• Asian Pacific Journal of Cancer Prevention
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• 제15권7호
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• pp.3179-3183
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• 2014

Background: The purpose of study was to evaluate radiologic or clinical features of breast cancer undergoing ultrasound (US)-guided 14G core needle biopsy (CNB) and analyze the differences between underestimated and accurately diagnosed groups. Materials and Methods: Of 1,898 cases of US-guided 14G CNB in our institute, 233 cases were proven to be cancer by surgical pathology. The pathologic results from CNB were invasive ductal carcinoma (IDC) (n=157), ductal carcinoma in situ (DCIS) (n=40), high-risk lesions in 22 cases, and benign in 14 cases. Among high-risk lesions, 7 cases of atypical ductal hyperplasia (ADH) were reported as cancer and 11 cases of DCIS were proven IDC in surgical pathology. Some 29 DCIS cases and 157 cases of IDC were correctly diagnosed with CNB. The clinical and imaging features between underestimated and accurately diagnosed breast cancers were compared. Results: Of 233 cancer cases, underestimation occurred in 18 lesions (7.7%). Among underestimated cancers, CNB proven ADH (n=2) and DCIS (n=11) were diagnosed as IDC and CNB proven ADH (n=5) were diagnosed at DCIS finally. Among the 186 accurately diagnosed group, the CNB results were IDC (n=157) and DCIS (n=29). Comparison of underestimated and accurately diagnosed groups for BI-RADS category, margin of mass on mammography and US and orientation of lesion on US revealed statistically significant differences. Conclusions: Underestimation of US-guided 14G CNB occurred in 7.7% of breast cancers. Between underestimated and correctly diagnosed groups, BI-RADS category, margin of the mass on mammography and margin and orientation of the lesions on US were different.

• 대한세포병리학회지
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• 제14권2호
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• pp.76-81
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• 2003

Apocrine carcinoma of the breast is a very rare subtype. Although it has no clinical differences from usual ductal carcinoma of the breast, it should be categorized as a subtype of breast carcinoma because the cells of apocrine carcinoma reveal characteristic abundant eosinophillic cytoplasms with intraductal apical snouting as well as round or oval nuclei and central macronucleoli. On fine needle aspiration cytology, the cells of apocrine carcinoma have a lot of similarity to benign or reactive apocrine cells of the breast. Therefore, it is difficult to make a differential diagnosis of apocrine carcinoma from mammary neoplasms with similar cytologic findings unless the subtle cytologic differences are recognized. We report the cytologic and histologic findings of a case of apocrine carcinoma in the breast of a 40-year-old female patient. After the fine needle aspiration cytology, she received the lumpectomy and lymph node dissection. The cellularity was moderate to high. The cytoplasmic borders of tumor cells of three-dimensional clusters were relatively distinctive, and the cytoplasm was abundant, eosinophilic, and granular. Although the nuclear/cytoplasmic ratio was low, the nuclei of the cells were variable in size and shape with prominent macronucleoli. Histologically, it was a typical invasive apocrine carcinoma, showing numerous cytoplasmic lysosomes and mitochondriae on electron microscopy.

• Asian Pacific Journal of Cancer Prevention
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• 제16권3호
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• pp.1041-1045
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• 2015

Background: Paget's disease (PD) is a rare form of intraepithelial adenocarcinoma that involves breast and extramammarian tissues. It is often associated with ductal carcinoma in situ and/or invasive ductal cancer. Molecular pathways that play a role in development of Paget's disease are stil unclear. Expression patterns of Cox-2 and bcl-2 were therefore assessed. Materials and Methods: Patients with a histopathological diagnosis of Paget's disease were included in this study. Patient files were analysed retrospectively. Results: Invasive cancer was diagnosed in 35 (76.1%) of the patients, 7 (15.2%) had ductal carcinoma in situ and 4 (8.7%) patients had no associated neoplasm. Twenty four (52.2%) patients showed COX-2 expression in Paget cells whereas no expression was seen in 22 (47.8%) patients. No relation was found between COX-2 expression and the lesion underlying Paget's disease (p=0.518). Bcl-2 expression in Paget cells was found positive in 12 (26.1%) and negative in 27 (58,7%) cases. There was no relation between Bcl-2 expression and the lesion accompanying Paget's disease (p=0.412). No relation was observed between COX-2 expression and Bcl-2 expression (p=0.389). Conclusions: In breast cancer, COX-2 expression is associated with poor prognostic factors. As COX-2 expression increases the tendency to metastasize also increases. In our study we found a significantly high COX-2 expression in Paget's disease of the breast. We suggest that COX-2 expression and inflammatory processes may play a role in pathogenesis of the Paget's disease of the breast.

• Asian Pacific Journal of Cancer Prevention
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• 제13권2호
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• pp.693-698
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• 2012

Breast cancer is the most frequent cancer of women worldwide, with considerable geographic and racial/ethnic variation. Data are generally derived from population based cancer registries in the developed countries but hospital data are the most reliable source in the developing countries. Ten years data from 1st Jan 2000 to 31st Dec 2009 of a cancer hospital in Pakistan were here analyzed by descriptive statistics to evaluate the clinicopathologic profile of local breast cancer patients. Among 28,740 cancer patients, 6,718 were registered as breast cancer. The female to male ratio was 100:2. Breast cancer accounted for 23% of all and 41% of female cancers. Some 46% were residents of Lahore, with a mean age of $47{\pm}12$ years. Less than 1% were at Stage 0 and 10%, 32%, 35% and 23% were at Stage I, II, III and IV respectively. Histopathology was unknown in 4% while 91%, 2% and 1% had invasive ductal carcinoma (IDC), invasive lobular carcinoma (ILC) and mucinous carcinoma respectively. Rare carcinomas accounted for the rest. Tumor grade 1, 2 and 3 was 11%, 55% and 34% among the known. Profile of breast cancer patients in Pakistan follows a pattern similar to that of other developing countries with earlier peak age and advanced disease stage at presentation. The male breast cancer accounts for higher proportion in the local population. Local women have higher frequency of IDC and lower frequency of ILC and DCIS, owing probably to a different risk profile. Use of hospital information systems and establishment of population based cancer registry is required to have accurate and detailed local data. Promotion of breast health awareness and better health care system is required to decrease the burden of advanced disease.

• Asian Pacific Journal of Cancer Prevention
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• 제15권19호
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• pp.8057-8062
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• 2014

Purpose: The aim of the study was to evaluate the correlation of ultrasound features with breast cancer molecular status. Materials and Methods: A retrospective review was performed of ultrasound findings in 263 patients diagnosed with breast invasive ductal carcinoma for comparison with immunohistochemistric results were obtained from each lesion. Relationships between ultrasound findings and molecular status were investigated by using multiple regression analysis by means of stepwise logistic regression. Differences in ultrasound criteria were assessed among women with different molecular status. Results: ER positivity was associated with small size, lobulate, angular or spiculated margin contours, absence of calcification, posterior tumor shadowing and low elasticity score; PR positivity was associated with small size, lobulate or angular or spiculated margin contours and absence of calcification; HER2 positivity was associated with presence of calcification and absence of any echogenic halo. The calculated models of predicted molecular status were accurate and discriminating with AUCs of 0.78, 0.74, and 0.74, respectively. Conclusions: Breast cnacer ultrasound features show some correlation with the molecular status. These models may help to expand the scope of ultrasound in predicting tumor biology.

• Investigative Magnetic Resonance Imaging
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• 제18권1호
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• pp.43-51
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• 2014

목적 : 유방암을 진단 받은 환자의 자기공명영상에서 추가적으로 발견된 유두상 병변의 자기공명영상 소견과 수술적 절제 후 상향화 비율을 알아보고자 한다. 대상 및 방법 : 본원에서 유방암 진단된 환자의 수술 전 자기공명영상 1729건에서 지표 종양 외에 악성 의심 조영증강을 보인 병변 중 초음파 유도하 핵생검에서 유두 종양으로 진단된 21명의 환자의 22개 병변을 대상으로 하였다. 이 중 수술적 절제를 시행한 병변은 핵생검 결과와 절제 생검 결과를 비교하였다. 또한 이 병변들의 자기공명영상 소견을 BI-RADS MRI lexicon에 따라 후향적으로 분석하여 특징을 알아보았다. 결과 : 자기공명영상에서는 종괴 8예, 비종괴 7예, 초점 7예로 관찰되었고 초점으로 나타난 병변은 병리 조직에서 모두 (100%) 양성 병변으로 진단되었고, 역동적 조영증강 검사에서 고원형과 세척형 양상을 보였다. 양성 유두종 1예 (11.1%), 비정형요소를 가진 유두 종양 3예 (100%), 유두 종양 3예 (60%)가 수술적 절제 후 관상피내암, 침윤성 관상피암, 침윤성 소엽암 등으로 상향화되었다. 결론 : 초음파 유도하 핵생검에서 유두상 병변으로 진단된 병변들의 자기공명영상 소견은 양성과 악성을 예측하기에 특징적인 차이점을 보이지 않아 영상소견만으로 양성과 악성을 구분할 수 없으며 다수에서 수술적 절제 후 조직학적 상향화를 보여 (41.2%, 7/17) 반드시 수술적 절제를 통한 확진이 필요할 것이다.

• 대한영상의학회지
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• 제81권2호
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• pp.428-435
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• 2020

저자들은 BRCA 유전자 변형 환자의 양측 삼중음성 유방암의 선행화학요법에 대한 상이한 반응에 대한 증례를 보고한다. 우측은 T1cN0M0, 좌측은 T4dN3aM0으로 각각 진단되었다. 환자는 Adriamycin, cyclophosphamide 항암요법 4차, docetaxel 4차를 시행 받았다. 양측 유방암은 첫 번째 항암요법 4차 이후에 부분 관해를 보였다. Docetaxel 항암요법 중 양측 유방암은 상이한 반응을 보였다. 우측 유방암은 지속적인 관해를 보였으나, 좌측 유방암은 진행되는 양상을 보였다. 전절제술 결과, 우측 유방암은 0.3 cm, 좌측은 12 cm로 측정되었다. 동일한 삼중음성 유방암에서도 항암요법에 대하여 좌우가 상이한 반응을 보일 수 있으므로, 면밀한 추적 관찰이 고려되어야 할 것이다.

• 대한영상의학회지
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• 제85권2호
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• pp.421-427
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• 2024

이소성 유방조직은 겨드랑이에서 사타구니 선까지 유방 능선을 따라 발생할 수 있으며 가장 일반적으로 발생하는 부위는 겨드랑이이다. 이소성 유방조직에서 발생하는 원발성 암종은 극히 드물다. 왼쪽 겨드랑이에 부유방조직을 절제한 병력이 있는 61세 여성이 왼쪽 겨드랑이에 만져지는 종괴로 내원하였고 종괴의 평가를 위해 액와미부 촬영을 포함한 유방촬영술, 초음파 및 유방 MRI를 시행하였으며 특히 액와미부 촬영으로 왼쪽 겨드랑이의 특징적인 악성미세석화화의 양상과 범위를 평가하였다. 초음파 유도하 생검술을 통해 이 병변은 침윤성 유방암으로 진단되었고 조영증강 복부 CT에서 다발성 간전이가 확인되어 환자는 이후 고식적 항암요법을 받았다. 저자들은 겨드랑이 부유방 조직에서 발생한 드문 원발성 유방암에 대해 액와미부 촬영을 시행한 증례를 보고하고자 한다.

• Asian Pacific Journal of Cancer Prevention
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• 제16권2호
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• pp.823-829
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• 2015

The aim of the present study was to investigate the expression of the transcription factor Ki-67, ER, PR, Her2/neu, p21, EGFR, and TOP II-${\alpha}$ in the tumor tissue of patients with invasive ductal carcinoma(IDC); in addition, we examined correlations between these markers. Two hundred and sixteen IDC patients, who were not previously been treated with chemo- or radiotherapy, were included in the study. All tumors were grade I-III. Expression of molecular markers was determined by immunohistochemical analysis on paraffin-embedded tissue sections. Follow-up data were collected for 3 months to 10 years and analyzed for tumor recurrence, survival time, and prognostic risk factors. We determined Ki-67 expression correlates with the expression of ER, PR, HER-2, EGFR, and TOP-${\alpha}$, as well as lymph node involvement, high tumor grade, lymphovascular invasion, high tumor stage, and high TNM stage in IDC. Positive Ki-67 expression was a risk factor for rapid tumor recurrence and may help tumor progression, leading to poor prognosis in IDC. Ki-67 was directly correlated with EGFR, TOP II-${\alpha}$, lymph node involvement, high tumor grade, lymphovascular invasion, high tumor stage, and high TNM stage in the hormone receptor subtypes of breast cancer. In triple negative breast cancer, Ki-67 correlated with TOP II-${\alpha}$. Expression of Ki-67 correlated with that of ER, PR, HER-2, EGFR, TOP II-${\alpha}$, and p21. In addition, the biomarker Ki-67 has a role as a prognostic factor and indicates a poor prognosis in IDC.

• 대한한방내과학회지
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• 제44권3호
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• pp.555-561
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• 2023

A 63-year-old female patient was admitted to the hospital with complaints of coldness in the head and right femur, persistent vertigo, dry mouth, vexation, general weakness, anorexia, and hot flashes. After being diagnosed with left-sided ductal carcinoma in 2017 and undergoing partial resection, she was recommended radiotherapy, chemotherapy, and hormone therapy, but she refused and did not receive any treatment. At a checkup in November 2022, the left-sided invasive ductal carcinoma recurred. She underwent partial resection and was scheduled to receive radiotherapy two months later. During hospitalization, the patient received traditional Korean medicine treatment, including Korean herbal medicine (Osuyubujaijung-tang), acupuncture, moxibustion, and cupping. Subjective symptom changes were evaluated daily. At discharge, the patient's symptoms improved, and her condition varied with the presence of Aconitum carmichaelii. This study suggests that "Osuyubujaijung-tang" cared the coldness and vertigo caused by "Han-dam (寒痰)" in patients with Soeumin visceral syncope pattern (少陰人 臟厥症) and that A. carmichaelii played a major role in this outcome.