• Radiation Oncology Journal
• /
• v.31 no.3
• /
• pp.138-146
• /
• 2013

Purpose: To analyze the results of locoregional and systemic therapy in the breast cancer patients with locoregional recurrence (LRR) after mastectomy. Materials and Methods: Seventy-one patients who received radiotherapy for isolated LRR after mastectomy between January 1999 and December 2009 were retrospectively reviewed. Among the 71 patients, 59 (83.1%) underwent wide excision and radiotherapy and 12 (16.9%) received radiotherapy alone. Adjuvant hormonal therapy was given to 45 patients (63.4%). Oncologic outcomes including locoregional recurrence-free survival, disease-free survival (DFS), and overall survival (OS) and prognostic factors were analyzed. Results: Median follow-up time was 49.2 months. Of the 71 patients, 5 (7%) experienced second isolated LRR, and 40 (56%) underwent distant metastasis (DM). The median DFS was 35.6 months, and the 3- and 5-year DFS were 49.1% and 28.6%, respectively. The median OS was 86.7 months, and the 5-year OS was 62.3%. Patients who received hormone therapy together showed better 5-year DFS and OS than the patients treated with locoregional therapy only (31.6% vs. 22.1%, p = 0.036; 66.5% vs. 55.2%, p = 0.022). In multivariate analysis, higher N stage at recurrence was a significant prognostic factor for DFS and OS. Disease free interval (${\leq}30$ months vs. >30 months) from mastectomy to LRR was also significant for OS. The patients who received hormone therapy showed superior DFS and showed trend to better OS. Conclusion: DM was a major pattern of failure after the treatment of LRR after mastectomy. The role of systemic treatment for LRR after mastectomy should be investigated at prospective trials.

• Women's Health Nursing
• /
• v.18 no.1
• /
• pp.49-61
• /
• 2012

Purpose: The purpose of this study was to examine the experiences of the use of external breast prostheses among breast cancer survivors in Korea. Methods: A qualitative descriptive study was conducted, using focus groups. Data were collected from breast cancer survivors who were patients of C women's hospital in Seoul, Korea. Data were analyzed using content analysis in order to identify significant themes. Results: Participants included forty breast cancer survivors who had mastectomy as a surgical treatment. Four themes emerged from the collected data were: 1) concern over the high price of external breast prosthesis, 2) irregular use of external breast prosthesis, 3) unsatisfied with mastectomy bra, and 4) wanting to hide or not to talk about using breast prosthesis openly. Conclusion: Since most participants reported irregular use and negative experiences related to external breast prosthesis or mastectomy bra use, healthcare workers should allow more time for proper fitting and counseling and consulting with breast cancer survivors. In addition, health care providers as well as family and friends should keep in mind that cancer survivors need support that can help them cope by using positive reframing. Furthermore, improvements in the coverage of costs and services are needed for these women. This would be helpful for breast prosthesis users.

• Journal of the Korean Society of Costume
• /
• v.51 no.3
• /
• pp.5-18
• /
• 2001

The purpose of this study is to suggest size specifications for the development of mastectomy bras and breast prostheses. To collect anthropometric data, 250 middle aged women's body measurement were taken and the data were analyzed by statistical methods such as ANOVA, correlation analysis, factor analysis and cluster analysis. The results of the analysis of measurement data showed that lengths. breadths, depths, circumferences are increased significantly when getting older. The results of the correlation analysis showed that there was no direct linear relationship between chest circumference and cup size. From 29 measurements, 4 factors were selected as key factors by the tractor analysis and the breast type were classified into 2 groups by cluster analysis. To set up sizing systems for the mastectomy brassiere, chest circumference and cup size were selected and the loss function was used to decide Intervals of each of them. 6 sizes from chest circumference and 4 sizes from cup sizes were picked, Breast breadth, breast length and breast height were chosen to establish sizing systems for the breast prosthesis. To decide intervals of each of them, the loss function was used and 8 sizes from composition of the 3 factors were picked.

• Asian Oncology Nursing
• /
• v.9 no.2
• /
• pp.129-135
• /
• 2009

Purpose: This study was to explore the psychosocial adjustment, marital intimacy and family support of post-mastectomy patients. Methods: The subjects were 90 post-mastectomy patients (stage I or II) who were eligible and agreed to participate in the study. The data collection period was from March to May, 2008. Subjects completed a survey including demographics, psychosocial adjustment scale by Lee (a 4-point Likert scale), marital intimacy scale by Kim (a 4-point Likert scale), and family support by Shim (a 5-point Likert scale). Data were analyzed using SAS (ver 9.0) program and frequency, mean (SD), t-test, ANOVA and Pearson correlation coefficients were used. Results: The mean scores of the psychosocial adjustment and marital intimacy were 2.8 (${\pm}0.4$) and 2.5 (${\pm}0.5$). Also, the mean score of the family support was 3.6 (${\pm}0.7$). Regarding the correlation between the psychosocial adjustment, marital intimacy and family support, there was a positive correlation. Conclusion: These results showed that subjects who had higher marital intimacy and family support showed better in psychosocial adjustment. To improve psychosocial adjustment of post-mastectomy patients for breast cancer more effectively, there is an necessity to provide various strategic supports and intervention for effective communication with spouse and family.

• Women's Health Nursing
• /
• v.12 no.1
• /
• pp.37-46
• /
• 2006

Purpose: The purpose of this study was to investigate the effects of an exercise program on physical function and quality of life of mastectomy patients. Method: This study was conducted from October, 2004 to June, 2005. The subjects consisted of 60 patients with breast cancer(30 each in the experimental and control groups). The subjects in the experimental group participated in an exercise program for 16 weeks. Evaluation was performed four times in both the experimental and control group. Results: The results revealed an increase in physical function in the experimental group including wrist circumstance, function of shoulder joint, stretching, and upper endurance. Also, an increase in function scales in quality of life were significantly higher in the experimental group than the control group. In addition subjective comments on how they felt after participating in the exercise program were good in the experimental group. Conclusion: The 16-week exercise program showed a large positive effect on physical function and quality of life of breast cancer patients after a mastectomy.

• Journal of muscle and joint health
• /
• v.19 no.3
• /
• pp.319-328
• /
• 2012

Purpose: The purpose of this study was to explore effects of a Cancer-overcome BeHaS exercise program that consists of exercise, education, and cognitive supports to improve shoulder external rotation, cancer coping, group cohesion in mastectomy patients. Methods: A one group pre-post test design was used. Thirty mastectomy patients from C Hospital participated in the supervised exercise program once a week for 8 weeks. Data were collected from May to July 2011 using self-administered questionnaires and physical measurement. SPSS/WIN 19.0 was used for the data analysis. Results: The mean age of participants was 53.7 and the mean postoperative period after the surgery was 12.93 months. There were significant differences in the shoulder external rotation, cancer coping, group cohesion between pre and post program. Conclusion: The results showed that cancer-overcome BeHaS exercise program was an effective nursing intervention for improving breast cancer patient's shoulder external rotation, cancer coping and group cohesion.

• Women's Health Nursing
• /
• v.25 no.2
• /
• pp.219-231
• /
• 2019

Purpose: The purpose of this study was to identify the levels of body image, sexual intimacy, and sexual satisfaction, and to explore factors affecting sexual intimacy and satisfaction among women within one year of mastectomy. Methods: The present study was a cross-sectional survey and involved 101 women who had undergone mastectomy at a University hospital of D city, Korea. Measurement included the scales of body image, sexual intimacy, and sexual satisfaction. Results: Mean age of the subjects was 51 years. Scores of the body image, sexual intimacy, and sexual satisfaction were 59.62, 90.69, and 69.04, respectively. Body image, sexual intimacy, and sexual satisfaction were significantly related to each other. Sexual intimacy was higher when women were of young age (${\beta}=-.32$), had a shorter period since surgery (${\beta}=-.24$), and with higher levels of body image (${\beta}=.37$). Sexual satisfaction was higher when women had higher levels of body image (${\beta}=.19$) and greater levels of sexual intimacy (${\beta}=.74$). Conclusion: Higher levels of body image and greater levels of sexual intimacy were identified as the significant factors influencing sexual satisfaction among these women. Future research with a mixed-method research is needed to gain a deep understanding of the sexuality between women and their husbands.

• Journal of Korean Clinical Nursing Research
• /
• v.16 no.1
• /
• pp.83-93
• /
• 2010

Purpose: This study identified effects of laughter therapy administered to mastectomy patients as an adaptive coping mechanism. Methods: The study design was a non-synchronized design with a non-equivalent control group. Participants were 40 patients admitted to S hospital in Busan from July 1 to October 10, 2008. The laughter therapy was provided to the experimental group for 20 minutes, four times per week for 2 weeks in each patient's room. Results: The experimental and control groups showed significant differences in Mood (t=-2.314, p=.032), and Stress (t=-2.535 p=.020). Pain and serum cortisol in the experimental and control groups did not show any significant difference. Conclusion: Based on the findings the laughter therapy has significant effects on mastectomy patients' mood and stress.

• Archives of Plastic Surgery
• /
• v.34 no.5
• /
• pp.622-627
• /
• 2007

Purpose: Although the autogenous tissue transfer has been the mainstay of the breast reconstruction, concern for the donor site morbidity can lead to the superseded method using tissue expander with implant or permanent expander-implant. However, the additional procedure of tissue expansion possibly cause discomfort and raise the cost. We tried to verify the efficacy of using the saline-filled breast implant by itself for the safe and convenient immediate breast reconstruction modality if the patients have small, round and non-ptotic breasts and the sufficient breast skin can be saved with mastectomy. Methods: From July 2002 to July 2005, 29 breasts of 26 patients were restored only with the saline-filled breast implant immediately after the skin sparing or nipple-areolar skin sparing mastectomy in Asan Medical Center. A pocket with pectoralis major and serratus anterior muscle was created and the implant was covered with this muscle pocket. Simultaneous contralateral augmentation was performed in patients whose mastectomy specimen weighed less than 100g. Results: Using only the saline-filled breast implant resulted in the successful reconstruction with few complications including partial necrosis of nipple areolar skin (five cases, 17.2%), capsular contracture (three cases, 10.3%), hematoma (one case, 3.4%), depigmentation of areolar skin (one case, 3.4%), hypertrophic scar (one case, 3.4%), which were all healed by conservative management. There were no significant complications such as implant exposure and subsequent removal. Conclusion: Immediate breast reconstruction only with the saline-filled breast implant can be a satisfactory alternative option for the patients whose breast is small, round and non-ptotic, especially when the nipple-areolar skin of the breast is preserved in the mastectomy.

• Physical Therapy Korea
• /
• v.8 no.1
• /
• pp.35-50
• /
• 2001

The purposes of this study were to investigate the therapeutic effects of an early exercise program after mastectomy and to provide the early exercise program protocol for patients who had undergone mastectomy. The subjects were seventy women who were diagnosed with breast cancer. They were randomly as signed either to a experimental group (n=35) that received early postoperative exercise program or to a control group (n=35) that received only education by nurses. Data were obtained for each patient from goniometric measurements of shoulder flexion, abduction, external rotation, 10 elements of functional performance, and subjective pain evaluation using visual analogue scale (VAS). All variables were measured preoperatively, three days postoperatively, and one month postoperatively. Data were compared by groups using independent t-test and Mann-Whitney U test for parametric or non-parametric data, respectively. There were no significant differences between the groups for all variables preoperatively and at three days postoperatively. But there were significant differences at one month postoperatively. The experimental group showed a statistically significant increases in shoulder flexion, abduction, and external rotation and in the pain VAS at one month postoperatively (p<.05). Also, at one month postoperatively, the experimental group had less difficulty with three elements of functional performance-doing up a 'back' zippered article of clothing, reaching the ipsilateral scapula, and contralateral scapula with the fingers on the operated side-than the control group (p<.05). The results of this study suggest that, after mastectomy, the early exercise program conducted by a well-trained physical therapist can make a significant contribution to the return of more normal shoulder function and activities of daily living and to an increased quality of life.