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Rare cancer
Clinical Features of Li-Fraumeni Syndrome in Korea
Ran Song, Sun-Young Kong, Wonyoung Choi, Eun-Gyeong Lee, Jaeyeon Woo, Jai Hong Han, Seeyoun Lee, Han-Sung Kang, So-Youn Jung
Cancer Res Treat. 2024;56(1):334-341.   Published online August 9, 2023
DOI: https://doi.org/10.4143/crt.2023.794
AbstractAbstract PDFSupplementary MaterialPubReaderePub
Purpose
Li-Fraumeni syndrome (LFS) is a hereditary disorder caused by germline mutation in TP53. Owing to the rarity of LFS, data on its clinical features are limited. This study aimed to evaluate the clinical characteristics and prognosis of Korean patients with LFS.
Materials and Methods
Patients who underwent genetic counseling and confirmed with germline TP53 mutation in the National Cancer Center in Korea between 2011 and 2022 were retrospectively reviewed. Data on family history with pedigree, types of mutation, clinical features, and prognosis were collected.
Results
Fourteen patients with LFS were included in this study. The median age at diagnosis of the first tumor was 32 years. Missense and nonsense mutations were observed in 13 and one patients, respectively. The repeated mutations were p.Arg273His, p.Ala138Val, and pPro190Leu. The sister with breast cancer harbored the same mutation of p.Ala138Val. Seven patients had multiple primary cancers. Breast cancer was most frequently observed, and other types of tumor included sarcoma, thyroid cancer, pancreatic cancer, brain tumor, adrenocortical carcinoma, ovarian cancer, endometrial cancer, colon cancer, vaginal cancer, skin cancer, and leukemia. The median follow-up period was 51.5 months. Two and four patients showed local recurrence and distant metastasis, respectively. Two patients died of leukemia and pancreatic cancer 3 and 23 months after diagnosis, respectively.
Conclusion
This study provides information on different characteristics of patients with LFS, including types of mutation, types of cancer, and prognostic outcomes. For more appropriate management of these patients, proper genetic screening and multidisciplinary discussion are required.

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  • Consensus Statement: Recommendations on Actionable Biomarker Testing for Thyroid Cancer Management
    Ozgur Mete, Andrée Boucher, Kasmintan A. Schrader, Omar Abdel-Rahman, Houda Bahig, Cheryl Ho, Olfat Kamel Hasan, Bernard Lemieux, Eric Winquist, Ralph Wong, Jonn Wu, Nicole Chau, Shereen Ezzat
    Endocrine Pathology.2024;[Epub]     CrossRef
  • 3,284 View
  • 191 Download
  • 1 Crossref
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Breast cancer
Health-Seeking Behavior Returning to Normalcy Overcoming COVID-19 Threat in Breast Cancer
Eun-Gyeong Lee, Yireh Han, Dong-Eun Lee, Hyeong-Gon Moon, Hyoung Won Koh, Eun-Kyu Kim, So-Youn Jung
Cancer Res Treat. 2023;55(4):1222-1230.   Published online April 3, 2023
DOI: https://doi.org/10.4143/crt.2023.364
AbstractAbstract PDFSupplementary MaterialPubReaderePub
Purpose
The coronavirus disease 2019 (COVID-19) outbreak has significantly impacted the diagnosis and treatment of breast cancer. Our study investigated the change in diagnosis and treatment of breast cancer with the progress of COVID-19 pandemic.
Materials and Methods
The study group comprised 6,514 recently diagnosed breast cancer patients between January 1, 2019, and February 28, 2021. The patients were divided into two groups: pre–COVID-19 period (3,182; January 2019 to December 2019) and COVID-19 pandemic period (3,332; January 2020 to February 2021). Clinicopathological information related to the first treatment after breast cancer diagnosis was retrospectively collected and analyzed in the two groups.
Results
Among the 6,514 breast cancer patients, 3,182 were in the pre–COVID-19 period and 3,332 were in the COVID-19 pandemic period. According to our evaluation, the least breast cancer diagnosis (21.8%) was seen in the first quarter of 2020. The diagnosis increased gradually except for the fourth quarter in 2020. While early-stage breast cancer was diagnosed 1,601 (48.1%) during the COVID-19 pandemic (p=0.001), the number of surgical treatments increased 4.6% (p < 0.001), and the treatment time was slightly shorter 2 days (p=0.001). The breast cancer subtype distribution was not statistically different between the pre–COVID-19 and COVID-19 period groups.
Conclusion
In the early stages of the pandemic, the number of breast cancer cases temporarily decreased; however, they stabilized soon, and no significant differences could be identified in the diagnosis and treatment when compared to the period before the pandemic.
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Androgen Receptor as a Predictive Marker for Pathologic Complete Response in Hormone Receptor–Positive and HER-2–Negative Breast Cancer with Neoadjuvant Chemotherapy
Eun-Gyeong Lee, Dong-Eun Lee, Hyun hee Kim, Jai Hong Han, Seeyoun Lee, Han-Sung Kang, Eun Sook Lee, Heejung Chae, Sung Hoon Sim, Keun Seok Lee, Youngmee Kwon, So-Youn Jung
Cancer Res Treat. 2023;55(2):542-550.   Published online September 8, 2022
DOI: https://doi.org/10.4143/crt.2022.834
AbstractAbstract PDFSupplementary MaterialPubReaderePub
Purpose
This study investigated pathological complete response (pCR) according to androgen receptor (AR) in breast cancer patients undergoing neoadjuvant chemotherapy and estimated the relationship between AR expression and clinicopathological factors.
Materials and Methods
We identified 624 breast cancer patients who underwent surgery after neoadjuvant chemotherapy at the National Cancer Center in Goyang, Korea from April 2016 to October 2019. We retrospectively collected the clinicopathologic information and AR expression results and analyzed the data according to cancer stage, hormonal receptor (HR) status, human epidermal growth factor receptor 2 (HER2) status, tumor subtype, and pCR.
Results
Among the 624 breast cancer patients, 529 (84.8%) were AR-positive (AR+) patients and 95 (15.2%) were AR-negative (AR–) patients. AR+ patients showed more estrogen receptor (ER) positivity, progesterone receptor (PR) positivity, HER2-positivity, and HR-positive and HER2-negative (HR+/HER2–) subtype. The rate of pCR was 31.4% (196/624). AR– patients had a significantly higher rate of pCR than AR+ patients (AR– 43.2% vs. AR+ 29.3%, p=0.007). The tumor factors associated with pCR were early stage, histologic grade 3, ER-negative, PR-negative, AR-negative, HER2-positive, and high Ki-67 values. In univariable analysis, AR+ significantly decreased the state of pCR (odds ratio, 0.546; 95% confidence interval, 0.349 to 0.853; p=0.008). According to tumor subtype, AR– tumor showed higher pCR rate in HR+/HER2– subtype (AR– 28.6% vs. AR+ 7.3%, p=0.022).
Conclusion
AR expression is predominant in the HR+/HER2– subtype. AR– is significantly associated with the pCR rate in breast cancer patients, especially within HR+/HER2– subtype. When determining neoadjuvant chemotherapy for the HR+/HER2– subtype, AR expression can be considered as a pCR predictive marker.

Citations

Citations to this article as recorded by  
  • Neo-adjuvant therapies for ER positive/HER2 negative breast cancers: from chemotherapy to hormonal therapy, CDK inhibitors, and beyond
    Athina Stravodimou, Ioannis A. Voutsadakis
    Expert Review of Anticancer Therapy.2024; 24(3-4): 117.     CrossRef
  • Luminal androgen receptor subtype and tumor-infiltrating lymphocytes groups based on triple-negative breast cancer molecular subclassification
    Miseon Lee, Tae-Kyung Yoo, Byung Joo Chae, Ahwon Lee, Yoon Jin Cha, Jieun Lee, Sung Gwe Ahn, Jun Kang
    Scientific Reports.2024;[Epub]     CrossRef
  • Evaluating the Clinico-Pathological Relationship Between Stromal Tumor-Infiltrating Lymphocytes and Androgen Receptor Expression Across Molecular Subtypes of Invasive Breast Carcinoma
    Adil Aziz Khan, Sana Ahuja, Kiruthikasri G., Sufian Zaheer
    Indian Journal of Surgical Oncology.2024; 15(4): 802.     CrossRef
  • Biomarkers and translational research approaches in breast cancer—an update
    Angelika M. Starzer, Anna S. Berghoff, Rupert Bartsch
    memo - Magazine of European Medical Oncology.2023; 16(1): 42.     CrossRef
  • Evaluation of predictive and prognostic value of androgen receptor expression in breast cancer subtypes treated with neoadjuvant chemotherapy
    Zhendong Shi, Yingxue Liu, Shichao Zhang, Shuanglong Cai, Xu Liu, Jie Meng, Jin Zhang
    Discover Oncology.2023;[Epub]     CrossRef
  • 5,010 View
  • 174 Download
  • 5 Web of Science
  • 5 Crossref
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Fear of Cancer Recurrence and Its Negative Impact on Health-Related Quality of Life in Long-term Breast Cancer Survivors
Thi Xuan Mai Tran, So-Youn Jung, Eun-Gyeong Lee, Heeyoun Cho, Na Yeon Kim, Sungkeun Shim, Ho Young Kim, Danbee Kang, Juhee Cho, Eunsook Lee, Yoon Jung Chang, Hyunsoon Cho
Cancer Res Treat. 2022;54(4):1065-1073.   Published online December 8, 2021
DOI: https://doi.org/10.4143/crt.2021.835
AbstractAbstract PDFSupplementary MaterialPubReaderePub
Purpose
Fear of cancer recurrence (FCR) is a common psychological issue in breast cancer (BC) survivors during early survivorship but whether the same is true among long-term survivors has yet to be empirically evaluated. This study investigated FCR level, its associated factors, and impact on quality of life (QoL) in long-term BC survivors.
Materials and Methods
Participants included women diagnosed with BC between 2004 and 2010 at two tertiary hospitals. Survey was conducted in 2020. The study measured FCR with the Fear of Cancer Recurrence Inventory and other patient-reported outcomes, including depression and cancer-related QoL. Logistic regression was used to identify factors associated with FCR, and structural equation modeling was conducted to explore the impact of FCR on other outcomes.
Results
Of 333 participants, the mean age at diagnosis was 45.5, and 46% experienced FCR. Age at diagnosis ≤ 45 (adjusted odds ratio [aOR], 2.64; 95% confidence interval [CI], 1.51 to 4.60), shorter time since diagnosis (aOR, 1.75, 95% CI, 1.08 to 2.89), and having a history of recurrence (aOR, 2.56; 95% CI, 1.16 to 5.65) was associated with more FCR. FCR was significantly associated with an increased risk of depression (β=0.471, p < 0.001) and negatively impacted emotional functioning (β=–0.531, p < 0.001). In addition, a higher FCR level may impair overall health-related QoL in long-term BC survivors (β=–0.108, p=0.021).
Conclusion
Ten years after diagnosis, long-term BC survivors still experienced a high level of FCR. Further, the negative impact of FCR on QoL and increased depression risk require an FCR screening and appropriate interventions to enhance long-term BC survivors' QoL.

Citations

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    Diana Todea, Andreea Luca, Ioana R. Podina
    Journal of Rational-Emotive & Cognitive-Behavior Therapy.2025;[Epub]     CrossRef
  • Satisfaction with and perceived benefits of needs-assessment related to rehabilitation after chemotherapy among patients with breast cancer
    Marta Kramer Mikkelsen, Helle Elisabeth Jensen, Guri Spiegelhauer, Kirsten Amdi, Kasper Madsen, Kirstine Steen Nybom, Rikke Balschmidt Holm-Petersen, Dorte Nielsen
    Disability and Rehabilitation.2024; 46(12): 2548.     CrossRef
  • Fear of recurrence in postoperative lung cancer patients: Trajectories, influencing factors and impacts on quality of life
    Xiaoyan Yang, Yonglin Li, Jialing Lin, Jianqing Zheng, Huimin Xiao, Weiti Chen, Feifei Huang
    Journal of Clinical Nursing.2024; 33(4): 1409.     CrossRef
  • Unmet care needs of women who have undergone breast cancer surgery: A scoping review
    Qiaohong Ke, Fiona Timmins, Eileen Furlong, Diarmuid Stokes
    Journal of Advanced Nursing.2024; 80(5): 1732.     CrossRef
  • Dyadic association between mindfulness, family avoidance of communication about cancer and fear of cancer recurrence among breast cancer couples: A cross-sectional study
    Xiangyu Zhao, Yunxue Zhang, Rui Qin, Guopeng Li, Xudong He, Xiaona Shen, Ping Li
    European Journal of Oncology Nursing.2024; 68: 102491.     CrossRef
  • Prevalence and Factors Contributing to Fear of Recurrence in Breast Cancer Patients and Their Partners: A Cross-Sectional Study
    Ling Tong, Yuan Wang, Dewu Xu, Yibo Wu, Ling Chen
    International Journal of Women's Health.2024; Volume 16: 229.     CrossRef
  • Fear of Cancer Progression: A Comparison between the Fear of Progression Questionnaire (FoP-Q-12) and the Concerns about Recurrence Questionnaire (CARQ-4)
    Andreas Hinz, Thomas Schulte, Anja Mehnert-Theuerkauf, Diana Richter, Annekathrin Sender, Hannah Brock, Michael Friedrich, Susanne Briest
    Healthcare.2024; 12(4): 435.     CrossRef
  • Factors affecting the fear of recurrence in Breast cancer patients
    Dinara Kussainova, Anar Tursynbekova, Gulshara Aimbetova, Fatima Bagiyarova, Dilyara Kaidarova
    Research Journal of Pharmacy and Technology.2024; : 314.     CrossRef
  • Fear of Cancer Recurrence in Differentiated Thyroid Cancer Survivors: A Systematic Review
    Jacob Hampton, Ahmad Alam, Nicholas Zdenkowski, Christopher Rowe, Elizabeth Fradgley, Christine J. O'Neill
    Thyroid®.2024; 34(5): 541.     CrossRef
  • Revisiting Combined Modality Therapy in Older Patients With Luminal Breast Cancer Through the Patient Lens
    Robert W. Mutter, Cynthia Chauhan, Matthew P. Goetz, Jean L. Wright
    Journal of Clinical Oncology.2024; 42(18): 2121.     CrossRef
  • The impact of fear of cancer recurrence on the quality of life of breast cancer patients: A longitudinal study of the mediation effect of cortisol and hope
    Meidi Xiong, Yuping Cheng, Ying Luo, Chao Fang, Hongmei Yao, Qianqian Liu, Fang Lu, Xuan Li, Ziying Bie, Jinbing Bai, Chunhua Zhang
    European Journal of Oncology Nursing.2024; 70: 102600.     CrossRef
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    Journal of Cancer Research and Clinical Oncology.2024;[Epub]     CrossRef
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    American Society of Clinical Oncology Educational Book.2024;[Epub]     CrossRef
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    Cancer Control.2024;[Epub]     CrossRef
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    European Journal of Oncology Nursing.2024; 71: 102651.     CrossRef
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    Nazanin Derakshan, Joanne Taylor, Bethany Chapman
    Frontiers in Psychology.2024;[Epub]     CrossRef
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    Counselling and Psychotherapy Research.2024; 24(4): 1632.     CrossRef
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    International Journal of Cancer Management.2023;[Epub]     CrossRef
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    D. Azria, C. Bourgier, C. Lemanski
    Cancer/Radiothérapie.2023; 27(3): 181.     CrossRef
  • Effects of CALM intervention on neutrophil-to-lymphocyte ratio (NLR), fear of cancer recurrence and quality of life in patients with lung cancer
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    Supportive Care in Cancer.2023;[Epub]     CrossRef
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    Sharon Manne, Katie Devine, Shawna Hudson, Deborah Kashy, Denalee O’Malley, Lisa E. Paddock, Elisa V. Bandera, Adana A. M. Llanos, Angela Fong, Neetu Singh, Sara Frederick, Andrew M. Evens
    BMC Cancer.2023;[Epub]     CrossRef
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    Seul Ki Park, Yul Ha Min
    Frontiers in Psychology.2023;[Epub]     CrossRef
  • Altered regional homogeneity and homotopic connectivity in Chinese breast cancer survivors with fear of cancer recurrence: A resting-state fMRI study
    Li Peng, Xiaofei Hu, Chen Xu, Yuanyuan Xu, Han Lai, Ying Yang, Ju Liu, Yuan Xue, Min Li
    Journal of Psychosomatic Research.2023; 173: 111454.     CrossRef
  • Protective Factors against Fear of Cancer Recurrence in Breast Cancer Patients: A Latent Growth Model
    Gabriella Bentley, Osnat Zamir, Rawan Dahabre, Shlomit Perry, Evangelos C. Karademas, Paula Poikonen-Saksela, Ketti Mazzocco, Berta Sousa, Ruth Pat-Horenczyk
    Cancers.2023; 15(18): 4590.     CrossRef
  • Health-related quality of life in long-term early-stage breast cancer survivors compared to general population in Korea
    Thi Xuan Mai Tran, So-Youn Jung, Eun-Gyeong Lee, Heeyoun Cho, Na Yeon Kim, Sungkeun Shim, Ho Young Kim, Danbee Kang, Juhee Cho, Eunsook Lee, Yoonjung Chang, Hyunsoon Cho
    Journal of Cancer Survivorship.2023;[Epub]     CrossRef
  • Cost-effectiveness versus treatment effectiveness: A radiation oncologist's dilemma in low-income and middle-income countries (LMIC)
    Priya Iyer
    The Lancet Regional Health - Southeast Asia.2022; 4: 100061.     CrossRef
  • 7,027 View
  • 237 Download
  • 30 Web of Science
  • 31 Crossref
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Gynecologic cancer
Second Primary Ovarian Epithelial, Fallopian Tube, and Primary Peritoneal Cancers after Breast Cancer Diagnosis: Korea Central Cancer Registry
Hyeong In Ha, Eun-Gyeong Lee, Jiwon Lim, So-Youn Jung, Yoon Jung Chang, Young-Joo Won, Myong Cheol Lim
Cancer Res Treat. 2021;53(2):541-548.   Published online November 18, 2020
DOI: https://doi.org/10.4143/crt.2020.1001
AbstractAbstract PDFPubReaderePub
Purpose
A prior history of breast cancer is a risk factor for the subsequent development of primary peritoneal, epithelial ovarian, and fallopian tubal (POFT) cancers. This study aimed to estimate the incidence of secondary POFT malignancy in breast cancer patients and the clinical outcomes of primary and secondary POFT cancer.
Materials and Methods
We searched the Korea Central Cancer Registry to find patients with primary and secondary POFT cancer who had breast cancer in 1999-2017. The incidence rate and standardized incidence ratio were calculated. Additionally, we compared the overall survival of patients with primary and secondary POFT cancer.
Results
Based on the age-standardized rate, the incidence of second primary POFT cancer after breast cancer was 0.0763 per 100,000 women, which increased in Korea between 1999 and 2017. Among the 30,366 POFT cancer patients, 25,721 were primary POFT cancer only, and 493 had secondary POFT cancer after a breast cancer diagnosis. Second primary POFT cancer patients were older at the time of diagnosis (55 vs. 53, p < 0.001) and had a larger proportion of serous histology (68.4% vs. 51.2%, p < 0.001) than patients with primary POFT. There were no differences between the two groups in tumor stage at diagnosis. The 5-year overall survival rates were 60.2% and 56.3% for primary and secondary POFT cancer, respectively (p=0.216).
Conclusion
The incidence of second primary POFT cancer after breast cancer increased in Korea between 1999 and 2017. Besides, second primary POFT cancer patients were diagnosed at older ages and had more serous histology.

Citations

Citations to this article as recorded by  
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    Eberhard Paul, Sebastian M. Jud
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  • 2 Crossref
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Comparing the Characteristics and Outcomes of Male and Female Breast Cancer Patients in Korea: Korea Central Cancer Registry
Eun-Gyeong Lee, So-Youn Jung, Myong Cheol Lim, Jiwon Lim, Han-Sung Kang, Seeyoun Lee, Jai Hong Han, Heein Jo, Young-Joo Won, Eun Sook Lee
Cancer Res Treat. 2020;52(3):739-746.   Published online February 13, 2020
DOI: https://doi.org/10.4143/crt.2019.639
AbstractAbstract PDFSupplementary MaterialPubReaderePub
Purpose
This study aimed to determine the incidence of male breast cancer (MBC) and its survival outcomes in Korea, and to compare these results to those for female breast cancer (FBC).
Materials and Methods
We searched the Korea Central Cancer Registry and identified 227,122 breast cancer cases that were diagnosed between 1999 and 2016. Demographic and clinical characteristics and overall survival (OS) rates were estimated according to sex, age, histological type, and cancer stage.
Results
The 227,122 patients included 1,094 MBC cases and 226,028 FBC cases. Based on the age-standardized rate, the male: female ratio was 0.0055:1. The most common ages at diagnosis were 60-69 years for MBC and 40-49 years for FBC (p < 0.001). Male patients were less likely than female patients to receive adjuvant radiotherapy (7.5% vs. 21.8%, p < 0.001) or adjuvant chemotherapy (40.1% vs. 55.4%, p < 0.001). The 5-year OS rates after diagnosis were 88.8% for all patients, although it was significantly lower for MBC than for FBC (76.2% vs. 88.9%, p < 0.001). In both groups, older age (≥ 60 years) was associated with shorter survival. The 5-year OS rates for the invasive histological types were 75.8% for men and 89.0% for women. The 5-year OS rates in both groups decreased with increasing cancer stage.
Conclusion
MBC was diagnosed at older ages than FBC, and male patients were less likely to receive radiotherapy and chemotherapy. The survival outcomes were worse for MBC than for FBC, with even poorer outcomes related to older age, the inflammatory histological types, and advanced stage. It is important that clinicians recognize the differences between FBC and MBC when treating these patients.

Citations

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    Meiling Huang, Jingjing Xiao, Changjiao Yan, Rui Ling, Ting Wang
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    Fumani Charles Makhandule, Mirza Mohamod Zahir Uddin Bhuiyan
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  • Risk of Lymphedema and Death after Lymph Node Dissection with Neoadjuvant and Adjuvant Treatments in Patients with Breast Cancer: An Eight-Year Nationwide Cohort Study
    Ye-Seul Lee, Yu-Cheol Lim, Jiyoon Yeo, Song-Yi Kim, Yoon Jae Lee, In-Hyuk Ha
    Healthcare.2023; 11(13): 1833.     CrossRef
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    Mi-ri Kwon, Yoosoo Chang, Inyoung Youn, Shin Ho Kook, Yoosun Cho, Boyoung Park, Seungho Ryu
    Breast Cancer Research and Treatment.2023; 202(2): 357.     CrossRef
  • Clinicopathological features and correlation analysis of male breast cancer
    Lei Xi, Jinxing Zhou, Yan Wu, Rong Rong
    Medicine.2023; 102(30): e34408.     CrossRef
  • Germline variants profiling of BRCA1 and BRCA2 in Chinese Hakka breast and ovarian cancer patients
    Yunuo Zhang, Heming Wu, Zhikang Yu, Liang Li, Jinhong Zhang, Xinhong Liang, Qingyan Huang
    BMC Cancer.2022;[Epub]     CrossRef
  • Poor prognosis of male triple-positive breast Cancer patients: a propensity score matched SEER analysis and molecular portraits
    Biyuan Wang, Hui Wang, Andi Zhao, Mi Zhang, Jin Yang
    BMC Cancer.2021;[Epub]     CrossRef
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    Ian S. Fentiman
    The Breast Journal.2021; 27(12): 877.     CrossRef
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    Xinli Wang, Shusong Liu, Yan Xue
    Journal of International Medical Research.2021;[Epub]     CrossRef
  • Prognostic Factors in Male Breast Cancer: A Retrospective Nationwide Study in South Korea by the Study of SMARTSHIP Group
    Sungmin Park, Ho Hur, Ji Sung Lee, JaeSun Yoon, Sung Mo Hur, Il Yong Chung, Jong Won Lee, Hyun Jo Youn, Se Jeong Oh, Cheol Wan Lim, Jihyoun Lee
    Journal of Breast Cancer.2021; 24(6): 561.     CrossRef
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    Jing Zhao, Bin Wang, Jing Zhao, Yiran Mao, Jun Liu, Yanfang Yang
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  • 7,611 View
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  • 15 Web of Science
  • 14 Crossref
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Different Patterns of Risk Reducing Decisions in Affected or Unaffected BRCA Pathogenic Variant Carriers
Eun-Gyeong Lee, Hyok Jo Kang, Myong Cheol Lim, Boyoung Park, Soo Jin Park, So-Youn Jung, Seeyoun Lee, Han-Sung Kang, Sang-Yoon Park, Boram Park, Jungnam Joo, Jai Hong Han, Sun-Young Kong, Eun Sook Lee
Cancer Res Treat. 2019;51(1):280-288.   Published online May 4, 2018
DOI: https://doi.org/10.4143/crt.2018.079
AbstractAbstract PDFPubReaderePub
Purpose
The purpose of this study was to investigate decision patterns to reduce the risks of BRCArelated breast and gynecologic cancers in carriers of BRCA pathogenic variants. We found a change in risk-reducing (RR) management patterns after December 2012, when the National Health Insurance System (NHIS) of Korea began to pay for BRCA testing and riskreducing salpingo-oophorectomy (RRSO) in pathogenic-variant carriers.
Materials and Methods
The study group consisted of 992 patients, including 705 with breast cancer (BC), 23 with ovarian cancer (OC), 10 with both, and 254 relatives of high-risk patients who underwent BRCA testing at the National Cancer Center of Korea from January 2008 to December 2016.We analyzed patterns of and factors in RR management.
Results
Of the 992 patients, 220 (22.2%) were carriers of BRCA pathogenic variants. About 92.3% (203/220) had a family history of BC and/or OC,which significantly differed between BRCA1 and BRCA2 carriers (p < 0.001). All 41 male carriers chose surveillance. Of the 179 female carriers, 59 of the 83 carriers (71.1%) with BC and the 39 of 79 unaffected carriers (49.4%) underwent RR management. None of the carriers affected with OC underwent RR management. Of the management types, RRSO had the highest rate (42.5%) of patient choice. The rate of RR surgery was significantly higher after 2013 than before 2013 (46.3% [74/160] vs. 31.6% [6/19], p < 0.001).
Conclusion
RRSO was the preferred management for carriers of BRCA pathogenic variants. The most important factors in treatment choice were NHIS reimbursement and/or the severity of illness.

Citations

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