유방암 환자에서 타장기에 발생한 원발성 악성종양의 임상적 특성

정상희,곽승수,김성철,박문기,이건석,김희정,이정선,안세현,손병호 한국유방암학회 2007 Journal of breast cancer Vol.10 No.4

Purpose: Since 2001, breast cancer has been the most common type of cancer observed in Korean women. Due to improved screening and treatment, multiple primary cancer (MPC) in association with breast cancer has been more prevalent. However, there is a lack of information regarding MPC in Korea. Therefore, this study was conducted to provide an overview of the clinical characteristics of MPC that occurs in association with breast cancer. Methods: We retrospectively investigated 149 patients with MPC, including breast cancer patients, who were treated between July 1989 and December 2005 at the Breast clinic in Asan Medical Center. Patients with contra-lateral breast cancer as well as patients that experienced a recurrence of breast cancer were excluded from this study. We studied the clinical characteristics of patients including the mean age, stage of disease, hormone receptor status, cause of death, common cancers that were combined with breast cancer, the time interval between the onset of breast cancer and other cancers, and mean survival. We considered the cancer to be synchronous if a second cancer has been diagnosed at least six months before the diagnosis of an initial primary cancer, however, other forms of cancer were considered to be metachronous. Results: Of 149 patients, 146 patients were female (98.0%) and 3 were male (2.0%). The mean age of the study group was 51.5, which is higher than the mean age of 47.3 that was observed in breast cancer patients at our hospital during the same period (p<0.001). Forty-four of the patients evaluated in this study had synchronous cases of cancer, whereas the remaining 88 patients had metachronous MPC. In metachronous cancers, the average time between diagnosis with the primary cancer and the secondary cancer was 5.2 yr. The most common cancer found to be combined with breast cancer included cancer of the thyroid (45, 29.2%), cervix and uterus (28, 18.2%), stomach (19, 12.3%), colon and rectum (15, 9.7%), ovary (11, 7.1%) and lung (9, 5.8%). Conclusion: Thyroid cancer is the cancer most commonly associated with breast cancer, and the mean age of MPC patients was higher than that of patients who only had breast cancer. Due to the improved survival length and treatment, MPC associated with breast cancer is now a greater concern.

Predictors of Breast Cancer Screening Uptake: A Pre Intervention Community Survey in Malaysia

Dahlui, Maznah,Gan, Daniel Eng Hwee,Taib, Nur Aishah,Pritam, Ranjit,Lim, Jennifer Asian Pacific Journal of Cancer Prevention 2012 Asian Pacific journal of cancer prevention Vol.13 No.7

Introduction: Despite health education efforts to educate women on breast cancer and breast cancer screening modalities, the incidence of breast cancer and presentation at an advanced stage are still a problem in Malaysia. Objectives: To determine factors associated with the uptake of breast cancer screening among women in the general population. Methods: This pre-intervention survey was conducted in a suburban district. All households were approached and women aged 20 to 60 years old were interviewed with pre-tested guided questionnaires. Variables collected included socio-demographic characteristics, knowledge on breast cancer and screening practice of breast cancer. Univariate and multivariate analysis were performed. Results: 41.5% of a total of 381 respondents scored above average; the mean knowledge score on causes and risks factors of breast cancer was 3.41 out of 5 (SD1.609). 58.5% had ever practiced BSE with half of them performing it at regular monthly intervals. Uptake of CBE by nurses and by doctors was 40.7% and 37.3%, respectively. Mammogram uptake was 14.6%. Significant predictors of BSE were good knowledge of breast cancer (OR=2.654, 95% CI: 1.033-6.816), being married (OR=2.213, 95% CI: 1.201-4.076) and attending CBE (OR=1.729, 95% CI: 1.122-2.665). Significant predictors for CBE included being married (OR=2.161, 95% CI: 1.174-3.979), good knowledge of breast cancer (OR=2.286, 95% CI: 1.012-5.161), and social support for breast cancer screening (OR=2.312, 95% CI: 1.245-4.293). Women who had CBE were more likely to undergo mammographic screening of the breast (OR=5.744, 95% CI: 2.112-15.623), p<0.005. Conclusion: CBE attendance is a strong factor in promoting BSE and mammography, educating women on the importance of breast cancer screening and on how to conduct BSE. The currently opportunistic conduct of CBE should be extended to active calling of women for CBE.

Breast Cancer Knowledge and Screening Behaviour among Women with a Positive Family History: A Cross Sectional Study

Subramanian, Pathmawathi,Oranye, Nelson Ositadimma,Masri, Azimah Mohd,Taib, Nur Aishah,Ahmad, Nora Asian Pacific Journal of Cancer Prevention 2013 Asian Pacific journal of cancer prevention Vol.14 No.11

Background: Breast cancer is the commonest type of cancer among women, and in Malaysia 50-60% of the new cases are being detected at late stages. Do age, education level, income, ethnicity, relationship with breast cancer patients and knowledge of breast cancer risk factors influence breast screening practices? This study revealed interesting but significant differences. Objectives: To assess the knowledge of breast cancer risk factors and early detection measures among women in a high risk group. Materials and Methods: A cross sectional survey of one hundred and thirty one women relatives of breast cancer patients was carried out. Participants were selected through purposive sampling, during hospital visits. A self-administered questionnaire was used for data collection. Results: The majority of the respondents (71%) had poor knowledge of the risk factors for breast cancer. Income, relationship with a patient and practise of breast cancer screening predicted performance of mammography, $R^2$=0.467, F=12.568, p<0.0001. Conclusions: The finding shows inadequate knowledge of breast cancer risk factors and poor cancer screening practise among women with family history of breast cancer. Poor knowledge and practise of breast screening are likely to lead to late stage presentation of breast cancer disease. Some important predictors of breast cancer screening behaviour among women with positive family history of breast cancer were identified. An understanding of the strengths and significance of the association between these factors and breast screening behaviour is vital for developing more targeted breast health promotion.

Ultrasound screening of contralateral breast after surgery for breast cancer

Kim, S.J.,Chung, S.Y.,Chang, J.M.,Cho, N.,Han, W.,Moon, W.K. G. Thieme ; Elsevier Science Pub. Co 2015 European journal of radiology Vol.84 No.1

Objective: To determine whether supplemental screening ultrasound (US) to mammography could improve cancer detection rate of the contralateral breast in patients with a personal history of breast cancer and dense breasts. Materials and methods: During a one-year study period, 1314 screening patients with a personal history of breast cancer and dense breasts simultaneously underwent mammography and breast US. BI-RADS categories were given for mammography or US-detected lesions in the contralateral breast. The reference standard was histology and/or 1-year imaging follow-up, and the cancer rate according to BI-RADS categories and cancer detection rate and positive biopsy rate according to detection modality were analyzed. Results: Of 1314 patients, 84 patients (6.4%) were categorized as category 3 with one interval cancer and one cancer which was upgraded to category 4A after 6-month follow-up US (2.5% cancer rate, 95% CIs 1.5-9.1%). Fifteen patients (1.1%) had category 4A or 4B lesions in the contralateral breast. Four lesions were detected on mammography (two lesions were also visible on US) and 11 lesions were detected on US and 5 cancers were confirmed (33.3%, 95% CIs 15.0-58.5%). Six patients (0.5%) had category 4C lesions, 2 detected on mammography and 4 on US and 4 cancers were confirmed (66.7%, 95% CIs 29.6-90.8%). No lesions were categorized as category 5 in the contralateral breast. Cancer detection rate by mammography was 3.3 per 1000 patients and that by US was 5.0 per 1000 patients, therefore overall cancer detection rate by mammography plus US was 8.3 per 1000 patients. Positive biopsy rate of mammography-detected lesions was 66.7% (4 of 6) and that of US-detected lesions was 40.0% (6 of 15). Conclusion: US can be helpful to detect mammographically occult breast cancer in the contralateral breast with high positive biopsy rate and low category 3 rate in patients with a previous history of breast cancer and dense breasts.

Association of Knowledge and Cultural Perceptions of Malaysian Women with Delay in Diagnosis and Treatment of Breast Cancer: a Systematic Review

Khan, Tahir Mehmood,Leong, Jamie Pik Yan,Ming, Long Chiau,Khan, Amer Hayat Asian Pacific Journal of Cancer Prevention 2015 Asian Pacific journal of cancer prevention Vol.16 No.13

Background: Breast cancer is the most common cancer and the leading cause of cancer mortality among women of all ethnic and age groups in Malaysia. Delay in seeking help for breast cancer symptoms is preventable and by identifying possible factors for delayed diagnosis, patient prognosis and survival rates could be improved. Objectives: This narrative review aimed to understand and evaluate the level of in-depth breast cancer knowledge in terms of clinical breast examination and breast self-examination, and other important aspects such as side-effects and risk factors in Malaysian females. Since Malaysia is multicultural, this review assessed social perceptions, cultural beliefs and help-seeking behaviour in respect to breast cancer among different ethnic groups, since these may impinge on efforts to 'avoid' the disease. Materials and Methods: A comprehensive literature search of seven databases was performed from December 2015 to January 2015. Screening of relevant published journals was also undertaken to identify available information related to the knowledge, perception and help-seeking behaviour of Malaysian women in relation to breast cancer. Results: A total of 42 articles were appraised and included in this review. Generally, women in Malaysia had good awareness of breast cancer and its screening tools, particularly breast self-examination, but only superficial in-depth knowledge about the disease. Women in rural areas had lower levels of knowledge than those in urban areas. It was also shown that books, magazines, brochures and television were among the most common sources of breast cancer information. Delay in presentation was attributed mainly to a negative social perception of the disease, poverty, cultural and religion practices, and a strong influence of complementary and alternative medicine, rather than a lack of knowledge. Conclusions: This review highlighted the need for an intensive and in-depth breast cancer education campaigns using media and community health programmes, even with the existing good awareness of breast cancer. This is essential in order to avoid misconceptions and to frame the correct mind-set about breast cancer among women in Malaysia. Socio-cultural differences and religious practices should be taken into account by health care professionals when advising on breast cancer. Women need to be aware of the risk factors and symptoms of breast cancer so that early diagnosis can take place and the chances of survival improved.

Path Analysis of Attitude Toward Health Checkup and Breast Cancer on the Application of Physical Therapy after Breast Cancer Surgery

( Mi-joung Lee ),( Hyo-lyun Ro ) 대한물리의학회 2021 대한물리의학회지 Vol.16 No.4

PURPOSE: This study examined women’s attitudes toward the use of physical therapy in the treatment process after breast cancer surgery and the degree of interest in this application. Path analysis was conducted to discover the approaches to improve awareness of the necessity of physical therapy intervention after breast cancer surgery. METHODS: This study was a cross-sectional survey of 230 women aged 20 years and over with no history of breast cancer. The measurement tool used in this study was a structured questionnaire, composed of 17 items in five fields: five items on the demographic characteristics, four items related to health checkups, four items involving the viewpoints on breast cancer, one item related to the interest in breast cancer, and four items related to physical therapy after surgery. RESULTS: Women’s attitudes toward regular health checkups were major factors in the prevention and treatment of breast cancer. In addition, those with higher levels of interest in breast cancer showed stronger interest in using physical therapy after breast cancer surgery. CONCLUSION: Women believe that breast cancer can be prevented through the health checkups implemented by the government. Therefore, there is a need to utilize public relations to promote methods for the self-diagnosis of breast cancer in the health checkup system and the use of physical therapy after breast cancer surgery.

Epidemiological Pattern of Breast Cancer in Iranian Women: Is there an Ethnic Disparity?

Taheri, Neger Sadat,Nosrat, Sepideh Bakhshandeh,Aarabi, Mohsen,Tabiei, Mohammad Naeimi,Kashani, Elham,Rajaei, Siamak,Besharat, Sima,Semnani, Shahryar,Roshandel, Gholamreza Asian Pacific Journal of Cancer Prevention 2012 Asian Pacific journal of cancer prevention Vol.13 No.9

Introduction: Northeastern Iran is known as a high risk area of upper gastrointestinal cancers. Recent reports have suggested a declining trend for these cancers as well as an increase in the incidence of other malignancies including breast cancer. Our present aim was to describe the epidemiological pattern of breast cancer in this region during 2004-2009. Methods: All new cancer cases from public and private diagnostic and therapeutic centers of Golestan province were registered. A structured questionnaire was prepared and used based on the standerds of the International Association of Cancer Registries. The international classification of diseases for oncology was considered for coding. Age standardized incidence rates (ASR) of breast cancer were calculated. Results: A total of 11,038 new cancer cases were registered during 2004-2009, of which, 1,101 (10%) were females with breast cancer. The median age of the breast cancer patients was 46 years. The ASR for breast cancer was 28 per 100,000 person-years. We found an unusual rapid increase in breast cancer rate at the age of 25 years. The ASR of breast cancer was significantly lower in females from Turkmen ethnicity and those from rural areas(P value <0.01). Conclusion: Our study showed high rate of breast cancer in Golestan province of Iran. We found an unusual peak of breast cancer in young women. So, the age of starting screening programs may need to be revised in this area. The rate of breast cancer was significantly lower in women from Turkmen ethnicity. Further studies are warranted to clarify the role of important determinants, especially regarding the ethnic disparity, on breast cancer in this region.

Breast Cancer Risk and Early Diagnosis Applications in Turkish Women Aged 50 and Over

Ceber, Esin,Mermer, Gulengul,Okcin, Figen,Sari, Dilek,Demireloz, Mahide,Eksioglu, Aysun,Ogce, Filiz,Cakır, Dilek,Ozenturk, Gulsun Asian Pacific Journal of Cancer Prevention 2013 Asian Pacific journal of cancer prevention Vol.14 No.10

Background: The aim of the study was to determine breast cancer risk and early diagnosis applications in women aged ${\geq}50$. Materials and Methods: This cross-sectional, descriptive field study focused on a population of 4,815 in Mansuro$\breve{g}$lu with a 55.1% participation rate in screening. In the study, body mass index (BMI) was also evaluated in the calculation of breast cancer risk by the Breast Cancer Risk Assessment Tool (BCRA) (also called the "Gail Risk Assessment Tool"). The interviewers had a three-hour training provided by the researchers, during which interactive training methods were used and applications were supported with role-plays. Results: The mean age of the women participating in the study was $60.1{\pm}8.80$. Of these women, 57.3% were in the 50-59 age group, 71.7% were married, 57.3% were primary school graduates and 61.7% were housewives. Breast-cancer development rate was 7.4% in the women participating in the study. When they were evaluated according to their relationship with those with breast cancer, it was determined that 73.0% of them had firstdegree relatives with breast cancer. According to the assessment based on the Gail method, the women's breast cancer development risk within the next 5 years was 17.6%, whereas their calculated lifetime risk was found to be as low as 0.2%. Statistically significant differences (P=0.000) were determined between performing BSE-CBE and socio-demographic factors. Conclusions: It was determined that 17.6% of the participants had breast cancer risk. There was no statistically significant difference between the women with and without breast cancer risk in terms of early diagnosis practices, which can be regarded as a remarkable finding. It was planned to provide training about the early diagnosis and treatment of breast cancer for people with high-risk scores, and to conduct population-based breast cancer screening programs.

Risk of Breast Cancer among Young Women and Importance of Early Screening

Memon, Zahid Ali,Kanwal, Noureen,Sami, Munam,Larik, Parsa Azam,Farooq, Mohammad Zain Asian Pacific Journal of Cancer Prevention 2015 Asian Pacific journal of cancer prevention Vol.16 No.17

Background: Breast cancer is the most common type of cancer in women throughout the world. However, in comparison with Western women, it presents relatively early in women of Asian ethnicity. Early menarche, late menopause, use of OCP's, family history of benign or malignant breast disease, exposure to radiation and BMI in the under-weight range are well known risk factors for the development of breast cancer in premenopausal women. Early detection with the use of breast self-examination (BSE) and breast cancer screening programs can lead to a reduction in the mortality rates due to breast cancer. The aim of our study was to assess the risk factors for breast cancer among young women and to emphasize the importance of early screening among them. Materials and Methods: We conducted a cross-sectional study among women aged 18 to 25 using a self-administered questionnaire. Data was collected over a period of 6 months from June to December, 2014. A total of 300 young women selected randomly from Dow Medical College and various departments of Karachi University successfully completed the survey. Results: Respondents were 18-25 years of age (mean age=21.5). Out of the 300 young females, 90 (30%) had at least one risk factor, 90 (30%) had two, 40 (13%) had three, 8 (2.7%) had four, 2 (0.7%) had five while one female was found to have six positive risk factors for breast cancer. Some 66 women (22%) experienced symptoms of breast cancer such as non-cyclical pain and lumps. While 222 women (74%) had never performed breast self-examination, 22 (7.3%) had had a breast examination done by a health professional while 32 (10.7%) had participated in breast screening programs. A total of 223 (74.3%) women considered breast cancer screening important for young women. Conclusions: The percentage of young women with risk factors for breast cancer was found to be alarmingly high. Therefore, screening for breast cancer should start at an early age especially in high risk groups. Awareness about breast self-examination should be emphasized. Moreover, screening programs should be started to ensure early detection and reduction of mortality rates caused by breast cancer also in young Pakistani females.

Oncologist Perspectives on Breast Cancer Screening in India-Results from a Qualitative Study in Andhra Pradesh

Bodapati, Srikanthi Lakshmi,Babu, Giridhara Rathnaiah Asian Pacific Journal of Cancer Prevention 2013 Asian Pacific journal of cancer prevention Vol.14 No.10

Background: It is important to understand the perceptions of oncologists to understand the comprehensive picture of clinical presentation of breast cancer. In the absence of clear evidence, clinical practice involving patients of breast cancer in India should provide insights into stages of breast cancer with which women present to their clinics and mode of screening of breast cancer prevalent in Andhra Pradesh. Materials and Methods: A qualitative study was conducted to understand the perceptions of oncologists regarding clinical presentation of breast cancer, stages at which women present to clinics, and mode of screening of breast cancer prevalent in Andhra Pradesh. In-depth interviews (IDI) were conducted with ten practising oncologists from various public and private cancer hospitals in Hyderabad city to understand their perspectives on breast cancer and screening. The data were triangulated to draw inferences suitable for the current public Health scenario. Results: Late presentation was indicated as the most important cause of decreased survival among women. Most women present at Stage 3 and 4 when there is no opportunity for surgical intervention. The results indicate that there is a huge gap in awareness about breast cancer, especially in rural areas and among poor socioeconomic groups. Even despite knowledge, most women delay in reporting due to reasons like fear, embarrassment, cost, ignorance, negligence, and easy going attitude. Conclusions: It is important to improve awareness about breast cancer and screening methods for promoting early screening. The study inferred that it would be beneficial to establish cancer registries in rural areas. Also, the policymakers need to make key decisions which among three methods (breast self examination (BSE), clinical breast examination and mammography) can best be used as a screening tool and how to successfully implement population wide screening program to prevent mortality and morbidity from breast cancer in India.