The Reliability and Validity of World Health Organization Quality of Life Assessment Instrument (WHOQOL) in Patients with Breast Cancer: Physical Domain and Depression / 한국유방암학회지

PURPOSE: This study was designed to investigate the reliability and validity of the World Health Organization Quality of Life Assessment Instrument (WHOQOL) in patients with breast cancer according to depressive symptoms. METHODS: One-hundred seventeen patients with breast cancer who had undergone a radical operation were recruited. The 100 item-WHOQOL instrument and Hamilton Rating Scale for Depression were used to measure all the subjects. The five domain scores, except for the WHOQOL spiritual domain, were compared between patients with and without depressive symptoms, and then the reliability and validity of the five domains were calculated. RESULTS: Depressed patients with breast cancer had lower scores in all five domains of the WHOQOL than those who were not depressed in all five domains of WHOQOL [df=(1, 115), F=46.6, p<0.001]. Reliability and validity in the physical domain of depressed patients with breast cancer decreased markedly. CONCLUSION: WHOQOL is a valid and useful instrument for evaluating the quality of life in patients with breast cancer, but is limited in scoring of depressed patients with breast cancer, particularly in the physical domain. Therefore, quality of life must be interpreted with carefully hand in depressed patients with breast cancer.

Malignant Peripheral Nerve Sheath Tumor of the Breast in a Patient without Neurofibromatosis: A Case Report / 한국유방암학회지

Malignant peripheral nerve sheath tumors (MPNSTs) are malignant variants of peripheral nerve sheath tumors that develop at major or minor peripheral nerve branches or at the sheaths of peripheral nerve fibers. These tumors are derived from Schwann cells or pluripotent cells of a neural crest origin. Malignant tumors of the peripheral nerve sheath are most commonly seen in deeper soft tissues, and usually in the proximity of a nerve trunk. MPNSTs of the breast are very uncommon and they have rarely been reported on. We report here on a case of MPNST of the breast in a 59-year-old female who presented with a painless breast lump for two months. The excisional biopsy revealed a malignant peripheral nerve sheath tumor based on the microscopic findings and immunohistochemical staining. We performed wide excision of breast tissue around the biopsy site and thereafter the patient underwent radiation therapy. The patient remains well without signs of recurrence 1 year following surgery.

Clinical review of abnormal cervical cytology in pregnancy / 대한주산의학회잡지

PURPOSE: This study was performed to evaluate the clinical significance of abnormal cervical cytology in pregnancy and the effectiveness of cytologic and colposcopic surveillance of these women. METHODS: A retrospective analysis was conducted in pregnant women referred to the colposcopic clinic with abnormal cervical cytologic results above ASCUS between Jan. 2002 and Dec. 2007. The Initial colposcopy was performed at the end of 1st trimester. Cervical cytology and colposcopy were repeated once or twice during remaining period of pregnancy and at postpartum 6~8 weeks. Colposcopy directed cervical biopsies were taken in case of colposcopic abnormalities. Without evidence of invasion, no invasive procedure was attempted during pregnancy. Above CIN2 patients were treated postnatally. The postpartum diagnoses were compared to the worst antepartum impressions and initial cytologies. RESULTS: One hundred three pregnant women were referred to colposcopic clinic for 5 years. There was no invasive cervical cancer antenatally. After delivery, 53 patients were followed up and 17 patients above CIN2 lesions treated. Two microinvasive squamous cell carcinoma and 1 invasive adenocarcinoma were found postnatally. In 33 initial ASCUS cytologies, there were 7 CIN2,3 lesions and 3 invasive cancers. One CIN3 was found in 13 LSIL cytologies. All 7 HSIL patients had CIN3 lesions. There were 2 microinvasive cancers postnatally in 17 antenatal CIN2,3 patients. CONCLUSION: ASCUS cervical cytologic results in pregnancy have 30% possibility of CIN2,3 and cancer. LSIL results are normal in 85% and HSIL group 100% CIN3. Even though there is 12.5% risk of microinvasion in antenatal CIN2,3 lesions, noninvasive conservative management is reasonable.