• Journal of Preventive Medicine and Public Health
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• 제41권3호
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• pp.186-194
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• 2008

Objectives : This study describes trends in the socioeconomic disparities in breast cancer screening among US women aged 40 or over, from 2000 to 2005. We assessed 1) the disparities in each socioeconomic dimension; 2) the changes in screening mammography rates over time according to income, education, and race; and 3) the sizes and trends of the disparities over time. Methods : Using data from the Behavioral Risk Factor Surveillance System (BRFSS) from 2000 to 2005, we calculated the age-adjusted screening rate according to relative household income, education level, health insurance, and race. Odds ratios and the relative inequality index (RII) were also calculated, controlling for age. Results : Women in their 40s and those with lower relative incomes were less likely to undergo screening mammography. The disparity based on relative income was greater than that based on education or race (the RII among low-income women across the survey years was 3.00 to 3.48). The overall participation rate and absolute differences among socioeconomic groups changed little or decreased slightly across the survey years. However, the degree of each socioeconomic disparity and the relative inequality among socioeconomic positions remained quite consistent. Conclusions : These findings suggest that the trend of the disparity in breast cancer screening varied by socioeconomic dimension. Continued differences in breast cancer screening rates related to income level should be considered in future efforts to decrease the disparities in breast cancer among socioeconomic groups. More focused interventions, as well as the monitoring of trends in cancer screening participation by income and education, are needed in different social settings.

• 한국산학기술학회논문지
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• 제16권1호
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• pp.507-515
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• 2015

본 연구는 초음파영상에서 컴퓨터보조진단으로 유방질환의 병변인식률을 알아보고자 6가지 질감특성분석 파라미터(평균밝기, 대조도, 평탄도, 왜곡도, 균일도, 엔트로피) 알고리즘을 제안하였다. 2013년 8월에서 2014년 1월까지 부산소재 대학병원을 내원한 환자 중 영상의학과 전문의의 판독과 세포병리학 진단 결과를 토대로 한 90증례의 유방 초음파영상을 대상으로 하였다. 연구방법은 유방 초음파영상에서 관심영역을 $50{\times}50$ 픽셀 크기로 설정하였으며, 획득된 실험영상(정상, 양성, 악성)에 히스토그램 평활화의 전처리 과정 후 MATLAB을 이용한 질감특성분석 알고리즘의 결과값을 산출하였다. 그 결과 제안된 질감특성분석 파라미터 중 평균밝기, 왜곡도, 균일도, 엔트로피의 정상과 악성의 병변인식률은 100%로 높게 나타났으며. 정상과 양성의 병변인식률은 약 83~96%를 나타내었다. 이러한 결과는 유방질환에서 감별진단의 전처리 단계로 자동진단의 가능성을 나타내며, 향후 제안된 알고리즘의 추가적인 연구와 다양한 임상증례에 대한 신뢰성과 재현성이 제공된다면 컴퓨터보조진단의 실용화기반을 마련할 수 있을 것이고, 다양한 초음파 영상에 대한 적용이 가능할 것으로 사료된다.

• 정신신체의학
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• 제29권2호
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• pp.77-85
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• 2021

유방암은 여성에서 가장 높은 유병율을 보이는 암으로, 진단과 치료과정 및 치료 후에도 다양한 정신사회적 디스트레스가 자주 나타난다. 유방암 환자의 치료에는 의학적 치료뿐만 아니라 정신신체의학적 통합치료가 필요하다. 유방암 환자는 스트레스, 불안장애, 우울장애, 적응 장애 등에 대한 취약성이 증가하고, 이러한 정신장애는 유방암의 악화 또는 재발과 연관이 있다. 유방암 환자의 불안과 우울에 대한 정신사회적 치료는 환자의 삶의 질을 증진시키고, 유방암의 재발과 악화를 감소시킨다. 본 연구에서는 5편의 유방암 치료 가이드라인에서 정신사회적 디스트레스에 대한 정신사회적 치료와 대체의학적 치료가 포함된 정신신체의학적 통합치료 부분에 초점을 맞추어 논의하였다. 5편의 가이드 라인에서 사용한 서로 다른 근거 기준은 US Preventive Service Task Force (USPSTF) 기준에 맞춰 연구자들이 평가하여 근거를 기술하였다. 또한 유방암 환자의 불안, 우울, 기분, 삶의 질에 대한 정신사회적 치료의 효과 크기를 요약하였고, 정신신체의학적 통합치료 서비스 제공에 대한 장벽과 이에 대한 대안을 제시하였다. 다학제 팀을 구성하고, 환자 요구도를 조사하며, 정신사회적 치료의 정보를 환자에게 제공하여 환자와 가족이 참여하는 것이 중요하다. 또한 준비된 계획에 따라 정기적으로 정신사회적 디스트레스를 평가하고, 정신신체의학 전문가 또는 자문조정 정신건강의학과 의사에 의한 정신신체의학적 통합치료가 환자에게 제공되는 것이 가장 중요하다.

• International Journal of Computer Science & Network Security
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• 제21권6호
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• pp.101-106
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• 2021

Breast cancer is the number one cause of deaths from cancer in women, knowing the type of breast cancer in the early stages can help us to prevent the dangers of the next stage. The performance of the deep learning depends on large number of labeled data, this paper presented convolutional neural network for classification breast cancer from images to benign or malignant. our network contains 11 layers and ends with softmax for the output, the experiments result using public BreakHis dataset, and the proposed methods outperformed the state-of-the-art methods.

• 대한영상의학회지
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• 제84권3호
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• pp.770-775
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• 2023

악성 말초 신경 초종은 드문 연부조직 종양으로, 주로 몸통, 사지, 두경부에 주로 위치하며, 유방에는 드물다. 저자들은 신경섬유종증 1을 가진 27세 여자 환자에서 유방으로 전이된 악성 말초 신경 초종 증례를 보고하고자 한다. 흉부 단층촬영에서 오른쪽 유방에 경계가 분명한 타원형의 약간 조영 증강되는 종괴가 보였다. 초음파에서 혈류와 증등도의 탄성을 가진 경계가 분명한 타원형의 비균질한 에코의 종괴로 보였다. 유방 종괴는 수술로 제거되었고, 악성 말초 신경 초종으로 최종 진단되었다. 드물지만, 악성 말초 신경 초종은 신경섬유종증 1을 가진 환자에서 유방 종괴의 감별진단에 포함되어야 한다.

• Asian Pacific Journal of Cancer Prevention
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• 제16권18호
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• pp.8265-8270
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• 2016

Purpose: A cost-utility analysis was performed to assess the cost-utility of neoadjuvant chemotherapy regimens containing doxorubicin and cyclophosphamide (AC) versus paclitaxel and gemcitabine (PG) for locally advanced breast cancer patients in Iran. Materials and Methods: This cross-sectional study in Namazi hospital in Shiraz, in the south of Iran covered 64 breast cancer patients. According to the random numbers, the patients were divided into two groups, 32 receiving AC and 32 PG. Costs were identified and measured from a community perspective. These items included medical and non-medical direct and indirect costs. In this study, a data collection form was used. To assess the utility of the two regimens, the European Organization for Research and Treatment of Cancer Quality of Life Questionnaire-Core30 (EORTC QLQ-C30) was applied. Using a decision tree, we calculated the expected costs and quality adjusted life years (QALYs) for both methods; also, the incremental cost-effectiveness ratio was assessed. Results: The results of the decision tree showed that in the AC arm, the expected cost was 39,170 US$ and the expected QALY was 3.39 and in the PG arm, the expected cost was 43,336 dollars and the expected QALY was 2.64. Sensitivity analysis showed the cost effectiveness of the AC and ICER=-5535 US$. Conclusions: Overall, the results showed that AC to be superior to PG in treatment of patients with breast cancer, being less costly and more effective.

• KSII Transactions on Internet and Information Systems (TIIS)
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• 제17권3호
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• pp.678-700
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• 2023

Diagnosing breast diseases using ultrasound (US) images remains challenging because it is time-consuming and requires expert radiologist knowledge. As a result, the diagnostic performance is significantly biased. To assist radiologists in this process, computer-aided diagnosis (CAD) systems have been developed and used in practice. This type of system is used not only to assist radiologists in examining breast ultrasound images (BUS) but also to ensure the effectiveness of the diagnostic process. In this study, we propose a new approach for breast lesion localization and segmentation using a multi-scale pyramid of the ultrasound image of a breast organ and a convolutional semantic segmentation network. Unlike previous studies that used only a deep detection/segmentation neural network on a single breast ultrasound image, we propose to use multiple images generated from an input image at different scales for the localization and segmentation process. By combining the localization/segmentation results obtained from the input image at different scales, the system performance was enhanced compared with that of the previous studies. The experimental results with two public datasets confirmed the effectiveness of the proposed approach by producing superior localization/segmentation results compared with those obtained in previous studies.

• 대한영상의학회지
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• 제84권2호
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• pp.372-385
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• 2023

유방암은 여성에서 가장 흔한 암이며, 많은 합병증을 발생시킨다고 알려져 있다. 오늘날 자기공명영상촬영(이하 MRI)은 유방암 수술 전 검사에서 필수적인 방법이다. 유방 MRI의 사용 빈도가 높아지면서 우연히 발견되는 유방 외 소견이 증가하고 있다. 이에 본 임상 화보에서는 유방 MRI 촬영에서 발견된 종격동, 폐, 상복부, 뼈 및 연조직 등의 다양한 유방 외 소견을 초음파(ultrasonography), 흉부 컴퓨터단층촬영(이하 CT), 간 MRI, 양전자방출단층촬영/컴퓨터단층촬영 스캔(PET/CT), 뼈 스캔(bone scan) 등과 비교하여 알아보고자 한다.

• Asian Pacific Journal of Cancer Prevention
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• 제15권24호
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• pp.10739-10743
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• 2015

The present study aimed at evaluating and comparing the diagnostic performance of B-mode ultrasound (US), elastography score (ES), and strain ratio (SR) for the differentiation of breast lesions. This retrospective study enrolled 431 lesions from 417 in-hospital patients. All patients were examined with both conventional ultrasound and elastography. Two experienced radiologists reviewed ultrasound and elasticity images. The histopathologic result obtained from ultrasound-guided core biopsy or operation excisions were used as the reference standard. Pathologic examination revealed 276 malignant lesions (64%) and 155 benign lesions (36%). A cut-off point of 4.15 (area under the curve, 0.891) allowed significant differentiation of malignant and benign lesions. ROC (receiver-operating characteristic) curves showed a higher value for combination of B-mode ultrasound and elastography for the diagnosis of breast lesions. Conventional ultrasound combined elastography showed high sensitivity, specificity, and accuracy for group II lesions (10mm${\leq}20mm$). Elastography combined with conventional ultrasound show high specificity and accuracy for differentiation of benign and malignant breast lesions. Elastography is particularly important for the diagnosis of BI-RADS 4 and small breast lesions.

• Asian Pacific Journal of Cancer Prevention
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• 제15권21호
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• pp.9093-9099
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• 2014

A growing body of evidence suggests that the peroxisome proliferator-activated receptor-gamma ($PPAR{\gamma}$) gene may harbor targets for the chemoprevention of breast cancer. However, it is unclear whether polymorphisms in the $PPAR{\gamma}$ gene are associated with the susceptibility of breast cancer. We performed a candidate gene association study between $PPAR{\gamma}$ polymorphisms and breast cancer and a meta-analysis on the association of breast cancer with selected $PPAR{\gamma}$ variants. Six single nucleotide polymorphisms (SNPs) in the $PPAR{\gamma}$ gene were analyzed among 456 breast cancer patients and 461 controls from the National Cancer Center in Korea. Association between the polymorphisms and breast cancer risk were assessed using the Cochrane-Armitage test for trend and a multivariate logistic regression model. Two SNPs, rs3856806 and rs1801282, had been previously analyzed, thus enabling us to perform pooled analyses on their associations with breast cancer susceptibility. Our findings from the candidate gene association study showed no association between the $PPAR{\gamma}$ gene polymorphisms and breast cancer risk. A meta-analysis combining existing studies and our current study also refuted an association of the $PPAR{\gamma}$ gene with breast cancer. Our findings suggest that the $PPAR{\gamma}$ gene may not harbor variants that alter breast cancer susceptibility, although a moderate sample size might have precluded a decisive conclusion.