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배영태 부산대학교 병원 암연구소 2006 부산대병원학술지 Vol.- No.20
Background: In Korea the incidence of breast cancer is continuous increasing and most common cancer in women. Purposes: Purposes of the present study were to evaluate the number the patients with breast cancers, age distribution, stages, and methods of treatment of breast cancer. Methods: Author studied the clinical data of breast cancer patients who were treated in department of surgery, Pusan National University Hospital in 2001. Results: The total number of patients was 150, the number of females was 149 including 1 male patient. The descending order of the age distribution was 40' s, 50' s, 30' s with the youngest age of 28 years and oldest age of 79years; and the median age was 48 years. The duration of clinical manifestations prior to diagnosis was most frequent (32.4%), between 1 to 3 month, and less than 1 month 29.5%. which were painless lump (52.0%), painful lump (7.1%). The operation methods were mastectomy (24.0%), breast conservation surgery (69.3%), and biopsy(1.0%). The stages were 0 (7.5%), Ⅰ (35.4%), ⅡA (27.2%), ⅡB (2.2%), ⅢA (8.2%), ⅢB (6.1%) Ⅳ (3.4%) bu AJCC. The pathological diagnosis were invasive ductal carcinoma NOS (74.5%) invasive carcinoma with intraductal predominant type (8.2%) mucinous carcinoma (3.6%) and tubular carcinoma(3.6%). The positive rate of ER was 44.2%, and PgR was 46.9%. The rates of strong positive for p-53 and c-erbB2 were 10.2%, 23.4%. respectively. Condusionions: Several characteristics of breast cancer among these patients are following the patterns of Western countries, remarkably this study showed major modality of surgery was breast conservation surgery with good patient satisfaction and cosmetic results but this study was needed to understand recurrence rate, disease free survival rate etc through continuous investigations.
배영태 대한의사협회 2009 대한의사협회지 Vol.52 No.10
For the majority of patients with breast cancer, a surgery that minimizes breast loss combined with radiotherapy has become a popular treatment of choice. The wider clearance margins are necessary for the lower risk of local recurrences, although the greater amount of breast tissue should be removed and the risk of deformation of the breast is higher. Satisfactory cosmetic results can be achieved by oncoplastic breast surgery. The aims of this paper are to review articles of oncoplastic surgery for breast cancer and to summarize the full range of immediate reconstructions from local flaps to sophisticated perforator flaps. It is important for a surgeon to minimize breast loss while the operation and maintain the patient’s feeling that her breasts are still a part of her own body after the operation. The oncoplastic breast surgery will become an integral element of the surgical treatment of breast cancer in the future.
Lateral Thoracodorsal Fasciocutaneous Flap을 이용한 유방 재건 방법
배영태 한국유방암학회 2007 Journal of breast cancer Vol.10 No.3
Purpose: A lateral thoracodorsal fasciocutaneous flap (LTFF) is a local fasciocutaneous flap that has been used in breast reconstructions since the 1980s. Although the LTFF is a wellstudied reconstruction procedure after radical surgery in Western countries, there is no report in Korea. By introducing the LTFF procedure, we suggest an easy reconstruction technique that can be performed by the breast surgeon directly. Methods: Patients with lateral breast cancer and redundant lateral thoracic region might be candidates for this procedure. The flap consists of the lateral and dorsal extensions of the inframammarian fold as well as an extended line from the anterior axillary line. A quadrantectomy is performed through a planned skin incision, and an axillary lymph node dissection can be performed simultaneously if the sentinel lymph node is positive. The skin and subcutaneous fat with the fascia of the serratus anterior and latissimus dorsi muscle should be dissected carefully. A wedge-shaped flap can be acquired successfully. The lateral breast defect is then reconstructed by a rotation of the flap. The axis of the flap is drawn following the inframammarian fold so that the final scar would be under the brassiere line. Results: Nineteen patients were treated with the LTFF after breast conserving surgery. All tumors were located in lateral breast regions. Seroma occurred in three and partial fat necrosis and partial flap necrosis were observed in each one. The cosmetic result based on four-point scoring system of breast cosmesis showed excellent in seventeen and good in two. Conclusion: Despite its long scar line, with appropriate patient selection, a LTFF might be a useful method for breast reconstructions.
유방보존술 시 반대편 대흉근유선이식술을 이용한 즉각적 유방재건술
배영태 한국유방암학회 2008 Journal of breast cancer Vol.11 No.4
Purpose: There has been much reported data showing that breast reconstruction surgery does not result in reduced patient survival if the accepted principles of cancer surgery are closely followed. The proper reconstructive technique can be selected according to diverse factors, but breast size and the site of tumor are mostly important. The latissimus dorsi musculocutaneous flap (LDMCF) is one of the most commonly used techniques for early breast cancer patients who have small breasts. But, it has difficulties for supplying enough tissues to the widely excised tumor site. Especially for ptosis patients, reduction mammoplasty by itself is not enough to achieve symmetry of the breast. We suggest that the pectoralis major myomammary flap (PMMF) is a useful technique for the patients with ptosis. Methods: Seventeen patients with ptosis were treated with breast conserving surgery with PMMF reconstruction. A quadrantectomy rather than lumpectomy was performed through a planned skin incision, and axillary lymph node dissection was performed according to the results of sentinel lymph node biopsy. The PMMF is carefully harvested without perforating branch injury to the internal thoracic artery. Reconstruction was done via the PMMF through the medial tunnel between both breasts. Results: Among the seventeen patients, seroma occurred in two patients and no necrosis occurred at all. The cosmetic result was fair in 15 patients and poor in two patients, based on the four-point scoring system of breast cosmetics. Conclusion: After performing enough quadrantectomy to adhere to the accepted principles of cancer surgery, PMMF was quite useful to supply enough proper tissues for breast reconstructions, and especially for the ptosis patients.