• Annals of Occupational and Environmental Medicine
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• v.35
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• pp.44.1-44.11
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• 2023

Background: A series of breast cancer cases were recently reported in a tertiary university hospital in South Korea. Nurses are generally exposed to risk factors for breast cancer such as night shift work, antineoplastic agents, and job strain. However, the epidemiological evidence of excess incidence among nurses remains lacking. This study aims to investigate the excess incidence of breast cancer among nurses in a tertiary university hospital and provide epidemiological evidence of occupational risk factors. Methods: A retrospective cohort was developed using personnel records of female workers in the nursing department who worked from January 2011 to June 2021 in a tertiary university hospital in South Korea. Sick leave records were used to identify cases of breast cancer. The standardized incidence ratio of breast cancer among nurses was compared to the general population. Results: A total of 5,509 nurses were followed up for 30,404 person-years, and 26 breast cancer cases were identified. This study revealed a significantly increased breast cancer incidence among all included nurses, with a standardized incidence ratio of 1.65 (95% confidence interval [CI]: 1.08-2.41), compared to the general population. Workers, who handle antineoplastic agents in their representative department and current and/or former department, had significantly elevated breast cancer standardized incidence ratios of 2.73 (95% CI: 1.008-5.94) and 3.39 (95% CI: 1.46-6.68), respectively. Conclusions: This study provides significant evidence of increased breast cancer risk among nursing staff in a hospital setting, particularly those who handle antineoplastic drugs. Measures that reduce exposure to risk factors should be implemented, especially anticancer drugs, to protect healthcare professionals. Further research at a national level that focuses on healthcare workers is necessary to validate breast cancer incidence and its contributing factors.

• Clinical and Experimental Pediatrics
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• v.59 no.9
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• pp.355-361
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• 2016

The menarcheal age of Korean women has been rapidly decreasing for the last 50 years, and the average menarcheal age of women born in the 1990s is approaching 12.6 years. In addition, interest in early puberty has been increasing recently owing to the rapid increase in precocious puberty. Generally, out of concern for short stature and early menarche, idiopathic central precocious puberty in female adolescents is treated with gonadotropin-releasing hormone analogs. Studies to date have described the association between early menarche and psychosocial problems such as delinquency and risky sexual behavior, as well as physical health problems such as obesity, diabetes, cardiovascular diseases, and breast cancer throughout the lifespan of women. However, the pathophysiological mechanism underlying this association has not been clarified thus far. In this article, we review and discuss the existing literature to describe the current understanding of the effects of early menarche on the physical and psychosocial health of adolescent girls and adult women.

• Journal of Korean Academy of Nursing
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• v.48 no.6
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• pp.669-678
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• 2018

Purpose: The purpose of this study was to examine the effects of integrated psychoeducational program for distress management of newly diagnosed patients with breast cancer. Methods: A quasi-experimental trial was conducted. The participants consisted of 47 female patients with breast cancer assigned to an intervention group (n=25) and control group (n=22). The intervention group participated in integrated psychoeducational program, consisting of individual face-to-face education and telephone-delivered health-coaching sessions. Data were collected at three time points: pre-intervention (T1), post-intervention (T2), and 6-month follow-up (T3). Study instruments were Distress thermometer, Supportive Care Needs Survey Short Form 34 and Functional Assessment of Cancer Therapy-Breast. Results: Compared with the control group, breast cancer patients in the intervention group reported lower distress and supportive care needs than the control group. The intervention group reported higher quality of life (QOL) overall and higher emotional well-being than the control group. Conclusion: These findings indicate that the integrated psychoeducational program is an effective intervention for reducing distress and supportive care needs and increasing QOL of newly diagnosed patients with breast cancer. Oncology nurses need to provide psychoeducational intervention to support patients with breast cancer in managing their distress and helping them adjust to their life.

• Journal of the Korean Society of Radiology
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• v.81 no.6
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• pp.1504-1510
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• 2020

In this case report, we present the radiologic and pathologic findings of atypical ductal hyperplasia (ADH) in the male breast. It is well known that a high-risk lesion such as ADH is a precursor of breast cancer in females. However, the clinical significance of these lesions in the male breast is still uncertain because male breasts mainly consist of ducts without lobule formation, unlike the female breast. To our knowledge, imaging findings of ADH in the male breast have not been reported previously, except for a few studies on the pathologic findings of these lesions. Through this paper, we would like to present the possible imaging features of this high-risk lesion in the male breast and review the related literature.

• The Korean Journal of Cytopathology
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• v.14 no.2
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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.

• Women's Health Nursing
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• v.20 no.1
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• pp.72-82
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• 2014

Purpose: This study was conducted to investigate sexual behaviors and influencing factors affecting premenopausal women who have breast cancer and have undergone surgery. Methods: Seventy premenopausal women, ranging between 35~55 years of age, were included in this study. Sexual behaviors were evaluated using the WSBQ-F (Wilmoth Sexual Behaviors Questionnaire-Female). The in-depth interview was analyzed utilizing content analysis. Results: There were no significant differences regarding the type of surgery, age, time of marriage, education level, occupation, chemotherapy, use of Tamoxifen, and radiotherapy in the sexual activities of premenopausal women with breast cancer. However, quality-related information utilizing qualitative in-depth interviews, revealed 3 issues regarding sexual behaviors.. Participants reported physical discomfort such as vaginal dryness, dyspareunia, emotional changes such as decrease in sexual confidence, and interaction-related changes such as mandatory sexual life, sexual intimacy with one's partner, and being more active sexual behaviors. Conclusion: There were complex changes associated with sexual behavior after surgery for women with breast cancer which included various events related to stress regarding sexual behavior. Communication between women with breast cancer, their partners, and medical caregivers has a ability to maximize the sense of sexual wellbeing while minimizing the sexual crises.

• Korean Journal of Radiology
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• v.21 no.5
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• pp.550-560
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• 2020

Objective: To evaluate the interobserver agreement, diagnostic value, and associated clinical factors of automated breast ultrasound (ABUS) coronal features in differentiating breast lesions. Materials and Methods: This study enrolled 457 pathologically confirmed lesions in 387 female (age, 46.4 ± 10.3 years), including 377 masses and 80 non-mass lesions (NMLs). The unique coronal features, including retraction phenomenon, hyper- or hypoechoic rim (continuous or discontinuous), skipping sign, and white wall sign, were defined and recorded. The interobserver agreement on image type and coronal features was evaluated. Furthermore, clinical factors, including the lesion size, distance to the nipple or skin, palpability, and the histological grade were analyzed. Results: Among the 457 lesions, 296 were malignant and 161 were benign. The overall interobserver agreement for image type and all coronal features was moderate to good. For masses, the retraction phenomenon was significantly associated with malignancies (p < 0.001) and more frequently presented in small and superficial invasive carcinomas with a low histological grade (p = 0.027, 0.002, and < 0.001, respectively). Furthermore, continuous hyper- or hypoechoic rims were predictive of benign masses (p < 0.001), whereas discontinuous rims were predictive of malignancies (p < 0.001). A hyperechoic rim was more commonly detected in masses more distant from the nipple (p = 0.027), and a hypoechoic rim was more frequently found in large superficial masses (p < 0.001 for both). For NMLs, the skipping sign was a predictor of malignancies (p = 0.040). Conclusion: The coronal plane of ABUS may provide useful diagnostic value for breast lesions.

• Journal of Yeungnam Medical Science
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• v.28 no.2
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• pp.153-164
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• 2011

Background: It has been reported that estrogen receptor beta ($ER{\beta}$) mRNA expression was down-regulated during carcinogenesis and was inversely related to estrogen receptor alpha ($ER{\alpha}$) expression in breast cancer. The association of $ER{\beta}$ mRNA expression to tamoxifen resistance has also been reported. In this study, the expression of $ER{\alpha}$ and $ER{\beta}$ via immunohistochemistry (IHC) and reverse transcription-polymerase chain reaction (RT-PCR) was prompted, and an attempt was made to find out the relationship between $ER{\beta}$ expression and recurrence in the hormonal therapy group, and between $ER{\beta}$ expression and known prognostic factors. Methods: Tumor specimens were obtained at surgery from 67 female breast cancer patients during the period of September 1995 to December 2000. All the specimens were frozen in liquid nitrogen and kept at $-70^{\circ}C$ until they were used. The medical records were analyzed retrospectively. The expressions of ER were analyzed using IHC and RT-PCR methods. Results: The median follow-up was at 93.0 months (range: 14-157 months). The percentage of $ER{\alpha}+/ER{\beta}+$, $ER{\alpha}+/ER{\beta}-$, $ER{\alpha}-/ER{\beta}+$, and $ER{\alpha}-/ER{\beta}$ group were 35.9% 9.4%, 47.2%, and 7.5%, respectively, in 53 patients with hormonal therapy. $ER{\beta}$ was positive in 42 (82.3%) of 51 ER-positive patients. In the hormonal therapy group, the recurrence rates of each group was 15.8%, 0%, 40.0%, and 0%, respectively. In this group, the $ER{\beta}$ expression tended to recur, but there was no clinical significance (p=0.084). Conclusion: The $ER{\beta}$ expression may be a predictive marker of a poor response to endocrine therapy in breast cancer patients, although this needs to be confirmed in additional studies.

• The Journal of the Korea Contents Association
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• v.14 no.7
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• pp.356-366
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• 2014

The purpose of this study was to identify the impact of the mood state on the quality of life (QOL) of the female breast cancer survivor. The study was cross-sectional survey. This study was conducted from September 10th to September 20th, 2013. The subjects were 120 breast cancer survivors in Seoul city in Korea. The obtained data were analyzed by SPSS/WIN 21.0 program. The mean score of mood state was 39.20 and the mean score of the quality of life was 83.59. The levels of mood state and the quality of life were negatively correlated. The significant factors influencing quality of life were vigor and anger of the mood state, religion that explained 39.1% of the variance. The results suggests that appropriate support service should be provided to improve the quality of life after nurses evaluate breast cancer survivor's mood states and identify the symptoms of mood disturbances.

• Journal of Hospice and Palliative Care
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• v.26 no.2
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• pp.80-94
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• 2023

Purpose: This study aimed to identify attitudes toward advance directives (ADs) among female cancer patients and factors related to ADs. Methods: The study was conducted at a university hospital in Seoul from September 19, 2020, to January 20, 2021. The participants were 153 patients diagnosed with gynecological cancer or breast cancer. Data were collected using questionnaires and included general characteristics, disease- and AD-related characteristics, knowledge and attitudes about ADs, and attitudes about dignified death. Data were analyzed using the t-test, analysis of variance, and multiple regression analysis. Results: Only 2% of the participants completed ADs. The mean score for attitudes toward ADs was 3.30, indicating a positive knowledge and attitude toward dignified death. The factors related to attitudes toward ADs were attitudes toward dignified death (𝛽=0.25, P=0.001), experience discussing life-sustaining treatment (𝛽=0.17, P=0.037), preferred time to have a consultation about ADs (𝛽=0.19, P=0.046), intention to write ADs (𝛽=0.15, P=0.038), and Eastern Cooperative Oncology Group Performance Status (𝛽=-0.37, P<0.001). The explanatory power of these variables for attitudes toward ADs was 38.5%. Conclusion: Overall, patients preferred to have a consultation about ADs when they were still active, mentally healthy, and able to make decisions. Education about ADs should be provided to patients on the first day of hospitalization for chemotherapy or while awaiting treatment in an outpatient setting so patients can write ADs and discuss them with family and friends.