A Clinical Study of Infiltrating Lobular Breast Cancer / 대한암학회지

PURPOSE: Infiltrating lobular carcinoma of the breast was known to have a high incidence of multicentricity and bilaterality in patients. We analyzed the clinical features of infiltrating lobular breast cancer. MATERIALS AND METHODS: We studied 29 patients with infiltrating lobular carcinoma of the breast, from Jan. 1980 to Mar. 1997 in the Department of Surgery, Seoul National University Hospital. RESULTS: The age of the patients ranged from 32 to 71 years with an average of 45.2 years. The main complaining symptom was a painless mass. The diameter of the tumor ranged from 0.7 to 7 cm with a mean size of 2.8 cm. The axillary lymph node was positive for malignancy in 12 cases. The number of multicentric breast cancers were 7 cases (24.1%), and the number of bilateral breast cancers were 3 cases (10.3%). The estrogen receptor was positive in 66.7%, and the progesterone receptor was positive in 75% of the cases. There were one local recurrence and three distant metastases during a mean follow-up period of 4.5 years. The 5-year survival rate and 5-year disease free survival rate were 89.6% and 88.6%, respectively. CONCLUSION: Infiltrating lobular breast cancers are at greater risk of developing multicentricity and bilaterality than nonlobular breast cancers. Careful program of frequent follow-up examinations and thorough histopathological studies are needed for patients with infiltrating lobular breast cancers.

Clinicopathologic Analysis of 40 Mucinous Breast Carcinomas / 대한암학회지

PURPOSE: Mucinous carcinoma of breast was known to have a lower lymph node metastasis and better prognosis than other type of breast cancer. This study was performed to clarify the clinicopathologic features and prognosis of mucinous breast carcinoma. MATERIALS AND METHODS: We reviewed clinicopathologic features of 40 patients diagnosed mucinous breast carcinoma from Jan. 1985 to Dec. 1995 and compared 31 patients of unmixed mucinous breast carcinoma with 1128 patients of infiltrating ductal carcinoma group. RESULTS: Of total 40 mucinous ca., 31 cases were unmixed type showing no component of invasive ductal component(IDC) and 9 cases were mixed type showing IDC. The average age of the patients was 47 ranging from 31 to 71 years. The most common symptom was palpable breast mass(38 cases, 95%). According to TNM classification, the numbers of unmixed type were following, stage I 14 cases(45%), stage II 15 cases(48%), and stage III 2 cases(7%), and of mixed type, stage I 1 cases(11%), and stage II was 8 cases(89%). Axillary lymph node metastasis was shown to be negative in 26 cases of unmixed mucinous carcinoma(84%), whereas it did in 544 cases of infilterating ductal carcinoma(48%)(p<0.05). Because all patients with unmixed mucinous carcinoma survived except 2 patients who died of cancer unrelated causes, it was impossible to analyze the difference of outcome in unmixed mucinous carcinoma and infilterating ductal carcinoma(5YSR: 81%). CONCLUSION: Considering unmixed mucinous carcinoma had fewer axillary lymph node metatasis than infiterating ductal carcinoma, it may be concluded that unmixed mucinous carcinoma had better prognosis.

The Expression of Phospholipase C-gamma1 and Its Cellular Characteristics / 대한암학회지

BACKGROUND: The activation of phospholipase C(PLC) is one of the early cellular events in various growth process, including malignant transformation. PLC-gamma1 is activated through direct interaction with growth factor receptor tyrosine kinase. MATERIAL AND METHODS: Using immunoblot assay, we evaluated overexpression of PLC-gamma1 expression in twenty human breast cancer tissues. It was also determined whether there was any connection between other prognostic factors(numbers of metastatic axillary nodes, nuclear and histological grade, c-erbB2, p53 and E-cadherin) and the overexpression of PLC-gamma1 protein. RESULTS: Seventeen of 20 breast cancer tissues showed overexpression of PLC-gamma1, which was corresponded to that seen on the immunohistochemistry( kappa= 0.8275, p = 0.003). Of 3 tumor markers, immunohistochemically determined, positive expression of E-cadherin only was associated with PLC-gamma1 protein overexpression in a range of statistical significance (p=0.045, kappa=0.607). CONCLUSION: PLC-gamma1 overexpression might be pathogenic trigger involved in breast cancer and the relationship between expression of E-cadherin and PLC-gamma1 would require further elucidation.

Breast Cancer of 35 Years Old or Less / 대한암학회지

PURPOSE: The age of onset of Korean breast carcinoma is younger than that in western countries by some 10 years, thus the criteria of young age in manuscript from western countries cannot reflect the characteristics of young breast cancer properly in Korea. MATERIALS AND METHODS: We studied 290 breast cancer patients, 35 years old or younger retrospectively, from Jan. 1980 to Dec. 1995 in the Department of Surgery, Seoul National University Hospital. The age criteria of 30 and 35 years was utilized to define two groups. RESULTS: The group(age30). When we compared the group of age< or =30 to that of 31< or = age < or =35, there was statistically significant difference in primary tumor size, axillary nodal status and pathological stage(p=0.023, 0.019, 0.022 respectively). CONCLUSION: The age of 30 might be better criteria to define young age as prognostic factor rather than age of 35 in Korea.

Retroperitoneal Sarcoma / 대한암학회지

PURPOSE: To determine the clinical feature, surgical management of primary and recurrent disease, predictive factors for outcome, and impact of multimodality therapy in retroperitoneal sarcoma. MATERIALS AND METHODS: 60 patients were confirmed pathologically as soft-tissue sarcoma of the retroperitoneum by operation or needle biopsy in Seoul National University Hospital from 1983 to 1995. A retrospective analysis was performed. RESULTS: The abdominal mass was common presenting symptom. Histologically liposarcomas(25%) and leiomyosarcomas(23.3%) were most common, and MFHs(11.7%) and malignant schwannomas(11.7%) followed. The overall 5 year survival rate was 54.6%. Complete resection was possible in 51.7% of patients and strongly predicts outcome (<0.0001). These patients had a median survival of 130 months compared to 20 months for those undergoing partial resection and 9 months for those with unresectable tumors. 11(35%) of completely resected patients have had local recurrence. These patients underwent reoperation when feasible. Complete resection of recurrent disease was performed in 10 patients(90%), with a 42 months median survival time after reoperation. Resection of adjacent organ was performed in 19 patients. 14 of these were completely resected, and showed 100% of 5 year survival rate. Tumor grade was not a significant predictor of outcome. Gender, histologic type, encapsulation, stage, resectability, combined resection were significant prognostic factors by univariate analysis. But resectability was only independent prognostic factor on mutivariate analysis. Radiation therapy and chemotherapy could not be shown to have significant impact on survival. CONCLUSION: Complete resection is the most important prognostic factor of retroperitoneal sarcoma. Extensive and aggressive surgery must be considered including resection of adjacent organs. Multiple resection seems to improve survival in recunent cases.