[Show abstract][Hide abstract] ABSTRACT: The aim of this study was to evaluate the correlation between central lymph node (CLN) metastasis and clinicopathologic characteristics of papillary thyroid cancer (PTC). In addition, we investigated the incidence and risk factors for contralateral CLN metastasis in unilateral PTC. This study suggests the appropriate surgical extent for CLN dissection.
A prospective study of 500 patients with PTC who underwent total thyroidectomy and prophylactic bilateral CLN dissection was conducted.
Of 500 patients, 255 had CLN metastases. The rate of CLN metastasis was considerably higher in cases of younger patients (<45 years old) (P < 0.001; odds ratio [OR], 2.357) and of a maximal tumor size greater than 1 cm (P < 0.001; OR, 3.165). Ipsilateral CLN metastasis was detected in 83.1% of cases (133/160) of unilateral PTC, only contralateral CLN metastases in 3.7% of cases (6/160), and bilateral CLN metastases in 13.1% of cases (21/160). The rate of contralateral CLN metastasis was considerably higher in cases of PTC with a large tumor size (≥1 cm) (P = 0.019; OR, 4.440) and with ipsilateral CLN metastasis (P = 0.047; OR, 2.613).
Younger age (<45 years old) and maximal tumor size greater than 1 cm were independent risk factors for CLN metastasis. Maximal tumor size greater than 1 cm and presence of ipsilateral CLN macrometastasis were independent risk factors for contralateral CLN metastasis. Therefore, both CLN dissections should be considered for unilateral PTC with a maximal tumor size greater than 1 cm or presence of ipsilateral CLN macrometastasis.
Preview · Article · Feb 2015 · Annals of Surgical Treatment and Research
[Show abstract][Hide abstract] ABSTRACT: Purpose
The purpose of this study is to evaluate imaging and histopathologic findings including the immunohistochemical characteristics of invasive micropapillary carcinoma (IMPC) of the breast.
Twenty-nine patients diagnosed with IMPC were included in the present study. Mammographic, sonographic, and magnetic resonance imaging (MRI) findings were analyzed retrospectively according to the American College of Radiology Breast Imaging Reporting and Data System lexicon. 18F-fluorodeoxyglucose positron emission tomography-computed tomography (PET-CT) findings were also evaluated. Microscopic slides of surgical specimens were reviewed in consensus by two pathologists with a specialty in breast pathology.
Most IMPCs presented as a high density irregular mass with a non-circumscribed margin associated with microcalcifications on mammography, as an irregular hypoechoic mass with a spiculated margin on ultrasound, and as irregular spiculated masses with washout patterns on MRI. PET-CT showed a high maximum standardized uptake value (SUVmax) (mean, 11.2). Axillary nodal metastases were identified in 65.5% of the patients. Immunohistochemical studies showed high positivities for estrogen receptor and c-erbB-2 (93.1% and 51.7µ, respectively).
Even though the imaging characteristics of IMPCs are not distinguishable from typical invasive ductal carcinomas, this tumor type frequently results in nodal metastases and high positivities for both estrogen receptor and c-erbB-2. The high SUVmax value that is apparent on PET-CT might be helpful in the diagnosis of IMPC.
No preview · Article · Mar 2012 · Journal of Breast Cancer
[Show abstract][Hide abstract] ABSTRACT: AMP-activated protein kinase (AMPK) is a sensor of cellular energy status found in all eukaryotes. Recent studies indicate that AMPK activation strongly suppresses cell proliferation in tumor cells, which requires high rates of protein synthesis and de novo fatty acid synthesis for their rapid growth. Pomolic acid (PA) has been previously described as being active in inhibiting the growth of cancer cells. In this study, we investigated PA activated AMPK, and this activity was related to proliferation and apoptosis in MCF7 breast cancer cells. PA inhibited cell proliferation and induced sub-G(1) arrest, elevating the mRNA levels of the apoptotic genes p53 and p21. PA activated caspase-3, -9, and poly(ADP-ribose) polymerase, and this effect was inhibited by z-VAD-fmk. AMPK activation was increased by treating cells with PA, inactivated by treating cells with a compound C, and co-treatment consisting of PA and aminoimidazole carboxamide ribonucleotide (AICAR) synergistically activated AMPK. These anti-cancer potentials of PA were accompanied by effects on de novo fatty acid synthesis as shown by the decreased expression of fatty acid synthase, and decreased acetyl-CoA carboxylase activation and incorporation of [(3)H]acetyl-CoA into fatty acids. In addition, PA inhibited key enzymes involved in protein synthesis such as mammalian target of rapamycin (mTOR), 70 kDa ribosomal protein S6 kinase (p70S6K), and eukaryotic translation initiation factor 4E-binding protein 1 (4EBP1). These results suggest that PA exerts anti-cancer properties through the modulation of AMPK pathways and its value as an anti-cancer agent in breast cancer therapy.
No preview · Article · Jan 2012 · Biological & Pharmaceutical Bulletin
[Show abstract][Hide abstract] ABSTRACT: Purpose
This study examined breast cancer screening practice and health promoting behaviors and the predicting factors of breast cancer screening practice in Chinese women.
A correlational research design was used to recruit a convenience sample of 770 women living in four cities (Beijing, Shanghai, Guangzhou, and Xi’an) in China. Participants completed self-report questionnaire consisting of general characteristics, breast cancer screening, health promoting behaviors, perceived benefits and perceived barriers.
The participants were mostly 36−55 years old (51.3%), married (86.8%), premenopause (77.7%), had children (83.4%), and breastfed (73%). About 60% of Chinese women participated in some type of breast cancer screening practices, among them only 60 (7.8%) women used mammography, ultrasonogram and breast self-examination. The main reason for doing breast cancer screening was "feeling necessary for the screening". About 36% of the participants reported they did not perform any of screening practices, because they "don’t feel it necessary". The women who had breast cancer screening regularly reported better health promoting behavior and perceived benefits and less perceived barriers than those who did not (F = 10.45, p < .001). Logistic regression showed that model 1 (age, higher education, being employed) and model 2 (perceived benefits and health behaviors) were the significant predicting factors (p < .05), explaining 10−13.8% of variance in breast cancer screening practice.
On the basis of these results, public education about importance of breast cancer screening and health promoting behavior should be strongly advocated by health professionals and mass media in China.
No preview · Article · Sep 2011 · Asian Nursing Research
[Show abstract][Hide abstract] ABSTRACT: Purpose: The axillary lymph node status is an important prognostic factor for recurrence and survival of patients who have primary breast cancer. This study determined the accuracy of ultrasonography and 18F-FDG positron emission tomography (PET)/computed tomography (CT) in preoperative staging in axilla in patients with breast cancer. Methods: One hundred seventy-one patients with primary breast cancer were recruited from January 2007 to August 2008. All the patients underwent axillary ultrasonography and 18F-FDG PET/CT for the axillary staging before their operation. Results: The overall sensitivity, specificity, and the positive and negative predictive values and the accuracy of axillary ultrasonography for making the diagnosis of axillary metastasis were 73.07%, 84.87%, 67.85%, 87.82%, and 81.28%, respectively. On a visual assessment of 18F-FDG PET/CT, the diagnostic accuracy was 85.38% with 69.23% sensitivity, 92.43% specificity, a positive predictive value of 80.00%, and a negative predictive value of 87.30%. By the combined use axillary ultrasonography and 18F-FDG PET/CT to the axilla, the sensitivity, specificity, the positive and negative predictive values and the diagnostic accuracy were 82.35%, 97.91%, 93.33%, 94.00%, and 93.84%, respectively. Conclusion: The combination of 18F-FDG PET/CT and ultrasonography improves preoperative axillary staging in breast cancer that are often not found if only one imaging modalities are applied.
Preview · Article · Sep 2009 · Journal of Breast Cancer
[Show abstract][Hide abstract] ABSTRACT: Purpose: The purpose of the study was to identify effects of the BeHaS program on self esteem, fatigue and anxiety in postoperative care patients with breast cancer who had surgery with, chemotherapy, radiotherapy, with or without current hormone therapy. Methods: This study was a 2-group quasi-experimental research study with a pre and post test design. Fifty-four patients with breast cancer were assigned to the experimental (n=29) or control group (n=25). The BeHaS program which strengthens self esteem through support over a 90-minute period, consists of theme activity (30 minutes), education (15 minutes), group support (15 minutes) and exercise (30 minutes). The experimental group participated in the program once a week for 10 weeks, but the control group was not involved. Data were gathered from October to December, 2008 using a questionnaire with measures of self esteem, fatigue and anxiety. Data were analyzed using t-test with SPSS Win 12.0 to identify differences between the groups. Results: Self esteem was significantly increased (p= .001) and fatigue significantly decreased (p= .013) in the experimental group. But there was no significant difference in anxiety (p= .868). Conclusion: These results suggest that the BeHaS program for patients with breast cancer had beneficial effects on self esteem and fatigue.
[Show abstract][Hide abstract] ABSTRACT: Nodal involvement has long been known to represent the single most reliable indicator of the prognosis for early-stage breast cancer. In common parlance, high-risk node-positive breast cancer has generally been used to describe patients who have involvement of ten or more axillary lymph nodes (10+LN). Breast cancer patients who had 10+LN clearly have a strikingly high risk of tumor recurrence and death. Thus we tried to evaluate the clinical courses of breast cancer patients who had more than 10 positive axillary lymph nodes.
Preview · Article · Jan 2005 · Journal of Breast Cancer
[Show abstract][Hide abstract] ABSTRACT: Although the overexpression of c-erbB-Z has been reported to be associated with a poorclinieal outcome in breast cancer, its prognostic value remains controversial. The overexpression of c-erbB-2 can be detected using immunohistochemical analysis which is cost-effective. but not ideal due to variations in tissue fixation and processing, different testing methods with variable sensitivity and the subjectivity in grading.
Preview · Article · Jan 2005 · Journal of Breast Cancer
[Show abstract][Hide abstract] ABSTRACT: The objective of this study was to test the efficacy and toxicity of adriamycin plus docetaxel as primary chemotherapy for women with locally advanced breast carcinoma, including patients with inflammatory breast cancer.
[Show abstract][Hide abstract] ABSTRACT: The sentinel lymph node (SLN) biopsy was recently introduced into the treatment of early breast cancer. However, there have been varying degrees of success in identifying the SLNs. Lymphatic mapping in breast cancer performed solely by intraparenchymal injection of blue dye remains an accepted method of identifying SLNs, largely because of its simplicity. This article describes the technical aspect and improved results of combined peritumoral and subareolar injection of isosulfan blue dye.
[Show abstract][Hide abstract] ABSTRACT: Neoadjuvant chemotherapy is being used increasingly in the treatment of patient with large or locally advanced breast cancer with the aim of downstaging and eliminating micrometastasis. We report the correlation between tumor response to preoperative primary chemotherapy and patient outcome in the consecutive series of a 73 patients with breast cancer.