• Asian Oncology Nursing
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• v.12 no.3
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• pp.221-229
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• 2012

Purpose: The purpose of this study was to identify correlates influencing cognitive impairment in breast cancer patients receiving chemotherapy. Methods: Study subjects consisted of 102 breast cancer patients who received chemotherapy. Subjects were the members of a breast cancer self-help group. Data were collected using structured self-reporting questionnaires including scales of cognitive impairment, physical status, fatigue, quality of life, emotional status, sleeping, family support, and menopausal symptoms. Statistical Package for Social Sciences was used for statistical analyses. Results: Breast cancer patients receiving chemotherapy appeared to show a high level of cognitive impairment. Among demographic characteristics, the effects of economic status and family type on cognitive impairment were found to be statistically significant. Among disease related characteristics, the effect of duration of chemotherapy on cognitive impairment was statistically significant. Menopausal symptoms were positively associated with cognitive impairment. The model including postmenopausal symptoms and caregiver type explained about 66% of variability in cognitive impairment. Conclusion: These findings highlight the importance of contextual factors in understanding cognitive impairment in breast cancer patients receiving chemotherapy and can be used to develop appropriate, effective nursing interventions.

• Korean Journal of Adult Nursing
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• v.25 no.1
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• pp.33-40
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• 2013

Purpose: The purpose of this study was to explore conflict resolution styles, marital intimacy and family functions among breast cancer patients and their spouses. Methods: The subjects were total 126 participants. Breast cancer patients who completed chemotherapy and or radiation along with their spouses. Data were collected using questionnaires with questions about conflict resolution styles, marital intimacy and family functions. Results: There were no differences between breast cancer patients and their spouses in verbal aggression, avoidance of conflict resolution styles and family functions. As patients reported using positive conflict resolution styles the spouse-perceived marital intimacy and family functions were higher. Those patients who perceived marital intimacy as lower they also reported more verbal aggression and avoidance. As breast cancer patients perceived family functions increasing, their spouses perception of both intimacy and family function increased. Conclusion: As these results, it should be considered as basic data to develop family intervention programs such as positive communication and effective stress management and improving of conflict resolution, intimacy and family functions among breast cancer patients and their spouses.

• Asian Oncology Nursing
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• v.11 no.2
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• pp.136-146
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• 2011

Purpose: The purpose of this study was to examine the effects of self-efficacy promotion programs on self-efficacy, self-care behavior, and quality of life in breast cancer patients receiving radiation therapy. Methods: This study was conducted from November 1, 2009 to December 10, 2010. A total of 39 breast cancer patients, who received radiotherapy in a University hospital located in city B, participated in the study and were divided into two groups (experimental group 17 and control group 22). The data were analyzed with the ${\chi}^2$-test and ANCOVA using the SPSS/Win 17.0 program. Results: Self-efficacy promotion programs aimed at self-management were effective in enhancing concrete self-efficacy but not effective in promoting general self-efficacy, self-care behavior, and quality of life among breast cancer patients who have received radiotherapy. Conclusion: Organizing a support group for the breast cancer patients seems to be highly necessary to help themselves obtain higher level of specific self-efficacy, self-care behavior, and quality of life in general. It will also be beneficial for the breast cancer patients to understand their unique situations and improve their health problems for themselves.

• Asian Oncology Nursing
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• v.12 no.1
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• pp.20-26
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• 2012

Purpose: The purpose of this study was to identify the stress and the coping strategies in breast cancer patients and their spouses. Methods: The stress level was measured by the Stress Questionnaire of Andersson & Albertsson (2000). The coping strategies were measured by the modified Lazarus & Folkman's Ways of Coping Questionnaire. The data were collected by a survey sampling 49 couples from one hospital in Seoul. The data were analyzed by t-test, ANOVA and paired t-test. Results: There was no significant differences between the stress level of breast cancer patients and their spouses. The problem-focused coping of breast cancer patients was significant higher than their spouses. The cancer patients and their spouses used problem-focused coping mode more than emotion-focused coping mode. In the problem-focused coping mode, breast cancer patients used two coping strategies - 'seeking information' and 'cognitive reconstruction' - significantly more than their spouses. In emotion-focused coping mode, the breast cancer patients used one coping strategy, 'emotional expression', significantly more than the their spouses. Conclusion: Further study needs to attempt to develop nursing interventions that could improve positive coping strategies.

• Asian Oncology Nursing
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• v.12 no.1
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• pp.1-11
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• 2012

Purpose: This study reviewed articles related to breast cancer, cognitive function and chemotherapy available in 4 databases. Methods: The researcher reviewed 32 pieces of literature that were published between January 2001 and November 2011. Results: Within the last decade, several studies have investigated whether adjuvant treatment of breast cancer affects cognitive function. A number of prospective studies have reported inconsistent results regarding whether chemotherapy affects cognitive function. Approximately half of the studies reported subtle cognitive decline in a wide range of domains among some breast cancer patients following chemotherapy, and others did not. Conclusion: Breast cancer patients receiving adjuvant chemotherapy showed the most deterioration and the most persistent decline in cognitive function. Since cognitive impairment is subtle, if evident at all, discrepant findings are due to hormonal, physiological, psychological or temporal confounding variables and differences in study design. Especially, that chemotherapy may impair memory, executive function, attention and visuospatial function in women with breast cancer.

• Archives of Plastic Surgery
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• v.44 no.6
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• pp.502-508
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• 2017

Background Breast-conserving therapy is defined as a breast-conserving wide local excision (WLE) of a mammary tumour combined with postoperative radiotherapy. Immediate restoration of the mammary shape by use of breast reduction techniques (volume displacement) or tissue replacement techniques (volume replacement) is gaining popularity to prevent breast malformation. Methods To date, using the internal mammary artery perforator (IMAP) flap has been suggested for immediate volume replacement after WLE, but has never been evaluated in a published study. Results We applied this flap in 12 women (mean age, 56.1 years) after WLE (mean specimen weight, 46.5 g) of the medial aspect of the breast. Over a median follow-up of 35.3 months (standard deviation, 1.2 months), 4 women needed repeated surgery for dog-ear correction of the donor site. Conclusions In our experience, the use of an IMAP flap was a reliable technique with good cosmetic outcomes after oncoplastic reconstruction. In this series, donor site revision often proved necessary initially, but we showed that this may easily be prevented.

• Journal of Medicine and Life Science
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• v.20 no.2
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• pp.89-93
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• 2023

We present three cases of patients with breast cancer and psoriasis who received radiotherapy following breast-conserving surgery. One patient developed an extensive flare-up of psoriasis during chemotherapy. After discontinuing chemotherapy, she received conventional radiotherapy to the ipsilateral whole breast, axillary, and supraclavicular lymph nodes with 50.4 Gy in 28 fractions and boosted with 10 Gy in five fractions to the tumor bed. Two patients received hypofractionated whole-breast radiotherapy at a total dose of 40.05-42.4 Gy in 15-16 fractions. In all three cases, there was no flare-up of psoriatic events at least 6 months after the completion of radiotherapy. We hypothesized that there is a close relationship between psoriatic events and the extent of trauma rather than the daily dose of the fraction. Therefore, we confirmed that the effect of radiotherapy on psoriatic events is minimal if the radiation field size does not exceed that of the whole breast.

• Journal of Breast Cancer
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• v.21 no.4
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• pp.447-452
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• 2018

Purpose: The recent trend in breast cancer treatment is to minimize axillary dissection. However, no pattern of axillary metastasis has been precisely established. The purpose of this study was to evaluate the metastatic lymphatic pattern using near-infrared fluorescence imaging with indocyanine green (ICG) in breast cancer with cytologically proven axillary metastasis. Methods: This was a prospective single-center study. We evaluated 147 patients with breast cancer involving cytologically proven axillary metastasis, and compared physiological and nonphysiological lymphatic metastasis. Results: We performed lymphatic mapping for 64 patients who exhibited level II lymphatic flow on near-infrared fluorescence imaging with ICG, and found that all had axillary metastasis: 51 patients who did not receive neoadjuvant chemotherapy (NAC) and 13 patients post-NAC. Of patients who did not receive NAC, 32 had physiological lymphatic metastasis and 19 had nonphysiological lymphatic metastasis. The risk factors for nonphysiological lymphatic metastasis were age ${\geq}55$ years, high Ki-67 index (>20%), and perinodal extension in both univariate and multivariate analysis (p<0.05). Conclusion: Patients with identified risk factors in cytologically-proven axillary metastasis who did not receive NAC may have nonphysiological lymphatic metastasis.

• Archives of Plastic Surgery
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• v.41 no.5
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• pp.520-528
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• 2014

Background As the breast cancer incidence has increased, breast-conserving surgery has replaced total mastectomy as the predominant procedure. However, centrally located breast cancers pose significant challenges to successful breast-conserving surgeries. Therefore, we performed partial mastectomy and oncoplastic procedures on centrally located breast cancer as a means of partial breast reconstruction. The authors examined and evaluated the functional and aesthetic usefulness of this reconstruction method. Methods From January 2007 to June 2011, 35 patients with centrally located breast cancers who underwent various oncoplastic procedures based on the breast size and resection volume. The oncoplastic procedures performed included volume displacement surgical techniques such as purse-string suture, linear suture, and reduction mammaplasty. Other oncoplastic procedures included volume replacement procedures with an adipofascial, thoracoepigastric, intercostal artery perforator, thoracodorsal artery perforator, or latissimus dorsi flap. Results Mean patient age was 49 years, and mean follow-up period was 11 months. In cases of small to moderate-sized breasts and resection volumes <50 g, volume displacement procedures were performed. In cases of resection volumes >50 g, volume replacement procedures were performed. In cases of larger breasts and smaller resection volumes, glandular reshaping was performed. Finally, in cases of larger breasts and larger resection volumes, reduction mammaplasty was performed. This reconstruction method also elicits a high patient satisfaction rate with no significant complications. Conclusions In centrally located breast cancer, oncoplastic surgery considering breast size and resection volume is safe and provides appropriate aesthetic outcomes. Therefore, our method is advisable for breast cancer patients who elect to conserve their breasts and retain a natural breast shape.

• Archives of Plastic Surgery
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• v.45 no.3
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• pp.239-245
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• 2018

Background Breast reconstruction has become more common as mastectomy has become more frequent. In Korea, the National Health Insurance Service (NHIS) began covering breast reconstruction in April 2015. This study aimed to investigate trends in mastectomy and breast reconstruction over the past 10 years and to evaluate the impact of NHIS coverage on breast reconstruction. Methods Nationwide data regarding mastectomy and breast reconstruction were collected from the Korean Breast Cancer Society registry database. Multiple variables were analyzed in the records of patients who underwent breast reconstruction from January 2005 to March 2017 at a single institution. Results At Seoul National University Hospital, the total number of reconstruction cases increased 13-fold from 2005 to 2016. The proportion of immediate breast reconstruction (IBR) cases out of all cases of total mastectomy increased from 4% in 2005 to 52.0% in 2016. The proportion of delayed breast reconstruction (DBR) cases out of all cases of breast reconstruction and the overall number of DBR cases increased from 8.8% (20 cases) in 2012 to 18.3% (76 cases) in 2016. After NHIS coverage was initiated, the proportions of IBR and DBR showed statistically significant increases (P<0.05). Among the IBR cases, the percentage of prosthesis-based reconstructions increased significantly (P<0.05), but this trend was not found with DBR. Total mastectomy became significantly more common after the expansion of NHIS coverage (P<0.05). Conclusions Over the last decade, there has been an increase in mastectomy and breast reconstruction, and the pace of increase accelerated after the expansion of NHIS coverage. It is expected that breast reconstruction will be a routine option for patients with breast cancer under the NHIS.