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Original Articles
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.

Citations

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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; 35(4): 293.     CrossRef
  • 3,394 View
  • 196 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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Epidemiology of Second Non-breast Primary Cancers among Survivors of Breast Cancer: A Korean Population–Based Study by the SMARTSHIP Group
Haeyoung Kim, Su SSan Kim, Ji Sung Lee, Jae Sun Yoon, Hyun Jo Youn, Hyukjai Shin, Jeong Eon Lee, Se Kyung Lee, Il Yong Chung, So-Youn Jung, Young Jin Choi, Jihyoung Cho, Sang Uk Woo, Korean Breast Cancer Society
Cancer Res Treat. 2023;55(2):580-591.   Published online December 27, 2022
DOI: https://doi.org/10.4143/crt.2022.410
AbstractAbstract PDFSupplementary MaterialPubReaderePub
Purpose
This study aimed to evaluate the incidence and prognosis of second non-breast primary cancer (SNBPC) among Korean survivors of breast cancer.
Materials and Methods
Data from the Korean National Health Insurance Service were searched to identify women who received curative surgery for initial breast cancer (IBC) between 2003 and 2008 (n=64,340). Among them, patients with the following characteristics were excluded: other cancer diagnosis before IBC (n=10,866), radiotherapy before IBC (n=349), absence of data on sex or age (n=371), or male (n=248). Accordingly, data of 52,506 women until December 2017 were analyzed. SNBPC was defined as a newly diagnosed SNBPC that occurred 5 years or more after IBC diagnosis.
Results
The median follow-up time of all patients was 12.13 years. SNBPC was developed in 3,084 (5.87%) women after a median of 7.61 years following IBC diagnosis. The 10-year incidence of SNBPC was 5.78% (95% confidence interval [CI], 5.56 to 6.00). Higher SNBPC incidence was found in survivors with the following factors: old age at IBC diagnosis, low household income, and receiving combined chemotherapy with endocrine therapy, whereas receiving radiotherapy was related to a lower incidence of SNBPC (hazard ratio, 0.89; p < 0.01). Among the patients with SNBPC, the 5-year survival rate was 62.28% (95% CI, 65.53 to 69.02).
Conclusion
Approximately 5% of breast cancer survivors developed SNBPC within 10 years after IBC diagnosis. The risk of SNBPC was associated with patient’s age at IBC diagnosis, income level, and a receipt of systemic treatments.

Citations

Citations to this article as recorded by  
  • Association of radiotherapy for stage I–III breast cancer survivors and second primary malignant cancers: a population-based study
    Jin Shi, Jian Liu, Guo Tian, Daojuan Li, Di Liang, Jun Wang, Yutong He
    European Journal of Cancer Prevention.2024; 33(2): 115.     CrossRef
  • 4,524 View
  • 90 Download
  • 1 Web of Science
  • 1 Crossref
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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
  • 5,111 View
  • 175 Download
  • 5 Web of Science
  • 5 Crossref
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Estimating Age-Specific Mean Sojourn Time of Breast Cancer and Sensitivity of Mammographic Screening by Breast Density among Korean Women
Eunji Choi, Mina Suh, So-Youn Jung, Kyu-Won Jung, Sohee Park, Jae Kwan Jun, Kui Son Choi
Cancer Res Treat. 2023;55(1):136-144.   Published online April 4, 2022
DOI: https://doi.org/10.4143/crt.2021.962
AbstractAbstract PDFPubReaderePub
Purpose
High breast cancer incidence and dense breast prevalence among women in forties are specific to Asian. This study examined the natural history of breast cancer among Korean women.
Materials and Methods
We applied a three-state Markov model (i.e., healthy, preclinical, and clinical state) to fit the natural history of breast cancer to data in the Korean National Cancer Screening Program. Breast cancer was ascertained by linkage to the Korean Central Cancer Registry. Disease-progression rates (i.e., transition rates between three states), mean sojourn time (MST) and mammographic sensitivity were estimated across 10-year age groups and levels of breast density determined by the Breast Imaging, Reporting and Data System.
Results
Overall prevalence of dense breast was 53.9%. Transition rate from healthy to preclinical state, indicating the preclinical incidence of breast cancer, was higher among women in forties (0.0019; 95% confidence interval [CI], 0.0017 to 0.0021) and fifties (0.0020; 95% CI, 0.0017 to 0.0022), than women in sixties (0.0014; 95% CI, 0.0012 to 0.0017). The MSTs, in which the tumor is asymptomatic but detectable by screening, were also fastest among younger age groups, estimated as 1.98 years (95% CI, 1.67 to 2.33), 2.49 years (95% CI, 1.92 to 3.22), and 3.07 years (95% CI, 2.11 to 4.46) for women in forties, fifties, and sixties, respectively. Having dense breasts increased the likelihood of the preclinical cancer risk (1.96 to 2.35 times) and decreased the duration of MST (1.53 to 2.02 times).
Conclusion
This study estimated Korean-specific natural history parameters of breast cancer that would be utilized for establishing optimal screening strategies in countries with higher dense breast prevalence.

Citations

Citations to this article as recorded by  
  • Lead-Time Corrected Effect on Breast Cancer Survival in Germany by Mode of Detection
    Laura Schumann, Moritz Hadwiger, Nora Eisemann, Alexander Katalinic
    Cancers.2024; 16(7): 1326.     CrossRef
  • Estimating sojourn time and sensitivity of screening for ovarian cancer using a Bayesian framework
    Sayaka Ishizawa, Jiangong Niu, Martin C Tammemagi, Ehsan Irajizad, Yu Shen, Karen H Lu, Larissa A Meyer, Iakovos Toumazis
    JNCI: Journal of the National Cancer Institute.2024; 116(11): 1798.     CrossRef
  • Concordant and discordant breast density patterns by different approaches for assessing breast density and breast cancer risk
    Yoosun Cho, Eun Kyung Park, Yoosoo Chang, Mi-ri Kwon, Eun Young Kim, Minjeong Kim, Boyoung Park, Sanghyup Lee, Han Eol Jeong, Ki Hwan Kim, Tae Soo Kim, Hyeonsoo Lee, Ria Kwon, Ga-Young Lim, JunHyeok Choi, Shin Ho Kook, Seungho Ryu
    Breast Cancer Research and Treatment.2024;[Epub]     CrossRef
  • 3,646 View
  • 99 Download
  • 4 Web of Science
  • 3 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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  • CANCER. Is this Forever? Examining the Relationship Between Event Centrality and Fear of Cancer Recurrence from a Cognitive-Behavioral Standpoint
    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
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    Xiaoyan Yang, Yonglin Li, Jialing Lin, Jianqing Zheng, Huimin Xiao, Weiti Chen, Feifei Huang
    Journal of Clinical Nursing.2024; 33(4): 1409.     CrossRef
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    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
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    Ling Tong, Yuan Wang, Dewu Xu, Yibo Wu, Ling Chen
    International Journal of Women's Health.2024; Volume 16: 229.     CrossRef
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    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
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    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
  • Psychosocial factors associated with quality of life in cancer survivors: umbrella review
    Viktorya Voskanyan, Chiara Marzorati, Diana Sala, Roberto Grasso, Ricardo Pietrobon, Iris van der Heide, Merel Engelaar, Nanne Bos, Augusto Caraceni, Norbert Couspel, Montse Ferrer, Mogens Groenvold, Stein Kaasa, Claudio Lombardo, Aude Sirven, Hugo Vachon
    Journal of Cancer Research and Clinical Oncology.2024;[Epub]     CrossRef
  • Enhancing Early-Stage Breast Cancer Survivorship: Evidence-Based Strategies, Surveillance Testing, and Imaging Guidelines
    Mitchell J. Elliott, Sherry Shen, Diana L. Lam, Thelma Brown, Marissa B. Lawson, Neil M. Iyengar, David W. Cescon
    American Society of Clinical Oncology Educational Book.2024;[Epub]     CrossRef
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    Hongyan Li, Yabin Sun, Tianye Yang, Xin Yin, Zhu Zhu, Jianjun Shi, Lingling Tong, Jia Yang, Hui Ren
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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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    A. Maghous, I. Lalya, E. Marnouche, M. Hommadi, M. Belemlih, K. Andaloussi Saghir, M. Elmarjany, K. Hadadi, H. Sifat
    Indian Journal of Gynecologic Oncology.2024;[Epub]     CrossRef
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    Ka Ryeong Bae, So Hee Kim
    Asian Oncology Nursing.2024; 24(3): 125.     CrossRef
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    Kai‐Yue Wang, Hui Li, Nan Qin
    Public Health Nursing.2024;[Epub]     CrossRef
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    Mahsa Matbouei, Majid Samsami, Mohsen Soleimani
    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
    Jie Zhao, Menglian Wang, Runze Huang, Jian Xu, Chen Gan, Sheng Yu, Lingxue Tang, Senbang Yao, Wen Li, Huaidong Cheng
    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
  • Fear of cancer recurrence in South Korean survivors of breast cancer who have received adjuvant endocrine therapy: a cross-sectional study
    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
  • 7,225 View
  • 239 Download
  • 30 Web of Science
  • 31 Crossref
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Special Article
Guidelines for Cancer Care during the COVID-19 Pandemic in South Korea
Jii Bum Lee, Minkyu Jung, June Hyuk Kim, Bo Hyun Kim, Yeol Kim, Young Seok Kim, Byung Chang Kim, Jin Kim, Sung Ho Moon, Keon-Uk Park, Meerim Park, Hyeon Jin Park, Sung Hoon Sim, Hong Man Yoon, Soo Jung Lee, Eunyoung Lee, June Young Chun, Youn Kyung Chung, So-Youn Jung, Jinsoo Chung, Eun Sook Lee, Hyun Cheol Chung, Tak Yun, Sun Young Rha
Cancer Res Treat. 2021;53(2):323-329.   Published online March 15, 2021
DOI: https://doi.org/10.4143/crt.2020.1256
AbstractAbstract PDFPubReaderePub
At the end of 2019, the cause of pneumonia outbreaks in Wuhan, China, was identified as severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) infection. In February 2020, the World Health Organization named the disease cause by SARS-CoV-2 as coronavirus disease 2019 (COVID-19). In response to the pandemic, the Korean Cancer Association formed the COVID-19 task force to develop practice guidelines. This special article introduces the clinical practice guidelines for cancer patients which will help oncologists best manage cancer patients during the COVID-19 pandemic.

Citations

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  • Preoperative COVID-19 and Postoperative Mortality in Cancer Surgery: A South Korean Nationwide Study
    Jae-Woo Ju, Soo-Hyuk Yoon, Tak Kyu Oh, Ho-Jin Lee
    Annals of Surgical Oncology.2024; 31(10): 6394.     CrossRef
  • Impact of the COVID-19 Pandemic on Esophagogastroduodenoscopy and Gastric Cancer Claims in South Korea: A Nationwide, Population-Based Study
    Min Ah Suh, Su Bee Park, Min Seob Kwak, Jin Young Yoon, Jae Myung Cha
    Yonsei Medical Journal.2023; 64(9): 549.     CrossRef
  • The elderly population are more vulnerable for the management of colorectal cancer during the COVID-19 pandemic: a nationwide, population-based study
    Hong Sun Kang, Seung Hoon Jeon, Su Bee Park, Jin Young Youn, Min Seob Kwak, Jae Myung Cha
    Intestinal Research.2023; 21(4): 500.     CrossRef
  • Impact of Coronavirus Disease 2019 on Gastric Cancer Diagnosis and Stage: A Single-Institute Study in South Korea
    Moonki Hong, Mingee Choi, JiHyun Lee, Kyoo Hyun Kim, Hyunwook Kim, Choong-Kun Lee, Hyo Song Kim, Sun Young Rha, Gyu Young Pih, Yoon Jin Choi, Da Hyun Jung, Jun Chul Park, Sung Kwan Shin, Sang Kil Lee, Yong Chan Lee, Minah Cho, Yoo Min Kim, Hyoung-Il Kim,
    Journal of Gastric Cancer.2023; 23(4): 574.     CrossRef
  • 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 Research and Treatment.2023; 55(4): 1222.     CrossRef
  • Adherence to Physical Distancing and Health Beliefs About COVID-19 Among Patients With Cancer
    Sajida Fawaz Hammoudi, Oli Ahmed, Hoyoung An, Youjin Hong, Myung Hee Ahn, Seockhoon Chung
    Journal of Korean Medical Science.2023;[Epub]     CrossRef
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Original Articles
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.

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    Eberhard Paul, Sebastian M. Jud
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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.

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    Fumani Charles Makhandule, Mirza Mohamod Zahir Uddin Bhuiyan
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Clinicopathological Features of Patients with the BRCA1 c.5339T>C (p.Leu1780Pro) Variant
Hyung Seok Park, Jai Min Ryu, Ji Soo Park, Seock-Ah Im, So-Youn Jung, Eun-Kyu Kim, Woo-Chan Park, Jun Won Min, Jeeyeon Lee, Ji Young You, Jeong Eon Lee, Sung-Won Kim
Cancer Res Treat. 2020;52(3):680-688.   Published online January 28, 2020
DOI: https://doi.org/10.4143/crt.2019.351
AbstractAbstract PDFSupplementary MaterialPubReaderePub
Purpose
Recent studies revealed the BRCA1 c.5339T>C, p.Leu1780Pro variant (L1780P) is highly suggested as a likely pathogenic. The aim of this study was to evaluate clinicopathologic features of L1780P with breast cancer (BC) using multicenter data from Korea to reinforce the evidence as a pathogenic mutation and to compare L1780P and other BRCA1/2mutations using Korean Hereditary Breast Cancer (KOHBRA) study data.
Materials and Methods
The data of 54 BC patients with L1780P variant from 10 institutions were collected and the clinicopathologic characteristics of the patients were reviewed. The hereditary breast and/or ovarian cancer–related characteristics of the L1780P variant were compared to those of BC patients in the KOHBRA study.
Results
The median age of all patients was 38 years, and 75.9% of cases showed triple-negative breast cancer. Comparison of cases with L1780P to carriers from the KOHBRA study revealed that the L1780P patients group was more likely to have family history (FHx) of ovarian cancer (OC) (24.1% vs. 19.6% vs. 11.2%, p < 0.001 and p=0.001) and a personal history of OC (16.7% vs. 2.9% vs. 1.3%, p=0.003 and p=0.001) without significant difference in FHx of BC and bilateral BC. The cumulative risk of contralateral BC at 10 years after diagnosis was 31.9%, while the cumulative risk of OC at 50 years of age was 20.0%. Patients with L1780P showed similar features with BRCA1 carriers and showed higher penetrance of OC than patients with other BRCA1 mutations.
Conclusion
L1780P should be considered as a pathogenic mutation. Risk-reducing salpingo-oophorectomy is highly recommended for women with L1780P.

Citations

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    Rong Bu, Abdul K. Siraj, Saud Azam, Kaleem Iqbal, Zeeshan Qadri, Maha Al-Rasheed, Saif S. Al-Sobhi, Fouad Al-Dayel, Khawla S. Al-Kuraya
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Outcomes of Pregnancy after Breast Cancer in Korean Women: A Large Cohort Study
Moo Hyun Lee, Young Ae Kim, Jin Hyuk Hong, So-Youn Jung, Sunmi Lee, Sun-Young Kong, Boyoung Park, Eun Sook Lee
Cancer Res Treat. 2020;52(2):426-437.   Published online September 3, 2019
DOI: https://doi.org/10.4143/crt.2018.382
AbstractAbstract PDFSupplementary MaterialPubReaderePub
Purpose
The purpose of this study was to determine the rate and outcomes of pregnancies subsequent to breast cancer in Korea, and the effect of such pregnancies on the prognosis of women who survived breast cancer and subsequently conceived. Materials and Methods We followed a total of 31,761 Korean women 45 years of age or younger who were treated for primary breast cancer from 2002 to 2010. We also included follow-up surveys that were conducted through December 2011. We identified recurrence and mortality from breast cancer using data linked to the Korea National Health Insurance database. We used propensity score matching of the study cohort to analyze the risks of recurrence and mortality from breast cancer depending on pregnancy.
Results
Within our sample, 992 women (3.1%) became pregnant after receiving treatment for breast cancer. Of those, 622 (67.5%) successfully delivered; the remaining 370 (32.5%) failed to deliver. After propensity score matching, we found that the women who became pregnant after breast cancer did not have a different risk of recurrence (hazard ratio [HR], 0.503; 95% confidence interval [CI], 0.434 to 0.584) and death (HR, 0.520; 95% CI, 0.397 to 0.681), compared with those who did not conceive after breast cancer treatment. Conclusion Our study is the first to report outcomes for Korean women who survived breast cancer and subsequently conceived. Women who survived breast cancer and subsequently became pregnant did not show a poorer survival outcome, compared with those who did not become pregnant.

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    Matteo Lambertini, Eva Blondeaux, Marco Bruzzone, Marta Perachino, Richard A. Anderson, Evandro de Azambuja, Philip D. Poorvu, Hee Jeong Kim, Cynthia Villarreal-Garza, Barbara Pistilli, Ines Vaz-Luis, Cristina Saura, Kathryn J. Ruddy, Maria Alice Franzoi,
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Prognostic Value of Post-diagnosis Health-Related Quality of Life for Overall Survival in Breast Cancer: Findings from a 10-Year Prospective Cohort in Korea
Tran Thi Xuan Mai, Jin Hyuk Choi, Myung Kyung Lee, Yoon Jung Chang, So-Youn Jung, Hyunsoon Cho, Eun Sook Lee
Cancer Res Treat. 2019;51(4):1600-1611.   Published online April 12, 2019
DOI: https://doi.org/10.4143/crt.2018.426
AbstractAbstract PDFPubReaderePub
Purpose
We aimed to evaluate health-related quality of life (HRQOL) at 1-year post-diagnosis in breast cancer (BC) patients and its association with overall survival using data from the National Cancer Center Hospital.
Materials and Methods
Data of a BC cohort were first obtained between 2004 and 2006 and followed up. HRQOL was assessed using EORTC QLQ-C30 and BC specific module QLQ-BR23 few days after diagnosis and 1 year after that. We examined and compared the difference in the two HRQOL scores measured for each patient by the patient’s current survival status. The Cox proportional hazards model was fitted to evaluate the impact of HRQOL on survival, with adjustment for baseline HRQOL and other factors.
Results
Of 299 enrolled patients, 206 responded at 1-year post-diagnosis (80.6%) and were followed up for 11.6 years on average. At 1-year post-diagnosis, survivors had better HRQOL scores than those who died, although their health status was similar at baseline. Survivors reported significant increase 1 year after diagnosis in global health status and emotional scales. Between the groups, functional scales such as physical, role, and emotional were significantly different. Functional scales, including physical (adjusted hazard ratio [aHR], 0.70), role (aHR, 0.68), emotional (aHR, 0.72), and symptom scales, including fatigue (aHR, 1.34), dyspnea (aHR, 1.29), appetite loss (aHR, 1.24) were significantly associated with overall survival. Patients who were less worried about future health had favorable survival (aHR, 0.83).
Conclusion
Besides treatment-related symptoms, non-medical aspects at 1-year post-diagnosis, including functional well-being and future perspective, are predictive of long-term survival. Intervention to enhance physical, role, and emotional support for women soon after their BC diagnosis might help to improve disease survival outcomes afterwards.

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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.

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  • Risk-reducing decisions regarding germlineBRCApathogenic variant: focusing on the timing of genetic testing and RRSO
    Akiko Abe, Hidetaka Nomura, Atsushi Fusegi, Mayu Yunokawa, Arisa Ueki, Eri Habano, Hiromi Arakawa, Keika Kaneko, Yuko Minoura, Hitoshi Inari, Takayuki Ueno, Hiroyuki Kanao
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  • BRCA Mutation Patients: Are There Other Predisposing Factors for Ovarian Cancer Occurrence? A Multicenter Retrospective Study
    Vera Loizzi, Michele Mongelli, Francesca Arezzo, Isabella Romagno, Gerardo Cazzato, Ondina Popescu, Francesco Legge, Paolo Trerotoli, Erica Silvestris, Anila Kardhashi, Gennaro Cormio
    Gynecologic and Obstetric Investigation.2024; 89(2): 87.     CrossRef
  • Implementation of BRCA Test among Young Breast Cancer Patients in South Korea: A Nationwide Cohort Study
    Yung-Huyn Hwang, Tae-Kyung Yoo, Sae Byul Lee, Jisun Kim, Beom Seok Ko, Hee Jeong Kim, Jong Won Lee, Byung Ho Son, Il Yong Chung
    Cancer Research and Treatment.2024; 56(3): 802.     CrossRef
  • Pattern Anlysis of Risk-Reducing Strategies in Unaffected Korean BRCA1/2 Mutation Carriers
    Dabin Kim, Jai Min Ryu, Sang-Ah Han, Zisun Kim, Sung-Won Kim
    Current Oncology.2024; 31(11): 6767.     CrossRef
  • Impact of graphical display on the intention to undergo risk-reducing salpingo-oophorectomy and mastectomy in individuals positive for BRCA pathogenic variant
    Yoon-Jung Choi, Younju Park, Boyoung Park, Heejung Chae, So-Youn Jung, Kum Hei Ryu, Myong Cheol Lim, Soo Jin Park, Yoon Jung Chang, Sun-Young Kong
    Scientific Reports.2024;[Epub]     CrossRef
  • Impact of the coverage of risk-reducing salpingo-oophorectomy by the national insurance system for women with BRCA pathogenic variants in Japan
    Hidetaka Nomura, Akiko Abe, Atsushi Fusegi, Teruyuki Yoshimitsu, Satoki Misaka, Atsushi Murakami, Tsuyoshi Matsumoto, Shiho Tsumura, Motoko Kanno, Yoichi Aoki, Sachiho Netsu, Makiko Omi, Terumi Tanigawa, Sanshiro Okamoto, Kohei Omatsu, Mayu Yunokawa, Hiro
    Scientific Reports.2023;[Epub]     CrossRef
  • Characteristics of second primary breast cancer after ovarian cancer: a Korea central cancer registry retrospective study
    Eun-Gyeong Lee, Jiwon Lim, Hyeong In Ha, Myong Cheol Lim, Yoon Jung Chang, Young-Joo Won, So-Youn Jung
    Frontiers in Oncology.2023;[Epub]     CrossRef
  • Differences in Willingness to Undergo BRCA1/2 Testing and Risk Reducing Surgery among the General Public, Cancer Patients, and Healthcare Professionals: A Large Population-Based Survey
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    Journal of Personalized Medicine.2022; 12(5): 818.     CrossRef
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    M.L. Riis
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    Young Min Hur, Jaehee Mun, Mi-Kyung Kim, Maria Lee, Yun Hwan Kim, Seung-Cheol Kim
    Journal of Korean Medical Science.2021;[Epub]     CrossRef
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    Journal of Breast Cancer.2020; 23(6): 647.     CrossRef
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Locoregional Recurrence by Tumor Biology in Breast Cancer Patients after Preoperative Chemotherapy and Breast Conservation Treatment
Eunjin Jwa, Kyung Hwan Shin, Ja Young Kim, Young Hee Park, So-Youn Jung, Eun Sook Lee, In Hae Park, Keun Seok Lee, Jungsil Ro, Yeon-Joo Kim, Tae Hyun Kim
Cancer Res Treat. 2016;48(4):1363-1372.   Published online February 18, 2016
DOI: https://doi.org/10.4143/crt.2015.456
AbstractAbstract PDFPubReaderePub
Purpose
The purpose of this study is to determine whether breast cancer subtype can affect locoregional recurrence (LRR) and ipsilateral breast tumor recurrence (IBTR) after neoadjuvant chemotherapy (NAC) and breast-conserving therapy (BCT). Materials and Methods We evaluated 335 consecutive patients with clinical stage II-III breast cancer who received NAC plus BCT from 2002 to 2009. Patients were classified according to six molecular subtypes: luminal A (hormone receptor [HR]+/HER2–/Ki-67 < 15%, n=113), luminal B1 (HR+/HER2–/Ki-67 ≥ 15%, n=33), luminal B2 (HR+/HER2+, n=83), HER2 with trastuzumab (HER2[T+]) (HR–/HER2+/use of trastuzumab, n=14), HER2 without trastuzumab (HER2[T–]) (HR–/HER2+, n=31), and triple negative (TN) (HR–/HER2–, n=61).
Results
After a median follow-up period of 7.2 years, 26 IBTRs and 37 LRRs occurred. The 5-year LRR-free survival rates were luminal A, 96.4%; B1, 93.9%; B2, 90.3%; HER2(T+), 92.9%; HER2(T–), 78.3%; and TN, 79.6%. The 5-year IBTR-free survival rates were luminal A, 97.2%; B1, 93.9%; B2, 92.8%; HER2(T+), 92.9%; HER2(T–), 89.1%; and TN, 84.6%. In multivariate analysis, HER2(T–) (IBTR: hazard ratio, 4.2; p=0.04 and LRR: hazard ratio, 7.6; p < 0.01) and TN subtypes (IBTR: hazard ratio, 6.9; p=0.01 and LRR: hazard ratio, 8.1; p < 0.01) were associated with higher IBTR and LRR rates. A pathologic complete response (pCR) was found to show correlation with better LRR and a tendency toward improved IBTR controls in TN patients (IBTR, p=0.07; LRR, p=0.03). Conclusion The TN and HER2(T–) subtypes predict higher rates of IBTR and LRR after NAC and BCT. A pCR is predictive of improved IBTR or LRR in TN subtype.

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Identification of Prognostic Risk Factors for Transient and Persistent Lymphedema after Multimodal Treatment for Breast Cancer
Myungsoo Kim, Kyung Hwan Shin, So-Youn Jung, Seeyoun Lee, Han-Sung Kang, Eun Sook Lee, Seung Hyun Chung, Yeon-Joo Kim, Tae Hyun Kim, Kwan Ho Cho
Cancer Res Treat. 2016;48(4):1330-1337.   Published online February 3, 2016
DOI: https://doi.org/10.4143/crt.2015.463
AbstractAbstract PDFPubReaderePub
Purpose
The purpose of this study is to identify risk factors for transient lymphedema (TLE) and persistent lymphedema (PLE) following treatment for breast cancer. Materials and Methods A total of 1,073 patients who underwent curative breast surgery were analyzed. TLE was defined as one episode of arm swelling that had resolved spontaneously by the next followup; arm swelling that persisted over two consecutive examinations was considered PLE.
Results
At a median follow-up period of 5.1 years, 370 cases of lymphedema were reported, including 120 TLE (11.2%) and 250 PLE (23.3%). Initial grade 1 swelling was observed in 351 patients, of which 120 were limited to TLE (34%), while the other 231 progressed to PLE (66%). All initial swelling observed in TLE patients was classified as grade 1. In multivariate analysis, chemotherapy with taxane and supraclavicular radiation therapy (SCRT) were associated with development of TLE, whereas SCRT, stage III cancer and chemotherapy with taxane were identified as risk factors for PLE (p < 0.05). The estimated incidence of TLE among initial grade 1 patients was calculated using up to three treatment-related risk factors (number of dissected axillary lymph nodes, SCRT, and taxane chemotherapy). The approximate ratios of TLE and PLE based on the number of risk factors were 7:1 (no factor), 1:1 (one factor), 1:2 (two factors), and 1:3 (three factors). Conclusion One-third of initial swelling events were transient, whereas the other two-thirds of patients experienced PLE. Estimation of TLE and PLE based on known treatment factors could facilitate prediction of this life-long complication.

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Effect of Time Interval between Breast-Conserving Surgery and Radiation Therapy on Outcomes of Node-Positive Breast Cancer Patients Treated with Adjuvant Doxorubicin/Cyclophosphamide Followed by Taxane
Hyeon Kang Koh, Kyung Hwan Shin, Kyubo Kim, Eun Sook Lee, In Hae Park, Keun Seok Lee, Jungsil Ro, So-Youn Jung, Seeyoun Lee, Seok Won Kim, Han-Sung Kang, Eui Kyu Chie, Wonshik Han, Dong-Young Noh, Kyung-Hun Lee, Seock-Ah Im, Sung Whan Ha
Cancer Res Treat. 2016;48(2):483-490.   Published online June 5, 2015
DOI: https://doi.org/10.4143/crt.2015.111
AbstractAbstract PDFPubReaderePub
Purpose
This study evaluated the effect of surgery-radiotherapy interval (SRI) on outcomes in patients treated with adjuvant radiotherapy (RT) after breast-conserving surgery (BCS) and adjuvant four cycles of doxorubicin/cyclophosphamide (AC) followed by four cycles of taxane. Materials and Methods From 1999 to 2007, 397 eligible patients were diagnosed. The effect of SRI on outcomes was analyzed using a Cox proportional hazards model, and a maximal chi-square method was used to identify optimal cut-off value of SRI for each outcome.
Results
The median SRI was 6.7 months (range, 5.6 to 10.3 months). A SRI of 7 months was the significant cut-off value for distant metastasis-free survival (DMFS) and disease-free survival (DFS) using a maximal chi-square method. For overall survival, a significant cut-off value was not found. The patients with SRI > 7 months had worse 6-year DMFS and DFS than those with SRI ≤ 7 months on univariate analysis (DMFS, 81% vs. 91%, p=0.003; DFS, 78% vs. 89%, p=0.002). On multivariate analysis, SRI > 7 months did not affect DMFS and DFS. Conclusion RT delayed for more than 7 months after BCS and adjuvant four cycles of AC followed by four cycles of taxane did not compromise clinical outcomes.

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Impact of Molecular Subtype Conversion of Breast Cancers after Neoadjuvant Chemotherapy on Clinical Outcome
Siew Kuan Lim, Moo Hyun Lee, In Hae Park, Ji Young You, Byung-Ho Nam, Byeong Nam Kim, Jungsil Ro, Keun Seok Lee, So-Youn Jung, Young Mee Kwon, Eun Sook Lee
Cancer Res Treat. 2016;48(1):133-141.   Published online April 7, 2015
DOI: https://doi.org/10.4143/crt.2014.262
AbstractAbstract PDFPubReaderePub
Purpose
The aim of this study was to examine molecular subtype conversions in patients who underwent neoadjuvant chemotherapy (NAC) and analyze their clinical implications.
Materials and Methods
We included consecutive breast cancer patients who received NAC at the National Cancer Center, Korea, between August 2002 and June 2011, and had available data on estrogen receptor (ER), progesterone receptor (PR), and human epidermal growth factor 2 (HER2) receptor status prior to NAC. Molecular subtypes, hormone receptor (HR) status, and ER and PR Allred scores before and after NAC were compared, and the long-term outcomes were analyzed.
Results
Of 322 patients, 32 (9.9%) achieved a pathologic complete response after NAC. HR+/HER2– tumors tended to convert into triple negative (TN) tumors (10.3%), whereas 34.6% of TN tumors gained HR positivity to become HR+/HER2– tumors. Clinical outcomes of molecular subtype conversion groups were compared against patients who remained as HR+/HER2– throughout. The HR+/HER2– to TN group had significantly poorer recurrencefree survival (RFS) (hazard ratio, 3.54; 95% confidence interval [CI], 1.60 to 7.85) and overall survival (OS) (hazard ratio, 3.73; 95% CI, 1.34 to 10.38). Patients who remained TN throughout had the worst outcomes (for RFS: hazard ratio, 3.70; 95% CI, 1.86 to 7.36; for OS: hazard ratio, 5.85; 95% CI, 2.53 to 13.51), while those who converted from TN to HR+/HER2– showed improved comparable survival outcomes.
Conclusion
Molecular subtypes of breast cancers changed frequently after NAC, resulting in different tumor prognostication. Tumor subtyping should be repeated after NAC in patients with breast cancer.

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Breast Cancer–Related Lymphedema after Neoadjuvant Chemotherapy
Myungsoo Kim, In Hae Park, Keun Seok Lee, Jungsil Ro, So-Youn Jung, Seeyoun Lee, Han-Sung Kang, Eun Sook Lee, Tae Hyun Kim, Kwan Ho Cho, Kyung Hwan Shin
Cancer Res Treat. 2015;47(3):416-423.   Published online November 17, 2014
DOI: https://doi.org/10.4143/crt.2014.079
AbstractAbstract PDFPubReaderePub
Purpose
The risk for lymphedema (LE) after neoadjuvant chemotherapy (NCT) in breast cancer patients has not been fully understood thus far. This study is conducted to investigate the incidence and time course of LE after NCT. Materials and Methods A total of 313 patients with clinically node-positive breast cancer who underwent NCT followed by surgery with axillary lymph node (ALN) dissection from 2004 to 2009 were retrospectively analyzed. All patients received breast and supraclavicular radiation therapy (SCRT). The determination of LE was based on both objective and subjective methods, as part of a prospective database. Results At a median follow-up of 5.6 years, 132 patients had developed LE: 88 (28%) were grade 1; 42 (13%) were grade 2; and two (1%) were grade 3. The overall 5-year cumulative incidence of LE was 42%. LE first occurred within 6 months after surgery in 62%; 1 year in 77%; 2 years in 91%; and 3 years in 96%. In a multivariate analysis, age (hazard ratio [HR], 1.66; p < 0.01) and the number of dissected ALNs (HR, 1.68; p < 0.01) were independent risk factors for LE. Patients with both of these risk factors showed a significantly higher 5-year cumulative incidence of LE compared with patients with no or one risk factor (61% and 37%, respectively; p < 0.001). The addition of adjuvant chemotherapy did not significantly correlate with LE. Conclusion LE after NCT, surgery, and SCRT developed early after treatment, and with a high incidence rate. More frequent surveillance of arm swelling may be necessary in patients after NCT, especially during the first few years of follow-up.

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