PURPOSE: There is a continuing question as to whether breast conserving surgery confers a measure of psychological comfort superior to that of total mastectomy for women diagnosed with breast cancer. The purpose of this study was to determine the differences of the psychiatric symptoms experienced between modified radical mastectomy and breast conserving surgery patients. METHODS: We compared 38 patients who underwent modified radical mastectomy with 16 patients who underwent breast conserving surgery from a psychiatric aspect. Psychiatric symptoms and distress were measured following surgery with two self-rating scales: the Symptom Check List-90-Revision (SCL-90-R) and the General Health Questionnaire (GHQ: 28-item version). RESULTS: There were no statistically significant differences between the modified radical mastectomy patients and the breast conserving surgery patients on the two scales. CONCLUSION: From our findings, it appears that breast conserving surgery is not superior to modified radical mastectomy in terms of psychiatric morbidity for breast cancer patients. The absence of differences between modified radical mastectomy patients and breast conserving surgery patients on psychiatric measures is probably due to several factors. In this study, these factors appeared to be a fear of cancer recurrence, the nature of breast cancer itself, the burden of radiation therapy, a late post operative period and selection bias.
Breast Neoplasms ; Breast ; Female ; Humans ; Mastectomy, Modified Radical ; Mastectomy, Segmental ; Mastectomy, Simple ; Questionnaires ; Recurrence ; Selection Bias ; Weights and Measures

PURPOSE: Breast cancer is increasing in Korea. and it has become the second most common cancer in females. This study reviewed the history of surgery and clinical analysis with follow up result on 2,677 cases of breast cancer operated at the Gospel Hospital during the 50-year period 1951 to 2000 was performed. METHODS: We reviewed breast cancer cases by operative record datas and previous reports of our hospital during the 50-year period. RESULTS: Minimal age was 14 years old and Maximal age was 90 years old in all cases. The total count of operation was 2,677 cases during the 50-year period (1951~2000). In 1951, the hospital was opened. In 1953, 52-year old female was operated by mammary amputation. In 1958, 47-year old female was operated by radical mastectomy. In 1976, 50-year old female was operated by modified radical mastectomy. Since 1996, radical mastectomy has not been operated any more. Radical mastectomy was performed in 234 cases (8.7%), modified radical mastectomy in 2,164 cases (81.0%), simple mastectomy in 79 cases (3.0%), partial mastectomy with axillary dissection in 90 cases (3.4%), wide excision in 110 cases (4.0%) Overall 5 year survival rate was 41.5% (1970~1982), 79.0% (1983~1993), 82.3% (1994~2000). CONCLUSION: This study shows the fact that the incidence of breast cancer is increasing and the minimal age is getting younger and the maximal age is getting older. The treatment for breast cancer is changing according to the period. also it will be developing.
Adolescent ; Aged, 80 and over ; Amputation ; Breast Neoplasms ; Breast ; Female ; Follow-Up Studies ; Humans ; Incidence ; Korea ; Mastectomy, Modified Radical ; Mastectomy, Radical ; Mastectomy, Segmental ; Mastectomy, Simple ; Middle Aged ; Survival Rate

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.
Breast Neoplasms* ; Breast* ; Chungcheongnam-do ; Classification ; Disease-Free Survival ; Female ; Humans ; Incidence ; Korea* ; Lymph Nodes ; Male ; Mammaplasty ; Mastectomy ; Mastectomy, Modified Radical ; Mastectomy, Radical ; Mastectomy, Segmental ; Mastectomy, Simple ; Myocutaneous Flap ; Neoplasm Metastasis ; Rectus Abdominis ; Stomach Neoplasms ; Superficial Back Muscles

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.
Breast Neoplasms ; Breast ; Chungcheongnam-do ; Classification ; Disease-Free Survival ; Female ; Humans ; Incidence ; Korea ; Lymph Nodes ; Male ; Mammaplasty ; Mastectomy ; Mastectomy, Modified Radical ; Mastectomy, Radical ; Mastectomy, Segmental ; Mastectomy, Simple ; Myocutaneous Flap ; Neoplasm Metastasis ; Rectus Abdominis ; Stomach Neoplasms ; Superficial Back Muscles

Tamoxifen is a nonsteroidal triphenylethylene delivative that has been widely used in the treatment of breast cancer. tamoxifen is indicated for the adjuvant treatment of breast cancer in women following total mastectomy or segmental mastectomy, breast irradiation and chemotherapy. tamoxifen has been shown to have significant benificial effect in the treatment of breast cancer patient as hormonal therapy. However ,there is mounting evidence that tamoxifen may affect other hormon sensitive organs, including the uterus and ovaries. An increased risk of endometrial polyps, endometrial hyperplasia and adenocarcinoma has been reported in tamoxifen treated women. We have met cases of endometrial polyp and endocervical polyp which were associated with tamoxifen use, after modified radical mastectomy for infilterating ductal carcinoma of breast . So we report these cases with the brief review of literatures.
Adenocarcinoma ; Breast ; Breast Neoplasms ; Carcinoma, Ductal ; Drug Therapy ; Endometrial Hyperplasia ; Female ; Humans ; Mastectomy, Modified Radical ; Mastectomy, Segmental ; Mastectomy, Simple ; Ovary ; Polyps* ; Tamoxifen* ; Uterus

BACKGROUND: With no current method of prevention available, early detection of breast cancer by regular self and clinical examination in conjunction with screening mammography is emphasized. The rate of asymptomatic breast cancer detection has been increased due to the ability of mammography. METHODS: To address questions about the biology and clinical manifestation of mammographically detected breast cancer, a retrospective analysis was performed to the 31 cases of asymptomatic breast cancer treated from Jan. 1989 to Dec. 1996 at Department of Surgery, Seoul National University Hospital. RESULTS: The mean age was 50.0 with ranges from 27 to 80. The peak age was 5th decade. The most common mammographic findings of asymptomatic breast cancer was microcalcification (22 cases, 71.1%). Eighteen patients underwent modified radical mastectomy (58.1%): simple mastectomy in 4 cases (12.9%), and breast conserving surgery in 9 cases (29.0%). The histologic types were as follows: infiltrating ductal carcinoma in 17 cases (64.5%), microinvasive carcinoma in 3 cases (9.6%) and ductal carcinoma in situ in 9 cases (29.0%). Twenty one patients showed smaller than 1 cm in tumor size. Only 3 cases of invasive ductal carcinomas had axillary nodal metastasis. All cases except four cases demonstrated stage 0 (29.1%) and stage I (54.8%) according to the AJCC classification: whereas the rate of stage 0 and I in symptomatic patients during same study period was 4.1% and 19.6% respectively. CONCLUSIONS: The result of our study indicate that several benefits of mammographic screening are likely the result of detection of invasive carcinoma at an early stage and detection of noninvasive carcinoma that may later develop into or mark increased risk of invasive carcinoma. A prospective and systematic approach for evaluating efficiency of screening mammography would be necessary in Korea.
Biology ; Breast Neoplasms ; Breast ; Carcinoma, Ductal ; Carcinoma, Intraductal, Noninfiltrating ; Classification ; Humans ; Korea ; Mammography ; Mass Screening ; Mastectomy, Modified Radical ; Mastectomy, Segmental ; Mastectomy, Simple ; Neoplasm Metastasis ; Retrospective Studies ; Seoul

BACKGROUND: With no current method of prevention available, early detection of breast cancer by regular self and clinical examination in conjunction with screening mammography is emphasized. The rate of asymptomatic breast cancer detection has been increased due to the ability of mammography. METHODS: To address questions about the biology and clinical manifestation of mammographically detected breast cancer, a retrospective analysis was performed to the 31 cases of asymptomatic breast cancer treated from Jan. 1989 to Dec. 1996 at Department of Surgery, Seoul National University Hospital. RESULTS: The mean age was 50.0 with ranges from 27 to 80. The peak age was 5th decade. The most common mammographic findings of asymptomatic breast cancer was microcalcification (22 cases, 71.1%). Eighteen patients underwent modified radical mastectomy (58.1%): simple mastectomy in 4 cases (12.9%), and breast conserving surgery in 9 cases (29.0%). The histologic types were as follows: infiltrating ductal carcinoma in 17 cases (64.5%), microinvasive carcinoma in 3 cases (9.6%) and ductal carcinoma in situ in 9 cases (29.0%). Twenty one patients showed smaller than 1 cm in tumor size. Only 3 cases of invasive ductal carcinomas had axillary nodal metastasis. All cases except four cases demonstrated stage 0 (29.1%) and stage I (54.8%) according to the AJCC classification: whereas the rate of stage 0 and I in symptomatic patients during same study period was 4.1% and 19.6% respectively. CONCLUSIONS: The result of our study indicate that several benefits of mammographic screening are likely the result of detection of invasive carcinoma at an early stage and detection of noninvasive carcinoma that may later develop into or mark increased risk of invasive carcinoma. A prospective and systematic approach for evaluating efficiency of screening mammography would be necessary in Korea.
Biology ; Breast Neoplasms ; Breast ; Carcinoma, Ductal ; Carcinoma, Intraductal, Noninfiltrating ; Classification ; Humans ; Korea ; Mammography ; Mass Screening ; Mastectomy, Modified Radical ; Mastectomy, Segmental ; Mastectomy, Simple ; Neoplasm Metastasis ; Retrospective Studies ; Seoul

BACKGROUND: With no current method of prevention available, early detection of breast cancer by regular self and clinical examination in conjunction with screening mammography is emphasized. The rate of asymptomatic breast cancer detection has been increased due to the ability of mammography. METHODS: To address questions about the biology and clinical manifestation of mammographically detected breast cancer, a retrospective analysis was performed to the 31 cases of asymptomatic breast cancer treated from Jan. 1989 to Dec. 1996 at Department of Surgery, Seoul National University Hospital. RESULTS: The mean age was 50.0 with ranges from 27 to 80. The peak age was 5th decade. The most common mammographic findings of asymptomatic breast cancer was microcalcification (22 cases, 71.1%). Eighteen patients underwent modified radical mastectomy (58.1%): simple mastectomy in 4 cases (12.9%), and breast conserving surgery in 9 cases (29.0%). The histologic types were as follows: infiltrating ductal carcinoma in 17 cases (64.5%), microinvasive carcinoma in 3 cases (9.6%) and ductal carcinoma in situ in 9 cases (29.0%). Twenty one patients showed smaller than 1 cm in tumor size. Only 3 cases of invasive ductal carcinomas had axillary nodal metastasis. All cases except four cases demonstrated stage 0 (29.1%) and stage I (54.8%) according to the AJCC classification: whereas the rate of stage 0 and I in symptomatic patients during same study period was 4.1% and 19.6% respectively. CONCLUSIONS: The result of our study indicate that several benefits of mammographic screening are likely the result of detection of invasive carcinoma at an early stage and detection of noninvasive carcinoma that may later develop into or mark increased risk of invasive carcinoma. A prospective and systematic approach for evaluating efficiency of screening mammography would be necessary in Korea.
Biology ; Breast Neoplasms ; Breast ; Carcinoma, Ductal ; Carcinoma, Intraductal, Noninfiltrating ; Classification ; Humans ; Korea ; Mammography ; Mass Screening ; Mastectomy, Modified Radical ; Mastectomy, Segmental ; Mastectomy, Simple ; Neoplasm Metastasis ; Retrospective Studies ; Seoul

BACKGROUND: With no current method of prevention available, early detection of breast cancer by regular self and clinical examination in conjunction with screening mammography is emphasized. The rate of asymptomatic breast cancer detection has been increased due to the ability of mammography. METHODS: To address questions about the biology and clinical manifestation of mammographically detected breast cancer, a retrospective analysis was performed to the 31 cases of asymptomatic breast cancer treated from Jan. 1989 to Dec. 1996 at Department of Surgery, Seoul National University Hospital. RESULTS: The mean age was 50.0 with ranges from 27 to 80. The peak age was 5th decade. The most common mammographic findings of asymptomatic breast cancer was microcalcification (22 cases, 71.1%). Eighteen patients underwent modified radical mastectomy (58.1%): simple mastectomy in 4 cases (12.9%), and breast conserving surgery in 9 cases (29.0%). The histologic types were as follows: infiltrating ductal carcinoma in 17 cases (64.5%), microinvasive carcinoma in 3 cases (9.6%) and ductal carcinoma in situ in 9 cases (29.0%). Twenty one patients showed smaller than 1 cm in tumor size. Only 3 cases of invasive ductal carcinomas had axillary nodal metastasis. All cases except four cases demonstrated stage 0 (29.1%) and stage I (54.8%) according to the AJCC classification: whereas the rate of stage 0 and I in symptomatic patients during same study period was 4.1% and 19.6% respectively. CONCLUSIONS: The result of our study indicate that several benefits of mammographic screening are likely the result of detection of invasive carcinoma at an early stage and detection of noninvasive carcinoma that may later develop into or mark increased risk of invasive carcinoma. A prospective and systematic approach for evaluating efficiency of screening mammography would be necessary in Korea.
Biology ; Breast Neoplasms ; Breast ; Carcinoma, Ductal ; Carcinoma, Intraductal, Noninfiltrating ; Classification ; Humans ; Korea ; Mammography ; Mass Screening ; Mastectomy, Modified Radical ; Mastectomy, Segmental ; Mastectomy, Simple ; Neoplasm Metastasis ; Retrospective Studies ; Seoul

PURPOSE: Screening mammography is now a widely used procedure and as result, the incidence of ductal carcinoma in situ (DCIS) of the breast is increasing. The purpose of this study was to investigate the incidence and clinicopathologic features of DCIS and to evaluated the difference of clinical characteristics between breast conserving surgery and mastectomy. METHODS: We reviewed the clinical record of 112 patients with DCIS, including those with microinvasion, who were treated at the Department of Surgery, Keimyung University Hospital from January 1992 to December 2005. RESULTS: The incidence of DCIS and microinvasive carcinoma was 8.0% of all the breast cancers. The most prevalent age was in the fifth decade and the mean age was 48.8 years old. An abnormality on routine health screening exams was the most common cause of detection. Preoperatively, the diagnostic methods were fine needle aspiration biopsy in 7.6%, core needle biopsy in 19.0%, needle localization open biopsy in 33.3% and excisional biopsy in 40.0%. The surgical procedures were modified radical mastectomy or simple mastectomy in 48.2% and a breast conservation procedure in 51.8%. The final surgical margin status showed a free margin in 83.0%, a close margin in 12.8%, and an involved margin in 4.3%. The hormonal receptor positive rate was 75.3% and the c-erbB-2 positive rate was 32.9%. The patient who received mastectomy had a larger tumor size, a more common presentation of microcalcification on MMG, a more frequent comedo type lesion and a lesser expression of hormonal receptor. There was no significant difference between the two groups in terms of the c-erbB-2 expression. CONCLUSION: The widespread use of screening mammography will increase the chance to detect DCIS, and conservative surgery will be performed more frequently in a selected group of these patients.
Biopsy ; Biopsy, Fine-Needle ; Biopsy, Large-Core Needle ; Breast Neoplasms ; Breast ; Carcinoma, Ductal ; Carcinoma, Intraductal, Noninfiltrating ; Humans ; Incidence ; Mammography ; Mass Screening ; Mastectomy ; Mastectomy, Modified Radical ; Mastectomy, Segmental ; Mastectomy, Simple ; Needles