Clinical Analysis of Breast Cancer Surgeries in Korea

PURPOSE: In Korea, the incidence of breast cancer is continuously growing year after year, and it has become the second most common cancer in females following stomach cancer. This study analyzed the clinical results of 2,101 breast cancer surgeries performed in Korea. METHODS: 2,101 breast cancer surgeries were performed between Mar. 1989 and Dec. 1999 at the Breast Clinic in Asan Medical Center. RESULTS: Of 2,101 patients, 2,085 cases were female (99.2%), and 16 cases were male (0.8%). The mean age of the patients was 46 and 65% of them were under the age of 50. A radical mastectomy was performed in 1.0% of cases, a modified radical mastectomy in 75.4%, a simple mastectomy in 4.1%, breast-conserving surgery in 15.5%, and other procedures in 3.9%. Immediate breast reconstruction was performed in 136 cases (tissue expander in 61 cases, direct implant in 10 cases, transverse rectus abdominis muscle (TRAM) flap in 62 cases, and latissimus dorsi myocutaneous flap in 3 cases). The majority of reconstruction was changed to skin-sparing mastectomy (SSM) with TRAM flap. According to TNM classification, there were 156 cases (7.4%) of stage 0, 538 cases (25.6%) of stage I, 1,062 cases (50.6%) of stage II, 241 cases (11.5%) of stage III, 65 cases (3.1%) of stage IV, and 39 cases (1.9%) of an unknown stage. The axillary lymph node metastasis was present in 43.2%. The 5-year overall and disease-free survival rates were 83.1% and 76.7%, respectively. CONCLUSION: This study shows several features suggesting that the peak age of breast cancer in Korea is younger than that seen in western countries and that the types of Korean breast cancer tend to be similar to western patterns.

Clinical Analysis of Breast Cancer Surgeries in Korea

PURPOSE: In Korea, the incidence of breast cancer is continuously growing year after year, and it has become the second most common cancer in females following stomach cancer. This study analyzed the clinical results of 2,101 breast cancer surgeries performed in Korea. METHODS: 2,101 breast cancer surgeries were performed between Mar. 1989 and Dec. 1999 at the Breast Clinic in Asan Medical Center. RESULTS: Of 2,101 patients, 2,085 cases were female (99.2%), and 16 cases were male (0.8%). The mean age of the patients was 46 and 65% of them were under the age of 50. A radical mastectomy was performed in 1.0% of cases, a modified radical mastectomy in 75.4%, a simple mastectomy in 4.1%, breast-conserving surgery in 15.5%, and other procedures in 3.9%. Immediate breast reconstruction was performed in 136 cases (tissue expander in 61 cases, direct implant in 10 cases, transverse rectus abdominis muscle (TRAM) flap in 62 cases, and latissimus dorsi myocutaneous flap in 3 cases). The majority of reconstruction was changed to skin-sparing mastectomy (SSM) with TRAM flap. According to TNM classification, there were 156 cases (7.4%) of stage 0, 538 cases (25.6%) of stage I, 1,062 cases (50.6%) of stage II, 241 cases (11.5%) of stage III, 65 cases (3.1%) of stage IV, and 39 cases (1.9%) of an unknown stage. The axillary lymph node metastasis was present in 43.2%. The 5-year overall and disease-free survival rates were 83.1% and 76.7%, respectively. CONCLUSION: This study shows several features suggesting that the peak age of breast cancer in Korea is younger than that seen in western countries and that the types of Korean breast cancer tend to be similar to western patterns.

Clinical Analysis of Breast Cancer Surgeries in Korea / 한국유방암학회지

PURPOSE: In Korea, the incidence of breast cancer is continuously growing year after year, and it has become the second most common cancer in females following stomach cancer. This study analyzed the clinical results of 2,101 breast cancer surgeries performed in Korea. METHODS: 2,101 breast cancer surgeries were performed between Mar. 1989 and Dec. 1999 at the Breast Clinic in Asan Medical Center. RESULTS: Of 2,101 patients, 2,085 cases were female (99.2%), and 16 cases were male (0.8%). The mean age of the patients was 46 and 65% of them were under the age of 50. A radical mastectomy was performed in 1.0% of cases, a modified radical mastectomy in 75.4%, a simple mastectomy in 4.1%, breast-conserving surgery in 15.5%, and other procedures in 3.9%. Immediate breast reconstruction was performed in 136 cases (tissue expander in 61 cases, direct implant in 10 cases, transverse rectus abdominis muscle (TRAM) flap in 62 cases, and latissimus dorsi myocutaneous flap in 3 cases). The majority of reconstruction was changed to skin-sparing mastectomy (SSM) with TRAM flap. According to TNM classification, there were 156 cases (7.4%) of stage 0, 538 cases (25.6%) of stage I, 1,062 cases (50.6%) of stage II, 241 cases (11.5%) of stage III, 65 cases (3.1%) of stage IV, and 39 cases (1.9%) of an unknown stage. The axillary lymph node metastasis was present in 43.2%. The 5-year overall and disease-free survival rates were 83.1% and 76.7%, respectively. CONCLUSION:This study shows several features suggesting that the peak age of breast cancer in Korea is younger than that seen in western countries and that the types of Korean breast cancer tend to be similar to western patterns.

Outcome of Surgical Excision for Isolated Locoregional Recurrence of Breast Cancer / 한국유방암학회지

PURPOSE: Locoregional recurrence of breast cancer after surgery has been regarded as a harbinger of distant metastases. The present study was undertaken to determine survival following surgical excision of isolated locoregional recurrence and to analyze prognostic factors for impact on survival after locoregional recurrence. Also, this study may provide information on the benefit group from surgical management. METHODS: From March 1993 to December 1998, of 43 patients with isolated locoregional recurrence after breast cancer surgery, 26 patients were treated with surgical excision with or without irradiation. Survival was analyzed according to prognostic factors retrospectively. RESULTS: The median follow-up was 15 months. the 3-year disease-free and overall survival was 50% and 63% for locoregional recurrences treated with surgical resection, and 6% and 14% for patients without surgery, respectively(p=0.04, p=0.07). Univariative analysis demonstrated that the initial axillary node status and the disease-free interval were found to be significant prognostic factors for overall survival(p=0.04, p=0.06). The disease-free interval from surgery to recurrence was also a significant prognostic factor for disease-free survival(p=0.03). CONCLUSION: These results suggest that isolated locoregional recurrence of breast cancer with a long disease-free interval and an initial node negative status may survived for long periods of time with aggressive surgical treatment.

Outcome of Surgical Excision for Isolated Locoregional Recurrence of Breast Cancer

PURPOSE: Locoregional recurrence of breast cancer after surgery has been regarded as a harbinger of distant metastases. The present study was undertaken to determine survival following surgical excision of isolated locoregional recurrence and to analyze prognostic factors for their impact on survival after locoregional recurrence. Also, this study may provide information on the group that benefits from surgical management. METHODS: From March 1993 to December 1998, of 43 patients with isolated locoregional recurrence after breast cancer surgery, 26 patients were treated with surgical excision with or without irradiation. Survival was retrospectively analyzed according to prognostic factors. RESULTS: The median follow-up was 15 months. The 3-year disease-free survival rates were 50% for locoregional recurrences treated with surgical resection and 6% for patients treated without surgery (p=0.04), and the overall survival rates were 63% and 14%, respectively (p=0.07). Univariative analysis demonstrated that the initial axillary node status and the disease-free interval were significant prognostic factors for overall survival (p=0.04 and p=0.06, respectively). The disease-free interval from surgery to recurrence was also a significant prognostic factor for disease-free survival (p=0.03). CONCLUSION: These results suggest that patients suffering from isolated locoregional recurrence of breast cancer after a long disease-free interval and an initial node negative status may survive for long periods of time with aggressive surgical treatment.

Patterns of Locoregional and Systemic Failure after a Mastectomy in Breast Cancer and Risk Factors Predicting Failure

PURPOSE: In spite of improved local control and adjuvant therapy in breast cancer, many patients after a modified radical mastectomy suffer from locoregional or systemic failure. The purpose of this study was to assess both the patterns of failure following a mastectomy and the predictive factors affecting the risks of locoregional or systemic failure. METHODS: The study population consisted of 195 patients who developed locoregional or systemic failure from among 1,187 patients treated by using a modified radical mastectomy between July 1989 and October 1998 at the Asan Medical Center's Breast Clinic. The median follow-up time following the mastectomy was 41 months (range; 1-119 months). RESULTS: Isolated locoregional recurrence (LRR) developed in 46 patients (24%), LRR with distant metastasis in 43 (22%), and only distant metastasis in 106 (54%). The sites of LRR were as follows: the chest wall, 52%; the ipsilateral supraclaviclar node, 22%; and the axillary node, 15%; etc. The first sites of distant metastasis were as follows: bone, 46%; lung, 38%; liver, 12%; brain, 6%; and pleura, 6%; etc. Local or systemic failure appeared within the first 3 years following the mastectomy in 75-82% of the patients, and within 5 years in 95-98%. Multivariate analysis showed that increasing initial tumor size, increasing number of involved nodes, negative progesterone receptor, and increasing histologic grade were significant factors for increased risks of LLR or distant metastasis. CONCLUSION: Half of the locoregional recurrences following a mastectomy are isolated. T-stage, nodal status, progesterone receptor, and histo logic grade may help to identify patients at risk for locoregional or systemic failure after a mastectomy.