• Korean Journal of Adult Nursing
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• v.18 no.3
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• pp.357-366
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• 2006

Purpose: The purpose of this study were to examine the incidence of lymphedema and to compare to physiological and psychosocial symptoms between breast cancer patients with lymphedema and without lymphedema. Method: Four hundreds fifty women with breast cancer receiving mastectomy were recruited from two out-patient breast clinics of A and S university hospitals in Seoul, Korea from October, 2004 to May, 2005. Lymphedema was defined by circumferential measurement. Differences greater than 2cm between the affected arm and normal arm were considered to be lymphedema. A descriptive design was used for this study and data was collected using a structured questionnaire. The data were analyzed using descriptive statistics and independent t-test. Results: Lymphedema developed in 112(24.9%) of the 450 subjects. Subjects with lymphedema reported more severe sensation change of arm and more depression and confusion than subjects without lymphedema. Range of motion of shoulder as a physical indicator and social support, however, were not significantly different between the two groups. Conclusion: Lymphedema is recognized as an unpleasant and uncomfortable consequence of breast cancer-related treatment. Therefore, more research is needed to evaluate the impact of lymphedema on quality of life in patients with lymphedema and the efficacy of nursing intervention.

• Journal of the Korean Society of Clothing and Textiles
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• v.41 no.3
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• pp.556-574
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• 2017

This study explored the appearance management experiences of breast cancer patients undergoing mastectomy. For data collection, one-on-one interviews were held with 18 Korean females diagnosed with breast cancer from the first stage to the third stage from 2008 to 2015. The data was analyzed through a three-step analysis of grounded theory. QSR NVivo 11.0 for Mac was applied in order to avoid biased results according to the subjective viewpoint of researchers. From open coding results, six paradigms and 15 categories were drawn. The results of axial coding showed that the psychological changes category was the central phenomenon. Additionally, three categories (skin changes, scalp/hair changes, and general reactions) were found to be causal conditions, and five paradigms (clothing behavior, skin care behavior, makeup behavior, scalp/hair-care behavior, and shopping behavior) were found to be action/interaction strategies. Last, selective coding integrated fragmented qualitative data through open coding and axial coding in order to derive explanatory narratives. A comprehensive examination of the appearance management behaviors of breast cancer patients suffering from extreme stress due to physical/psychological changes enables this study to provide a foundation for related studies to be activated in the clothing and textiles discipline.

• Korean Parent-Child Health Journal
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• v.22 no.1
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• pp.10-21
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• 2019

Purpose: This study was carried out to evaluate the efficacy of exercise program on recovery of functional and quality of life in breast cancer patients through systematic literature review and meta-analysis. Methods: The following databases were used to search the literature: RISS, KISS, KMbase, and KoreaMed. Keywords included 'breast cancer', 'mastectomy' 'exercise', 'rehabilitation', 'intervention' and the evaluated articles were published from 2009 to 2018. The statistical was used R program, the effect size of shoulder functionality, grip strength, upper limb, pain and QOL were calculated by random-effects model. Results: 7 RCT studies were meta-analyzed and were evaluated for the risk of bias by the RoB of Cochrane Collaboration; the overall risk of bias was low. The effect sizes of exercise program was flexion (g=1.11), abduction (g=0.97) as indicated by a "large effect size". Conclusion: It is necessary to study the develop and apply a exercise programs to improve the function and quality of life in breast cancer patients.

• Journal of the Korean Society of Physical Medicine
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• v.6 no.1
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• pp.31-38
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• 2011

Purpose : The purpose of this study was to examine the effect of upper extremity exercise and Bandage on the edema and range of motion. Complex decongestive physiotherapy was one of the latest methods to deal with the limitation of range of motion and the edema that were the prime problems of patients with lymphedema. Methods : Twenty patients undergone mastectomy were participated in this study voluntarily. They had lymphedema on upper extremity and partial limitation of range of motion. The subjects had been treated with upper extremity home exercise and complex decongestive physiotherapy with Bandage for 4 weeks. The measure of these patients with upper extremity edema was included: the volume, arm circumfenence and range of motion. These were measured two times: before the treatment, after 4 weeks of the treatment. Results : The upper extremity edema of patients treated home exercise group and complex decongestive physiotherapy group with Bandage was definitely decreased (p<0.05). Moreover, the upper volume of those who were the same condition also significantly shrank and patients' arm circumferences of upper arm breathtakingly diminished as well (p<0.05). But home exercise group patients' arm circumferences of forearm was not remarkable(p>0.05). However, patients' range of motion who were treated with upper extremity exercise were evidently increased when compared to that of the before treatment (p<0.05). Conclusion : Complex decongestive physiotherapy and bandage performed by physical therapist increased the ROM of upper arm and reduced the edema in patients with lymphedema.

• Asian Pacific Journal of Cancer Prevention
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• v.14 no.4
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• pp.2509-2514
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• 2013

Background: The purpose of this study was to identify predictive factors for supraclavicular lymph node recurrence (SCLR) in N1 breast cancer patients and define a high-risk subgroup who might benefit from supraclavicular nodal radiotherapy (RT). Materials and Methods: From January 1995 to December 2009, 113 breast cancer patients with 1 to 3 positive axillary lymph nodes were enrolled in this study. All patients underwent breast-conserving surgery (BCS) or modified radical mastectomy (MRM). RT was given to all patients who received BCS. Among the patients given MRM, those with breast tumors >5 cm in size received RT. Regional nodal irradiation was not applied. Systemic chemotherapy was given to 105 patients (92.9%). Patient data were retrospectively reviewed and analyzed to identify predictive factors for SCLR. Results: The median follow-up duration was 6.5 years, with 5- and 10-year actuarial SCLR rates of 9.3% and 11.2%, respectively. Factors associated with SCLR on univariate analysis included histologic grade, number of dissected axillary lymph nodes, lymphovascular invasion, extracapsular extension (ECE), and adjuvant chemotherapy. On multivariate analysis, histologic grade and ECE remained significant. The patient group with grade 3 and ECE had a significantly higher rate of SCLR compared with the remainder (5-year SCLR rate; 71.4% vs. 4.0%, p<0.001). Conclusions: Histologic grade and ECE status are significant predictive factors for SCLR. Supraclavicular nodal RT is necessary in N1 breast cancer patients featuring histologic grade 3 and ECE.

• Archives of Plastic Surgery
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• v.37 no.1
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• pp.26-30
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• 2010

Purpose: Common complications of immediate breast reconstruction with implant are capsular contracture, malposition of implant, hematoma and seroma. Especially, the most severe complication is implant exposure caused by inflammation or necrosis of skin flap margin of mastectomy site. This article reports the experience of cases of salvage in such an exposure of implant. Methods: From July, 2002 to Feb., 2009, sixty-five patients who underwent immediate breast reconstruction with implant were retrospectively analyzed. Exposure of implant was happened in 5 of 65 patients and they were treated at out patient district. Two of five patients were reconstructed with saline implnt and all of them underwent the enveloping of the implant with AlloDerm$^{(R)}$ and Serratus muscle flap. Remaning three patients were reconstructed with silicone implant and all of them underwent the enveloping of the implant with AlloDerm$^{(R)}$. Results: In the group of patients who underwent reconstruction with saline implant, implant exposure was found in one patient due to partial necrosis of the margin of skin flap and debridement and primary repair were done. In the other one patient, dressing with antibiotic ointment were done. And debridement and primary repair were proceeded. In the group of patients who underwent reconstruction with silicone implant, implant exposure was found in one patient. After removal of the implant, tissue expansion was done and a new silicone implant was inserted. Implant exposure were found in the other two patients, antibiotics ointment application and primarily repaired. Conclusion: It was the common knowledge that the exposed implant should be removed. But salvage of the exposed implants may be possible with proper treatment. Four of five patients (80%) with exposed breast implant were salvaged with conservative management.

• Asian Pacific Journal of Cancer Prevention
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• v.17 no.10
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• pp.4577-4581
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• 2016

Objective: The aim of this study was to assess thyroid function in breast cancer patients exposed to therapeutic external beam radiation. The focus was on possible progressive changes and any relationships between the incidence of primary hypothyroidism, the time required to become hypothyroid, and factors such as chemotherapy, hormonotherapy and immunotherapy. Materials and Methods: Seventy females undergoing 3D conformal and IMRT radiation therapy for breast cancers were enrolled in a non-randomized prospective study. The patients was divided into two groups: those after mastectomy or breast conserving surgery (BCS) were irradiated to a scar of the chest wall/breast and the ipsilateral supraclavicular and the axillary areas (supraclavicular radiotherapy group - SC-RT group - 32 patients) and the control group receiving adjuvant chest wall/breast RT only (BCT group - 38 patients).The total doses were 50.0 to 70 Gy in 5 to 7 weeks. The median follow-up term was 24 months (range, 1-40 months). Thyroid function was evaluated by measuring thyroid stimulating hormone (TSH), free thyroxine (fT4), and free triiodothyronine (fT3) levels. The minimum, maximum and mean thyroid gland doses for 20 Gy (V20) were calculated for all patients. Results: Statistically significant results were obtained for the SC-RT group. Two yearsa fter the end of RT the chance of an event was increased in 6% of the population (p=0.009) in the SC-RT group. In the BCT group no significance was noted. No statistically significant differences were found for V20, chemio-, immunotherapy and hormonotherapy or Ki67 values (p=0.12). No significant results were obtained for development of hypothyroidism and clinical factors (age, thyroid volume, treatment modalities). Conclusion: Radiotherapy is associated with a higher incidence of thyroid toxicity in breast cancer patients. Routine thyroid function monitoring should be recommended in such cases.

• Asian Pacific Journal of Cancer Prevention
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• v.15 no.6
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• pp.2851-2856
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• 2014

The aim of this study is to evaluate clinicopathologic characteristics and the multi-disciplinary treatment results of metaplastic breast cancer (MBC) patients treated in a single institute. Seventeen female patients with MBC treated in our department between June 2000 and January 2012 were identified and retrospectively evaluated. The median age at diagnosis was 46 years (range, 26-66 years). The median tumor size at diagnosis was 3.5 cm (range 1.5-12 cm). Six (35%) patients underwent breast conservation surgery and 11 (65%) mastectomy. Axillary lymph node metastasis was found in 6 (35%) patients. Twelve (71%) had triple negative tumors. Postoperative RT and systemic adjuvant treatment was given to all patients accordingly to stage and biological characteristics. Median follow-up time was 27 months (range, 12-151 months). At the time of this analysis, 14 (82%) patients were alive with no evidence of disease, and 1 (6%) was alive with disease. The 3-year OS was 91% and 5-year 80%, and DFS rates were 76% and 76%, respectively. Despite the young age of our patients with mostly high grade tumors, larger tumor size and higher rates of lymph node metastasis, the survival outcomes in our study are favorable in comparison with previously reported series.

• Radiation Oncology Journal
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• v.35 no.2
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• pp.121-128
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• 2017

Purpose: To report the results of a correlation analysis of skin dose assessed by in vivo dosimetry and the incidence of acute toxicity. This is a phase 2 trial evaluating the feasibility of intraoperative radiotherapy (IORT) as a boost for breast cancer patients. Materials and Methods: Eligible patients were treated with IORT of 20 Gy followed by whole breast irradiation (WBI) of 46 Gy. A total of 55 patients with a minimum follow-up of 1 month after WBI were evaluated. Optically stimulated luminescence dosimeter (OSLD) detected radiation dose delivered to the skin during IORT. Acute toxicity was recorded according to the Common Terminology Criteria for Adverse Events v4.0. Clinical parameters were correlated with seroma formation and maximum skin dose. Results: Median follow-up after IORT was 25.9 weeks (range, 12.7 to 50.3 weeks). Prior to WBI, only one patient developed acute toxicity. Following WBI, 30 patients experienced grade 1 skin toxicity and three patients had grade 2 skin toxicity. Skin dose during IORT exceeded 5 Gy in two patients: with grade 2 complications around the surgical scar in one patient who received 8.42 Gy. Breast volume on preoperative images (p = 0.001), ratio of applicator diameter and breast volume (p = 0.002), and distance between skin and tumor (p = 0.003) showed significant correlations with maximum skin dose. Conclusions: IORT as a boost was well-tolerated among Korean women without severe acute complication. In vivo dosimetry with OSLD can help ensure safe delivery of IORT as a boost.

• Radiation Oncology Journal
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• v.30 no.3
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• pp.124-131
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• 2012

Purpose: To determine whether triple negative (TN) early stage breast cancers have poorer survival rates compared with other molecular types. Materials and Methods: Between August 2000 and July 2006, patients diagnosed with stage I, II early stage breast cancers, in whom all three markers (estrogen receptor, progesterone receptor, and human epidermal growth factor receptor [HER]-2) were available and treated with modified radical mastectomy or breast conserving surgery followed by radiotherapy, were retrospectively reviewed. Results: Of 446 patients, 94 (21.1%) were classified as TN, 57 (12.8%) as HER-2 type, and 295 (66.1%) as luminal. TN was more frequently associated with young patients younger than 35 years old (p = 0.002), higher histologic grade (p < 0.0001), and nuclear (p < 0.0001). The median follow-up period was 78 months (range, 4 to 130 months). There were 9 local relapses (2.0%), 15 nodal (3.4%), 40 distant metastases (9.0%), and 33 deaths (7.4%) for all patients. The rates of 5-year OS, DFS, LFS, and DMFS for all patients were 95.5%, 89.9%, 95.4%, and 91.7%, respectively. There were no significant differences in OS, DFS, LFS, and DMFS between triple negative and other subtypes (p > 0.05). Conclusion: We found that patients with TN early stage breast cancers had no difference in survival rates compared with other molecular subtypes. Prospective study in homogeneous treatment group will need for a prognosis of TN early stage breast cancer.