v.83 no.6
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• pp.1385-1393
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• 2022

Metaplastic carcinoma of the breast is a heterogeneous group of neoplasms with mixed epithelial and mesenchymal differentiation. Metaplastic carcinoma of the breast is a rare and aggressive malignancy, with high recurrence and metastasis. Metaplastic carcinoma with chondroid differentiation is an uncommon subtype that tends to have a relatively good prognosis than that of other subtypes. We report the imaging features of three cases of pathologically proven metaplastic carcinoma with chondroid differentiation as follows: a high-density mass with amorphous or coarse heterogeneous calcifications on mammography; a microlobulated or partially indistinct, complex cystic, and solid mass on sonography; and a relatively circumscribed or partially indistinct, irregular mass with heterogeneous T2 high-signal intensity and heterogeneous or rim enhancement with initial fast enhancement and delayed washout on MRI.

• Investigative Magnetic Resonance Imaging
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• v.17 no.2
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• pp.73-82
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• 2013

Purpose : To determine the quantitative parameters of breast MRI that predict tumor invasion in biopsy-proven DCIS. Materials and Methods: From January 2009 to March 2010, 42 MRI examinations of 41 patients with biopsy-proven DCIS were included. The quantitative parameters, which include the initial percentage enhancement ($E_1$), peak percentage enhancement ($E_{peak}$), time to peak enhancement (TTP), signal enhancement ratio (SER), arterial enhancement fraction (AEF), apparent diffusion coefficient (ADC) value, long diameter and the volume of the lesion, were calculated as parameters that might predict invasion. Univariate and multivariate analyses were used to identify the parameters associated with invasion. Results: Out of 42 lesions, 23 lesions were confirmed to be invasive ductal carcinoma (IDC) and 19 lesions were confirmed to be pure DCIS. Tumor size (p = 0.003; $6.5{\pm}3.2$ cm vs. $3.6{\pm}2.6$ cm, respectively) and SER (p = 0.036; $1.1{\pm}0.3$ vs. $0.9{\pm}0.3$, respectively) showed statistically significant high in IDC. In contrast, E1, Epeak, TTP, ADC, AEF and volume of the lesion were not statistically significant. Tumor size and SER had statistically significant associations with invasion, with an odds ratio of 1.04 and 22.93, respectively. Conclusion: Of quantitative parameters analyzed, SER and the long diameter of the lesion could be specific parameter for predicting invasion in the biopsy-proven DCIS.

• The Korean Journal of Nuclear Medicine
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• v.34 no.6
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• pp.478-486
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• 2000

Purpose: The sentinel lymph node is defined as the first draining node from a primary tumor and reflects the histologic feature of the remainder of the lymphatic basin status. The aim of this study was to evaluate the usefulness of lymphoscintigraphy and intraoperative radioguided gamma probe for identification and removal of sentinel lymph node in breast cancer. Materials and Methods: Lymphoscintigraphy was performed preoperatively in 15 patients with biopsy proven primary breast cancer. Tc-99m antimony sulfide colloid was injected intradermally at four points around the tumor. Imaging acquisition included dynamic imaging, followed by early and late static images at 2 hours. The sentinel lymph node criteria on lymphoscintigraphy is the first node of the highest uptake in early and late static images. We tagged the node emitting the highest activity both in vivo and ex vivo. Histologic study for sentinel and axillary lymph node investigation was done by Hematoxylin-Eosin staining. Results: On lymphoscintigraphy, three of 15 patients had clear lymphatic vessels in dynamic images, and 11 of 15 patients showed sentinel lymph node in early static image and three in late static 2 hours image. Mean detection time of sentinel lymph node on lymphoscintigraphy was $33.5{\pm}48.4$ minutes. The sentinel lymph node localization and removal by lymphoscintigraphy and intraoperative gamma probe were successful in 14 of 15 patients (detection rate: 93.3%). On lymphoscintigraphy, 14 of 15 patients showed $2.47{\pm}2.00$ sentinel lymph nodes. On intraoperative gamma probe, $2.36{\pm}1.96$ sentinel lymph nodes were detected. In 7 patients with positive results of sentinel lymph node metastasis, 5 patients showed positive results of axillary lymph node (sensitivity: 72%) but two did not. In 7 patients with negative results of sentinel lymph node metastasis, all axillary nodes were free of disease (specificity: 100%). Conclusion: Sentinel lymph node biopsy with lymphoscintigraphy and intraoperative gamma probe is a reliable method to predict axillary lymph node metastasis in breast cancer, and unnecessary axillary lymph node dissection can be avoided.

• Radiation Oncology Journal
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• v.26 no.2
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• pp.91-95
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• 2008

Purpose: To evaluate the response and survival rate after three-dimensional conformal radiation therapy(3D-CRT) of patients with a solitary sternal relapse of breast cancer. Materials and Methods: Seventeen patients between May 1996 and June 2005 were evaluated with the salvage 3D-CRT treatment of a solitary sternal relapse of breast cancer. The treatment fields included the gross tumor volume with 2 cm margins. The total radiation dose was $35.0{\sim}61.5$ Gy(biologic effective dose of $43.7{\sim}76.9Gy_{10}$ using an $\alpha/\beta$ ratio of 10 Gy), with a daily dose of $1.8{\sim}3.0$ Gy. The tumor response was evaluated by the change in maximum tumor size via follow up CT scans $1{\sim}3$ months after the completion of treatment. Results: An objective tumor response was achieved in all patients, with a complete response in 5 patients and a partial response in 12 patients. The 5-year overall survival rate was 51.9%(median survival time: 27 months), and the most important factor affecting overall survival was the disease-free interval(interval from primary surgery of breast cancer to the development of sternal metastasis): The 5-year overall survival rate was 61.8% for patients with a disease-free interval ${\geq}12$ months and 0.0% for patients with disease-free interval <12 months(p=0.03). Conclusion: The response to 3D-CRT was good in patients with solitary sternal relapse of breast cancer. Particularly, patients with long disease-free interval from primary surgery survived significantly longer than patients with short disease-free interval from primary surgery.

• Progress in Medical Physics
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• v.20 no.1
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• pp.21-29
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• 2009

Breast cancer is the most common form of cancer among korean woman. Therefore, the early detection activities of breast cancer such as breast self-examinations, clinical breast examinations, mammography are important. A yearly mammography examination has been recommended for women aged 40 and older for the early detection of breast cancer in asymptomatic periods. However, the glandular tissue of breast is the most radiation-sensitive tissue, and the determination of average glandular dose (AGD) forms an important part of the quality control of the mammographic systems. Because of the difficulty of estimating AGD directly, it is often estimated from the measurements of the incident air kerma and by applying the appropriate conversion factors. The primary objective of this study was to standardize the method of measuring AGD. The secondary objective was to evaluate the relationships between AGD per various composition and thickness of the breast using Monte Carlo simulations. As a result, we standardized the method of measuring AGD according to International Atomic Energy Agency (IAEA) guidelines (CoP: an international code of practice). Overall, AGD for mammographic practice in Korea was less than 3.0 mGy recommended by the Korea Food and Drug Adminstration (KFDA) protocol, and Korean Institute for Accreditation of Medical Image (KIAMI). The measured and simulated AGD for a given condition were calculated as 1.7 and 1.6 mGy, respectively. For the AGDs obtained, there was no significant difference between them. The simulated AGD was dependent on the fraction of glandular tissue of the breast. The AGD increases with increasing of the breast glandularity due to increasing absorption of low energy photons. The AGD also increases as a function of breast thickness. In conclusion, the results of this study could be used as a baseline to establish a reference level of radiation dose in mammography.

• Radiation Oncology Journal
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• v.28 no.1
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• pp.39-49
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• 2010

Purpose: This aim of this study is to analyze the dosimetric difference between intensity-modulated radiation therapy (IMRT) using 3 or 5 beams and MSF in the radiotherapy of the left breast. Materials and Methods: We performed a comparative analysis of two radiotherapy modalities that can achieve improved dose homogeneity. First is the multistatic fields technique that simultaneously uses both major and minor irradiation fields. The other is IMRT, which employs 3 or 5 beams using a fixed multileaf collimator. We designed treatment plans for 16 early left breast cancer patients who had taken breast conservation surgery and radiotherapy, and analyzed them from a dosimetric standpoint. Results: For the mean values of $V_{95}$ and dose homogeneity index, no statistically significant difference was observed among the three therapies. Extreme hot spots receiving over 110% of the prescribed dose were not found in any of the three methods. A Tukey test performed on IMRT showed a significantly larger increase in exposure dose to the ipsilateral lung and heart than multistatic fields technique (MSF) in the low-dose area, but in the high-dose area, MSF showed a slight increase. Conclusion: In order to improve dose homogeneity, the application of MSF, which can be easily planned and applied more widely, is considered an optimal alternative to IMRT for radiotherapy of early left breast cancer.