Molecular Portrait of the Normal Human Breast Tissue and Its Influence on Breast Carcinogenesis

Madalin Marius Margan,Andreea Adriana Jitariu,Anca Maria Cimpean,Cristian Nica,Marius Raica 한국유방암학회 2016 Journal of breast cancer Vol.19 No.2

Normal human breast tissue consists of epithelial and nonepithelial cells with different molecular profiles and differentiation grades. This molecular heterogeneity is known to yield abnormal clones that may contribute to the development of breast carcinomas. Stem cells that are found in developing and mature breast tissue are either positive or negative for cytokeratin 19 depending on their subtype. These cells are able to generate carcinogenesis along with mature cells. However, scientific data remains controversial regarding the monoclonal or polyclonal origin of breast carcinomas. The majority of breast carcinomas originate from epithelial cells that normally express BRCA1. The consecutive loss of the BRCA1 gene leads to various abnormalities in epithelial cells. Normal breast epithelial cells also express hypoxia inducible factor (HIF) 1α and HIF-2α that are associated with a high metastatic rate and a poor prognosis for malignant lesions. The nuclear expression of estrogen receptor (ER) and progesterone receptor (PR) in normal human breast tissue is maintained in malignant tissue as well. Several controversies regarding the ability of ER and PR status to predict breast cancer outcome remain. Both ER and PR act as modulators of cell activity in normal human breast tissue. Ki-67 positivity is strongly correlated with tumor grade although its specific role in applied therapy requires further studies. Human epidermal growth factor receptor 2 (HER2) oncoprotein is less expressed in normal human breast specimens but is highly expressed in certain malignant lesions of the breast. Unlike HER2, epidermal growth factor receptor expression is similar in both normal and malignant tissues. Molecular heterogeneity is not only found in breast carcinomas but also in normal breast tissue. Therefore, the molecular mapping of normal human breast tissue might represent a key research area to fully elucidate the mechanisms of breast carcinogenesis.

유방절제술을 시행한 유방암 환자의 시판 인조유방 착용 및 판매실태

구다솜,김연주,남윤자,서관식,이은신,노동영 한국의류산업학회 2020 한국의류산업학회지 Vol.22 No.1

The study surveyed patients undergoing a mastectomy to understand their experience and requirements on artificial breasts and sales status. We retrieved 149 of the 150 surveyed questionnaires; subsequently, 144 questionnaires, excluding missing values, were used in the analysis. According to the results of the study, about 67% of respondents said that artificial breasts were not used after undergoing a mastectomy, and more than half of the breast cancer patients were not aware of the importance of artificial breasts. Breast cancer patients wearing artificial breast felt uncomfortable and hot during daily activities as well as experienced difficulty in size selection and purchase price burdens. The three most responded brands were selected based on the results of the survey that also investigated the sales status of the commercial artificial breast. Company A was selling artificial breast to reflect the consumer's functional requirements, and Company C was selling artificial breast with various kinds of reduced weight. However, it is thought that consumers will have less choice since artificial breasts have more limited forms than various types. Therefore, it is believed that the patient needs artificial breasts that satisfy the shape of various types of mastectomy. This study can be used as basic data for artificial breast development studies.

유방통을 가진 한국 여성에서 Gamma Linolenic Acid의 임상적인 효과

김권천 최신의학사 2000 最新醫學 Vol.43 No.1

유방절제술 후 반대편 유방조직을 이용하여 유방재건한 증례

이동관,설정현,신혜경,임영빈,최준 대한성형외과학회 2009 Archives of Plastic Surgery Vol.36 No.4

Purpose: Unilateral breast reconstruction after mastectomy confront the challenges of recreating a natural appearing breast mound and achieving symmetricalness of the breasts. If the patient's remaining breast is large compared to reconstructed breast, the most common procedure is reduction mammoplasty of the large breast side. The authors experienced a new method of breast reconstruction using the excess breast tissue from the contralateral breast after breast reduction. Methods: The excess tissue from the contralateral breast after vertical reduction mammoplasty with superior pedicle and remaining lower breast tissue were transferred to the mastectomy site breast through the subcutaneous tunnel on the chest wall. The main blood supplies of the flap are perforator branches of the 4th, 5th and 6th anterior intercostal artery. After elevating and detaching the flap on the lower lateral area of the breast, the turn overed flap is fixed on the upper portion of the chest wall of the mastectomy site. Results: On two cases of the breast reconstructions, remaining excess breast tissue from reduction mammoplasty was transferred to the contralateral breast side as pedicles. Both patient and operator were satisfied with the outcome of the reconstruction as the breasts were symmetrical and natural shape. Conclusion: We have performed unilateral breast reconstruction using the excess breast tissue after reduction mammoplasty of the contralateral breast. As Oriental women's breasts are relatively smaller than that of Caucasian women, delayed breast reconstruction cases of Oriental women with large breasts(macromastia) seem to be ideal for this procedure.

A Case Report of Breast Sparganosis in a Patient with Ipsilateral Breast Cancer: MRI and Ultrasonographic Findings

이유진,추기석,배영태,김지연 대한영상의학회 2010 대한영상의학회지 Vol.63 No.6

Sparganosis of the breast is a quite rare parasitic infection of humans and presents as soft tissue masses that mimic breast malignancy or benign tumor, such as fibroadenoma. We present here a case of histologically confirmed breast sparganosis in the upper inner quadrant of the right breast with coexisting breast cancer in the ipsilateral breast upper outer quadrant. Ultrasonography of breast sparganosis showed a well defined, tubular hypoechoic mass with discrete multilayered wall and tubule-in tubule appearance, surrounded by heterogenous hyperechoic areas in the subcutaneous fat layer of the breast. MRI revealed an elongated tubular structure with persistent and progressive enhancement. This is the second report concerned with the MRI and ultrasonographic findings of breast sparganosis and the first report of breast sparganosis in a patient with ipsilateral breast cancer.

Potential Benefits of Neoadjuvant Chemotherapy in Clinically Node-Positive Luminal Subtype− Breast Cancer

김형석,유태경,박우찬,채병주 한국유방암학회 2019 Journal of breast cancer Vol.22 No.3

Purpose: Neoadjuvant chemotherapy (NAC) is less effective for luminal breast cancer because luminal breast cancer has a lower rate of pathological complete response (pCR) after NAC than human epidermal growth factor receptor 2 (HER2)-type and triple-negative breast cancer (TNBC). We investigated the efficacy of NAC and the predictive factors of a better response in luminal breast cancer. Methods: Between 2010 and 2016, we retrieved data of 244 patients with clinically node-positive breast cancer who were treated with NAC followed by surgery from a prospectively collected database. We classified breast cancer into luminal HER2− and non-luminal HER2− breast cancer (luminal HER2+, HER2+, and TNBC types). We analyzed each subtype with respect to surgical outcomes, response to NAC, and determined variables associated with surgical outcomes and response in patients with luminal HER2− breast cancer. Results: The total, breast, and axillary pCR rates were significantly lower in 114 patients with luminal HER2− breast cancer than in those with other subtypes (7.9%, 12.3%, and 22.8%, respectively). However, breast-conserving surgery (BCS) conversion and tumor response rates did not significantly differ between patients with luminal HER2− and those with non-luminal HER2− breast cancer (p = 0.836 and p = 0.180, respectively). In the multivariate analysis, high tumor response rate (≥ 46.4%) was significantly associated with an increased BCS conversion rate. In the subgroup analysis of luminal HER2− breast cancer, the multivariate analysis showed that higher Ki67 expression and axilla pCR and BCS conversion rates were significantly associated with tumor response to NAC. Conclusion: Despite the low pCR rate, the tumor response and BCS conversion rates after NAC of luminal HER2− breast cancer were similar to those of other subtypes. NAC has the potential benefit of reducing the size of breast cancer, thereby increasing the BCS conversion rate in luminal HER2− breast cancer.

Prevalence of Women with Dense Breasts in Korea: Results from a Nationwide Cross-sectional Study

조혜미,이은혜,고경란,강봉주,차주희,이안,정혜경,전재관 대한암학회 2019 Cancer Research and Treatment Vol.51 No.4

Purpose Women with dense breast are known to be at high risk for breast cancer, but their prevalence and number of Korean women are unknown. The current study was to investigate the distribution of mammographic breast density by age of women undergoing screening mammography, and to estimate the prevalence of Korean women with dense breasts, quantitatively. Materials and Methods For obtaining a nationwide representative sample, 6,481 mammograms were collected from 86 screening units participated in the National Cancer Screening Program for breast cancer. Based on the American College of Radiology Breast Imaging Reporting and Data System classification, breast density was evaluated by six breast radiologists, qualitatively. We applied these breast density distributions to age-specific counts of the Korean women population derived to mid-year 2017 to estimate the number of Korean women with dense breasts. Results Overall, 54.4% (95% confidence interval [CI], 52.9% to 55.8%) of women 40 to 69 years of age had heterogeneously or extremely dense breasts, and this proportion was inversely associated with age. Based on the age distribution of Korean women, we estimated that 6,083,000 women (95% CI, 5,919,600 to 6,245,600) age 40-69 years in Korean have dense breasts. Women aged 40-49 years (n=3,450,000) accounted for 56.7% of this group. Conclusion More than half of Korean women aged 40 and over have dense breasts. To prevent breast cancer effectively and efficiently, it is necessary to develop a new personalized prevention strategy considering her status of breast density.

모유 수유에 대한 일반인들의 인식에 관한 설문조사

반성환,이동환,박재옥,신상만 순천향의학연구소 1997 Journal of Soonchunhyang Medical Science Vol.3 No.1

OBJECT : From the late in 1970, the incidence of breast-feeding have been increased in the developed countries. But, there is a marked contrast in Korea, inspite of the campaign of breast-feeding. We researched the general opinions of general populations on breast feeding to find out a better way on successful breast-feeding and helping people's understanding. METHODS : To find out the factors influencing the incidence of breast-feeding, we made on ingury study in 234 women and their family member including their husbands during the period of April, 1995 to August, 1995. We analysed the results according to sex, age, and the status of education and marriage. RESULT People in the inquiry answered as follows : - breast feeding is to be taken for granted.(93-94%) - the reason of breast feeding is for protecting baby from disease.(81-83%) - feeding breast milk is much better than cow's milk.(82-83%) - breast feeding is good for hepling the bonding between mother and her baby.(89%) - most of them would like to follow the spouse's opinion to keep on breast feeding.(73-75%) - breast feeding could cause some inconveniences in sexual-life/(74-78%) - breast feeding woman are regarded more admiarable when compared with non-breast feeding woman.(80-84%) - breast feeding woman is less attactive.(22-23%) - the purpose of creating breast is to feed baby.(14-17%) - breast feeding in public place is permissible.(43%) - breast feeding can make breast shapeless.(22%) CONCLUSIONS : Every effort should be made so as to increase the recognition of the value of breast feeding, not only for pregnant women but also for their husbands. Both of them have to attend the breast feeding education classes given before and after childbirth. Students have to be taught about the merit and the way of breast feeding through school education. Doctors are expected to encourage people to realize the advantages of breast-feeding, participate in the campaign and never advise to give up breast feeding.

임신시 모유 수유 계획의 실천에 대한 추적 관찰

김혜순,서정완,김용주,이기형,김재영,고재성,배선환,박혜숙,Kim, Hae Soon,Seo, Jeong Wan,Kim, Yong Joo,Lee, Kee Hyoung,Kim, Jae Young,Ko, Jae Sung,Bae, Sun Hwan,Park, Hye Sook 대한소아청소년과학회 2003 Clinical and Experimental Pediatrics (CEP) Vol.46 No.7

목 적 : 임신 시 모유 수유를 계획한 수유모의 모유 수유 실천과 이에 영향을 주는 요인을 알아보고자 본 조사를 시행하였다. 방 법 : 임신 시 모유 수유를 계획했던 1,128명 중에서 지역과 병원급을 층화하여 무작위 추출한 152명을 연구의 대상으로 하였다. 2001년 11월부터 2002년 3월까지 연구 대상자의 출산 후 4개월에 전화로 설문을 실시하여 결과를 분석하였다. 결 과 : 1) 임신 시 모유 수유를 계획한 수유모 중에서 출산 4개월 후의 모유 수유율은 37.5%였고, 실패 이유는 66.3%가 모유가 나오지 않거나 양이 적어서라고 대답하였고 그 외 수유모의 직장 또는 일 13.7%, 수유모의 질환 7.4%, 변이 묽어서 5.3%, 아기의 질병 4.2% 등이었다. 2) 수유모의 연령, 자녀의 유무, 모유 수유를 결정한 사람, 가족의 형태에 따른 차이는 없었으나, 임신 시 모유 수유를 4개월 이상으로 계획했던 경우 모유 수유율이 2.3(95% 신뢰구간 1.15-4.62)배로 유의하게 높았다(P<0.05). 3) 전문대졸 이상의 수유모의 모유 수유율이 고졸 수유모보다 0.43(95% 신뢰구간 0.21-0.86)배로 유의하게 낮았으며 취업 수유모의 모유 수유율이 0.37(95% 신뢰구간 0.17-0.83)배로 유의하게 낮았다(P<0.05). 4) 모유 수유 장점과 수유의 방법에 대한 인식항목 20개에 대한 점수의 중앙값 12점을 기준으로 할 때 12점 이상인 사람의 모유 수유율은 41.5%였던 반면, 12점 미만인 경우 34.5%의 모유 수유율을 보여 인식이 높은 군이 낮은 군에 비해 1.35(95% 신뢰구간 0.70-2.62)배의 모유 수유율을 보였다(P>0.05). 5) 출산 장소가 산부인과 의원인 경우 종합병원 보다 모유 수유율이 3.97(95% 신뢰구간 11-14.23)배로 유의하게 높았다(P>0.05). 출산아 성별, 병원내 모유 수유, 모자동실 및 분만 형태에 따른 모유 수유율의 유의한 차이는 없었다. 결 론 : 모유 수유율 높이기 위해서 적극적인 산전 교육과 출산 후 병의원에서 모유 수유를 할 수 있도록 모자동실, 모유 수유 상담 및 교육이 적절하게 제공되어야 할 것이다. 또한 취업 수유모의 모유 수유를 위한 공간과 시설 및 휴가 문제 등이 사회 정책이나 국가 정책으로 제도화 되어야 할 것이다. Purpose : To investigate the success rate and factors that influence breast-feeding among women having antenatal breast-feeding plans. Methods : Questionnaires included items on success in breast-feeding, reasons for failure and perinatal factors. It was done by telephone calls to 152 randomly selected women having antenatal breast-feeding plans at 4 months after delivery. The questionnaires were analysed by bivariate ${\chi}^2$-analysis. Results : The breast-feeding rate for the first four months among women having antenatal breast-feeding plans was 37.5%. The major reason for breast-feeding failure was insufficient amount of breast milk(66.3%). The breast-feeding rate was 2.3(95% CI 1.15-4.62) times higher in women having antenatal breast-feeding plans for longer than 4 months(P<0.05), but maternal age, breast-feeding for previous baby, person advocating breast-feeding, and family size were not significant factors of success in breast-feeding. The breast-feeding rate of graduates of college was 0.43(95% CI 0.21-0.86) times lower than that of graduates of high school. The breast-feeding rate of employed mothers was 0.37(95% CI 0.17-0.83) times lower than that of housewives(P<0.05). Maternal disease, smoking, alcohol drinking, and understanding and knowledge about breast-feeding were not significant determinant factors of success in breast-feeding. Breast-feeding rate of infant born at local obstetric clinics was 3.97(95% CI 11-14.23) times higher than that of infant at general hospital(P<0.05). Conclusion : To increase the breast-feeding, medical personnel should educate mothers on problems during breast-feeding. Hospital polices that facilitate breast-feeding such as rooming-in must be promoted. For employed mothers, strategies for breast-feeding within companies must be encouraged.

Reconstructing hope with the breast: A meta-synthesis of the meaning of breast reconstruction in women breast cancer survivors

Ahn, Jeonghee,Suh, Eunyoung E. 한국간호과학회 2021 한국간호과학회 학술대회 Vol.2021 No.10

Aim(s): Breast cancer is the most frequent cancer in women worldwide. Nowadays breast reconstruction is broadly recommended to increase the quality of life and to reduce psychological distress by improving body image. However, little is known about what breast reconstruction ultimately means for women with breast cancer. This study aimed to examine the meaning of breast reconstruction in women breast cancer survivors by synthesizing qualitative research on the lived experience of the women who had undergone breast reconstruction. Method(s): A literature search using a combination of the keywords ‘breast reconstruction’ and ‘qualitative research’ was conducted in PubMed, CINAHL, EMbase, PsycInfo, ProQuest, and SCOPUS. Peer-reviewed journal articles, published in the last two decades from 2001 to 2020, were included in this research. A total of 22 qualitative studies were yielded and subjected to critical appraisal to ensure the integrity of findings. Meta-synthesis process developed by Sandelowski and Barroso was used to integrate findings across the studies. Result(s): Four core themes were identified: (1) restoring the disfigured body, (2) rebuilding the feminine self, (3) reconnecting the self to significant others, and (4) recovering from the psychological trauma due to breast cancer. Women with breast cancer regarded breast reconstruction as a healing process to returning the normal life as well as a surgical procedure to reshape the damaged body. Breast reconstruction enabled breast cancer survivors to regain the societal image of women, to reunion intimate relationships, and as a result, overcome stigma from breast cancer. Conclusion(s): This meta-synthesis develops an integrated interpretation and explanation of the meaning of breast reconstruction in women breast cancer survivors. This study provides insights and improves understanding of the holistic view on breast reconstruction for women with breast cancer. This may allow health professionals to provide appropriate and supportive counseling intervention for breast cancer patients.