ABSTRACT
PURPOSE: Breast cancer is the most frequently occurring cancer in Korean women, and recently its incidence has rapidly increased. The purpose of this study was to show the survival rate and prognostic factors for breast cancer in Korean women. METHODS: Nine hundred and eighty nine consecutive breast cancer patients, first diagnosed at the Dongsan Medical Center, Keimyung University between January 1990 and December 2001, were included in this study. RESULTS: The peak incidence occurred in the 40's age group, and the average age at diagnosis was 48.1 years old. Forty four patients (4.4%) were in stage 0, 218 (22.0%) in stage I, 572 (57.9%) in stage II, 112 (11.4%) in stage III, and 22 (2.2%) in stage IV. The 5 and 10 year disease free and overall survival rates were 73.8 and 68.8 and 79.7% and 65.4%, respectively. A univariate analysis of the prognostic factors showed that age, tumor size and number of metastatic lymph nodes were statistically significant. A multivariate analysis showed that the the number of metastatic lym, ph nodes was the most significant factor for the time to recurrence and overall mortality. CONCLUSION: This study showed that the peak age of the breast cancer patients in Korea was younger than that seen in Western countries, and the survival rates were similar, despite our patients being comprised of a smaller proportion of early breast cancers. The age at time of diagnosis, tumor size, and number of axillary lymph nodes involved were confirmed to have independent influence on the overall survival and disease free survival rates.
Subject(s)
Female , Humans , Breast Neoplasms , Breast , Diagnosis , Disease-Free Survival , Hydrogen-Ion Concentration , Incidence , Korea , Lymph Nodes , Mortality , Multivariate Analysis , Recurrence , Survival RateABSTRACT
PURPOSE: Clustered microcalcifications on mammogram represent an important feature of the breast cancer, especially that of intraductal carcinoma. The positive predictive value for malignancy of the clustered microcalcifications has been reported to be between 20 and 30%. This study was carried out to determine the radio-histological correlation of clustered microcalcifications seen on mammograms in a university hospital in Daegu, Korea. METHODS: The medical records of 77 consecutive patients who underwent wire localization biopsy for clustered microcalcifications between January 1997 and March 2001 were reviewed. Patients with palpable mass in the breast were excluded. All of the mammograms were read by a single radiologist and interpreted as at least category 3 or above according to the American College of Radiology Breast Imaging Reporting and Data System (BIRADS). The localization was done using a J wire in the Diagnostic radiology department in the morning on the day of surgery. Removal of the clustered microcalcifications was confirmed in each case with specimen mammography. RESULTS: All patient were female, with mean age of 47.7 years old. There was no complication from the procedures. Excision of the microcalcifications was incomplete in four patients, giving the successful complete excision rate of 94.8%. Pathologic report showed malignancy in 29.9% consisting of ductal carcinoma in situ in 19.5% and invasive carcinoma in 10.4%. Only one of eight patients with invasive carcinoma had axillary lymph node involvement. CONCLUSION: Needle localized surgical biopsy is safe, rapid, and accurate method for localizing small, potentially highly curable breast cancers with minimal sacrifice of breast tissue.
Subject(s)
Female , Humans , Biopsy , Breast , Breast Neoplasms , Carcinoma, Intraductal, Noninfiltrating , Information Systems , Korea , Lymph Nodes , Mammography , Medical Records , NeedlesABSTRACT
PURPOSE: With better screening methods and patient awareness in recent years, more early stage breast cancers are being found than in the past. The outcome of breast conservation therapy for patients with early stage breast carcinoma were retrospectively reviewed, and analyses carried out to obtain the 5 and 10 year disease free survival rates and significant prognostic factors. METHODS: One hundred and fifty nine breast cancer patients were treated with breast conserving therapy, consisting of wide excision, axillary dissection and radiotherapy, for early stage breast cancer at the Keimyung University Dongsan Medical Center between 1992 and December 2001. The five and 10 year survival rates were obtained using the Kaplan- Meier method and the prognostic factors were studied with univariate and multivariate analyses using SPSS 11.0. RESULTS: The average age at the time of operation was 44.7 years, and the mean tumor size was 1.84 cm. One hundred and eleven patients (69.8%) had pathologically node negative diseases. During a median follow up of 48.7 months, 16 patients developed local and/or systemic recurrences. The 5 and 10 year disease free survivals were 88.0 and 86.0%, respectively. The univariate analysis of the prognostic factors showed that the age at the time of operation (35 years or younger vs. 36 years or older; P=0.0051) and lymph node status (P=0.0015) were statistically significantly associated with a recurrence. The results of the multivariate analysis revealed that the number of axillary lymph node was the strongest independent predictor for a recurrence. CONCLUSION: A breast conserving procedure is useful and effective for patients with early stage breast cancer, and the axillary status was the strongest independent predictor for a recurrence.
Subject(s)
Humans , Breast Neoplasms , Breast , Disease-Free Survival , Follow-Up Studies , Lymph Nodes , Mass Screening , Mastectomy, Segmental , Multivariate Analysis , Radiotherapy , Recurrence , Retrospective Studies , Survival RateABSTRACT
BACKGROUND: A desmoid tumor is a rare neoplasm of a mature fibroblast within an extensive collagen matrix. These tumors are classified pathologically as aggressive fibromatosis with local invasiveness, showing recurrences after surgical treatment, although they do not metastasize. Complete surgical excision without leaving a remnant tumor seems to be the primary treatment option, but these tumors often recur after resection. Therefore, alternative treatment strategies, including radiation therapy, nonsteroidal anti-inflammatory agents, anti-estrogen compounds, and cytotoxic chemotherapy, have been employed. METHOD: The authors report the clinical characteristics and prognoses after treatment for seven patients who were diagnosed as having desmoid tumors and who underwent surgical excision for therapy during the ten-year period from 1986 to 1997 at Keimyung University Dongsan Medical Center. RESULTS: There were two males and five females. The most common chief complaint was a slowly growing painless mass. The duration of the symptom before diagnosis was quite different from patient to patient. The locations in the trunk were scattered diffusely: the shoulder, the chest wall, the abdominal wall, the retroperitoneum, and the pelvic cavity. The tumors were well visualized by imaging techniques such as ultrasonograms, CT scans, and MRI. Four of the seven patients experienced recurrent tumors after surgical excision; two are dead. The tumors in the recurrent patients were excised incompletely at initial surgery. CONCLUSION: Although the uncommon, solid desmoid tumors which develop in the musculoaponeurosis of the trunk are benign pathologically, they were recurrent after surgical excision when the resection margin is incomplete. Therefore, complete excision is the only curative therapeutic modality.
Subject(s)
Female , Humans , Male , Abdominal Wall , Anti-Inflammatory Agents, Non-Steroidal , Collagen , Diagnosis , Drug Therapy , Fibroblasts , Fibroma , Fibromatosis, Aggressive , Magnetic Resonance Imaging , Prognosis , Recurrence , Shoulder , Thoracic Wall , Tomography, X-Ray Computed , UltrasonographyABSTRACT
Detecting malignant cells in ascitic fluid from tumor patients is important since the existence of malignant cells in ascitic fluids is related to the prognosis of patients. Various laboratory methods are being used to obtain diagnosis in ascitic fluids, but some ascitic fluids can not be diagnosed reliably. Cytogenetic analysis of ascitic fluid is not used routinely as a laboratory tool. In this presentation a cytogenetic study of the ascitic fluids from 9 patients with malignant tumor was performed by a direct or short-term culture method. According to cytogenetic study, 5 cases had positive findings for malignant cells. One case had a inconclusive result. There were no malignant cells in the remaining 4 cases. On blind cytologic data, no informations could be obtained in 4 out of 9 cases and the remaining 5 cases had negative findings for detecting malignant cells. Among the 5 cases, cytogenetic findings were negative in 3 cases but in the remaining 2 cases, one was reported positive and the other inconclusive each other. In present study, even though the ascitic fluids from 5 patients were subjected to the comparison of the cytologic study with cytogenetic analysis, two different findings could be obtained. Therefore if further study of a large series of cancer patients with ascitic fluids is done, the value of cytogenetic analysis will be clearly shown. In addition, the cytogenetic study of cell present in ascitic fluids can be used as useful adjunct to cytologic study, and also it can indicate that more invasive diagnostic procedures are necessary.
Subject(s)
Humans , Ascitic Fluid , Cytogenetic Analysis , Cytogenetics , Diagnosis , PrognosisABSTRACT
During a 12-month period high-resolution, real-time ultrasonography (US) with graded compression was performed on 268 consecutive patients with clinically suspected acute appendicitis and its complication. US visualization of a fluid-filled, non-compressed appendix or a decompressed, thick-walled appendix was the primary criterion for a diagnosis of acute appendicitis. The sonographic findings were correlated with surgical-pathologic outcome in 92 cases and with the findings of clinical follow-up in the remainder. US was found to be accurate in the diagnosis of acute appendicitis and its complication with a sensitivity of 93.3%, a specificity of 98.9%, and an accuracy of 97%. The predictive value of a positive test was 97.7%; that of a negative test was 96.7%. There were two false-positive examination in patients with a thick-walled appendix or periapperdiceal abscess, which were surgically confirmed as appendiceal adenocarcinoma and perforated cecal diverticulitis respectively. There were six false-negative examination in patients with a sonographically no-visible appendix, which were confirmed surgically as acute appendicitis(n=5) and perforated appendicitis(n=1). Our results show that high-resolution, real-time US is an accureate imaging modality in the diagnosis of acute appendicitis and the evaluation of its complication.