Journal of Yeungnam Medical Science

Review article

Breast implant-associated anaplastic large-cell lymphoma (BIA-ALCL): Jun-Ho Lee; Yeungnam Univ J Med. 2021;38(3):175-182. Published online January 19, 2021; DOI: https://doi.org/10.12701/yujm.2020.00801

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Breast implant-associated anaplastic large-cell lymphoma (BIA-ALCL) is a rare T-cell non-Hodgkin lymphoma characterized as CD30 positive and anaplastic lymphoma kinase (ALK) negative. In 2016, the World Health Organization declared BIA-ALCL as a new disease entity. The first case of BIA-ALCL was reported in 1997, and as of July 2019, the United States Food and Drug Administration had cited a total of 573 United States and global medical device reports of BIA-ALCL, including 33 deaths. In all clinical case reports, except for those with unknown clinical history, the patient had received at least one textured surface breast implant. Although the etiology is not yet clear, chronic inflammation has been proposed as a potential precursor to tumorigenesis. The most common presentation of BIA-ALCL is peri-implant fluid collection following aesthetic or reconstructive implantation with textured surface breast implants. It can be accompanied by breast swelling, asymmetry, pain, skin lesions, lymphadenopathy, and B-type symptoms. Most cases are detected on average 7 to 10 years after implantation. Diagnostic specimens can be obtained with fine-needle aspiration or biopsy. BIA-ALCL is CD30 positive, epithelial membrane antigen positive, and ALK negative. It can be cured with complete surgical excision at the T1–T3 stage.

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Smooth vs Textured Expanders: Patient Factors and Anatomic Plane Are Greater Factors in Determining First-Stage Breast Reconstruction Outcomes
Emma S Dahmus, Amanda E Ruffino, Joshua D Madera, Alexandra Long, Shengxuan Wang, Christian A Kauffman, Sean Devitt, Christopher Sanders, Joseph DeSantis
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Complication Profiles of Smooth vs Textured Tissue Expanders in Breast Reconstruction: A Systematic Review and Meta-Analysis
Arman J Fijany, Sara C Chaker, Ya-Ching Hung, Ilana Zago, Nicole Friedlich, Sofia E Olsson, Cole A Holan, Lisandro Montorfano, Ronnie N Mubang, Kevin B Givechian, Michael J Boctor, Maxim Pekarev, Jorys Martinez-Jorge, Elizabeth D Slater
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The Polyvalent Role of CD30 for Cancer Diagnosis and Treatment
Adrian Vasile Dumitru, Dana Antonia Țăpoi, Georgian Halcu, Octavian Munteanu, David-Ioan Dumitrascu, Mihail Constantin Ceaușu, Ancuța-Augustina Gheorghișan-Gălățeanu
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Practice Trends in the Management of Asymptomatic Breast Reconstruction Patients with Textured Implants: A Survey Analysis
Laura A. Roider, David C. Nguyen, Shreya Pusapadi Ramkumar, Cody V. Tyson, Herluf G. Lund, Christina M. Plikaitis
Plastic and Reconstructive Surgery - Global Open.2023; 11(7): e5139. CrossRef
Place and objectives of ultrasound examination of the mammary glands after augmentation mammoplasty with silicone endoprostheses in the instrumental algorithm of patients with suspected BIA-ALCL (literature review)
E. P. Fisenko
Medical Visualization.2023; 27(4): 68. CrossRef
Evaluation of Different Breast Implant Shapes in the Same Patient: Is There Really a Difference between Round and Anatomical Implants?
Paolo Montemurro, Patrick Mallucci, Maurizio B. Nava, Per Hedén, William P. Adams, Johannes M. Wagner
Plastic and Reconstructive Surgery - Global Open.2023; 11(9): e5294. CrossRef
Implantes mamarios en tiempos de linfoma y COVID-19. ¿Han aumentado las complicaciones?
Estela Vélez-Benítez, Jesús Cuenca-Pardo, Bertha Torres-Gómez, Arturo Ramírez-Montañana, Raúl Alfonso Vallarta-Rodríguez, Rufino Iribarren-Moreno, Guillermo Ramos-Gallardo, Martín de la Cruz Lira-Álvarez
Cirugía Plástica.2023; 33(3): 100. CrossRef
Comprehensive Evaluation of the Current Knowledge on Breast Implant Associated-Anaplastic Large Cell Lymphoma
Hyokyung Yoo, Ji-Ung Park, Hak Chang
Archives of Plastic Surgery.2022; 49(02): 141. CrossRef

Case reports

Pancreatic metastasis from malignant phyllodes tumor of the breast: Seung Eun Lee, Young Kyung Bae, Joon Hyuk Choi; Yeungnam Univ J Med. 2021;38(1):78-82. Published online November 27, 2020; DOI: https://doi.org/10.12701/yujm.2020.00759

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Abstract PDF

Pancreatic metastasis from malignant phyllodes tumor (PT) of the breast is rare, and only a few cases have been reported in the literature. Here, we report a case of pancreatic metastasis from malignant PT of the breast in a 48-year-old woman. She had had three episodes of recurrence of malignant PT in her right breast. She presented with epigastric pain for 2 months. Computed tomography and magnetic resonance imaging revealed a 6 cm-sized, well-defined, heterogeneous mass with peripheral enhancement in the body of the pancreas. Endoscopic ultrasonography-guided fine-needle aspiration was performed, and the pathologic report suggested spindle cell mesenchymal neoplasm. Subsequently, surgical excision was performed, and the mass was confirmed as a metastatic malignant PT. The imaging findings are discussed and the literature is briefly reviewed in this report.

Citations

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Integrating single‐cell and spatial transcriptomes reveals COL4A1/2 facilitates the spatial organisation of stromal cells differentiation in breast phyllodes tumours
Xia Li, Xuewen Yu, Jiaxin Bi, Xu Jiang, Lu Zhang, Zhixin Li, Mumin Shao
Clinical and Translational Medicine.2024;[Epub] CrossRef
Case report: Osteosarcomatous differentiation in the lung metastasis of a malignant phyllodes tumor
Ruijing Liu, Jingli Xue, Wen Liu, Beibei Jiang, Fuyun Shi, Zhenzheng Wang, Peifeng Li
Frontiers in Medicine.2023;[Epub] CrossRef
Diagnostic approach to fibroepithelial tumors of the breast
Frances Tresserra, María Angeles Martinez-Lanao, Melissa Fernandez-Acevedo, Cristina Castellet, Sonia Baulies
Revista de Senología y Patología Mamaria.2022; 35: S22. CrossRef

Impressive effect of cisplatin monotherapy on a patient with heavily pretreated triple-negative breast cancer with poor performance: Dong Won Baek, Ji-Young Park, Soo Jung Lee, Yee Soo Chae; Yeungnam Univ J Med. 2020;37(3):230-235. Published online January 22, 2020; DOI: https://doi.org/10.12701/yujm.2019.00423

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Abstract PDF

Systemic therapy for metastatic triple-negative breast cancer (TNBC) still remains challenging because there are no targeted agents or endocrine therapies currently available. The present case report documents the successful use of cisplatin monotherapy to manage a heavily pretreated TNBC patient showing poor response to therapy. The patient was a 51-year-old woman who had already undergone several lines of systemic chemotherapy for widespread TNBC. Although the mutation analysis performed on DNA isolated from blood cells and progressed lesion samples confirmed the tumor to be germline BRCA wild-type, cisplatin monotherapy was administered based on the increasing evidence of safety and efficacy of platinum for breast cancer. After three cycles of cisplatin treatment, the patient’s metastatic lesions dramatically improved without any major toxicity, and she completed 17 cycles with good response. This case study indicates that patients with heavily pretreated TNBC can potentially achieve a good response to cisplatin monotherapy.

Citations

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Zeolitic Imidazole Framework/Silica Nanocomposite for Targeted Cancer Therapeutics: Comparative Study of Chemo-Drug Cisplatin (CPt) and Green Platinum (GPt) Efficacy
Hend Ghnaim Alotaibi, Eman Al-Abbad, Dana Almohazey, Vijaya Ravinayagam, Sultan Akhtar, Hatim Dafalla, B. Rabindran Jermy
International Journal of Molecular Sciences.2024; 25(6): 3157. CrossRef
Hypoxia: syndicating triple negative breast cancer against various therapeutic regimens
Nityanand Srivastava, Salman Sadullah Usmani, Rajasekaran Subbarayan, Rashmi Saini, Pranav Kumar Pandey
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Lu-Yao Zhang, Zhi-Xin Shen, Lu Guo
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Targeting Hypoxia Sensitizes TNBC to Cisplatin and Promotes Inhibition of Both Bulk and Cancer Stem Cells
Andrew Sulaiman, Sarah McGarry, Jason Chambers, Emil Al-Kadi, Alexandra Phan, Li Li, Karan Mediratta, Jim Dimitroulakos, Christina Addison, Xuguang Li, Lisheng Wang
International Journal of Molecular Sciences.2020; 21(16): 5788. CrossRef
Antioxidant Supplementation in the Treatment of Neurotoxicity Induced by Platinum-Based Chemotherapeutics—A Review
Jelena S. Katanic Stankovic, Dragica Selakovic, Vladimir Mihailovic, Gvozden Rosic
International Journal of Molecular Sciences.2020; 21(20): 7753. CrossRef

Review article

Prepectoral breast reconstruction: Sung-Eun Kim; Yeungnam Univ J Med. 2019;36(3):201-207. Published online August 26, 2019; DOI: https://doi.org/10.12701/yujm.2019.00283

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Abstract PDF

Implant-based breast reconstruction is the most commonly used reconstruction technique after mastectomy. This is because skin-sparing mastectomy has become possible with advancements in oncology. In addition, the development of breast implants and the advent of acellular dermal matrices have reduced postoperative complications and resulted in superior cosmetic results. The most frequently performed surgical breast reconstruction procedure for the past 20 years was the insertion of an implant under the pectoralis major muscle by means of the dual plane approach. However, some patients suffered from pain and animation deformity caused by muscle manipulation. Recently, a prepectoral approach has been used to solve the above problems in select patients, and the results are similar to subpectoral results. However, this technique is not always chosen due to the number of considerations for successful surgery. In this article, we will discuss the emergence of prepectoral breast reconstruction, indications and contraindications, surgical procedures, and outcomes.

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The current use of tissue expanders in breast reconstruction: device design, features, and technical considerations
Min-Jeong Cho, Rana V. Farhadi, David W. Nash, Joseph Kaleeny, Stephen P. Povoski, Albert H. Chao
Expert Review of Medical Devices.2024; 21(1-2): 27. CrossRef
The Effect of Early Cultures and Dual-port Expanders on Two-stage, Prepectoral Breast Reconstruction: The 25/25 Study
Hunter R. Moyer, Kayla M. Sisson
Plastic and Reconstructive Surgery - Global Open.2024; 12(1): e5507. CrossRef
Current Global Trends in Prepectoral Breast Reconstruction
Saima Taj, Ravi Chandavarkar, Raghavan Vidya
Medicina.2024; 60(3): 431. CrossRef
Mastectomy with one-stage or two-stage reconstruction in breast cancer: analysis of early outcomes and patient’s satisfaction
Angela Gurrado, Alessandro Pasculli, Alessia Toma, Michele Maruccia, Rossella Elia, Marco Moschetta, Michele Telegrafo, Giuseppe Massimiliano De Luca, Walter Lavermicocca, Elisabetta Poli, Francesco Paolo Prete, Lucia Ilaria Sgaramella, Giuseppe Giudice,
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Immediate prepectoral breast reconstruction using an ADM with smooth round implants: A prospective observational cohort study
Fabio Santanelli di Pompeo, Guido Firmani, Guido Paolini, Vittoria Amorosi, Francesca Briganti, Michail Sorotos
Journal of Plastic, Reconstructive & Aesthetic Surgery.2023; 80: 56. CrossRef
Optimizing Prepectoral Implant Placement and Concomitant Fat Grafting After Tissue Expansion
Alisa O. Girard, Christopher D. Lopez, Christina M. Ambrosino, Kristen P. Broderick
Annals of Plastic Surgery.2023; 90(6S): S483. CrossRef
A Propensity Score–Matched Comparison of Perioperative Outcomes in Prepectoral Smooth Versus Textured Tissue Expander Breast Reconstruction
Kevin Perez, Pope Rodnoi, Sumeet S. Teotia, Nicholas T. Haddock
Annals of Plastic Surgery.2023; 90(5S): S242. CrossRef
Prepectoral Breast Reconstruction and Quality of Life: One Step Further
Michael Kontos
Journal of Investigative Surgery.2022; 35(4): 848. CrossRef
Selective Denervation of Pectoralis Major Muscle Improves Cosmetic Outcome and Quality of Life in Retro-Pectoral Implant Based Breast Reconstruction
Marco Bernini, Silvia Sordi, Niccolo’ Bembi, Icro Meattini, Diego De Benedetto, Jacopo Nori Cucchiari, Lorenzo Livi, Lorenzo Orzalesi
Clinical Breast Cancer.2022; 22(1): 60. CrossRef
Meshed Acellular Dermal Matrix for Two-Staged Prepectoral Breast Reconstruction: An Institutional Experience
Jessica Luo, Rhett N. Willis, Suzanna M. Ohlsen, Meghan Piccinin, Neal Moores, Alvin C. Kwok, Jayant P. Agarwal
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Chances and challenges—analysis of trends in breast reconstruction
Siling Yang, Xixi Lin, Maximilian Kückelhaus, Tobias Hirsch, Marie-Luise Klietz, Matthias M. Aitzetmüller
Journal of Plastic, Reconstructive & Aesthetic Surgery.2022; 75(8): 2584. CrossRef
Cost analysis of pre-pectoral implant-based breast reconstruction
Sachin Chinta, Daniel J. Koh, Nikhil Sobti, Kathryn Packowski, Nikki Rosado, William Austen, Rachel B. Jimenez, Michelle Specht, Eric C. Liao
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Francesca Corduas, Dimitrios A. Lamprou, Elena Mancuso
Bio-Design and Manufacturing.2021; 4(2): 278. CrossRef
Examining the Effects of Postmastectomy Radiation Therapy in Prepectoral Versus Subpectoral Autologous Breast Reconstruction
Ashraf A. Patel, Connor P. Arquette, Pooja S. Yesantharao, Mimi R. Borrelli, Kristen P. Broderick, Jennifer E. Cheesborough, Gordon K. Lee, Rahim S. Nazerali
Annals of Plastic Surgery.2021; 86(5S): S390. CrossRef
Day-case approach to immediate breast reconstruction: pushing the boundaries of ambulatory breast surgery in the post-COVID-19 era
H Shaker, NAR Leena, V Mayers, F Koussa, A Deshpande
The Annals of The Royal College of Surgeons of England.2021; 103(6): 426. CrossRef
Meta-analysis of prepectoral implant-based breast reconstruction: guide to patient selection and current outcomes
Olivia Abbate, Nikki Rosado, Nikhil Sobti, Brittany L. Vieira, Eric C. Liao
Breast Cancer Research and Treatment.2020; 182(3): 543. CrossRef

Case Report

Mammary Paget’s disease without underlying malignancy of the breast: Nuri Jang, Suhwan Kang, Young Kyung Bae; Yeungnam Univ J Med. 2018;35(1):99-103. Published online June 30, 2018; DOI: https://doi.org/10.12701/yujm.2018.35.1.99

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Abstract PDF

Mammary Paget’s disease (MPD) is usually accompanied by underlying breast malignancy; however, a few cases have been reported as only skin lesions without any evidence of malignancy of the breast on imaging tests and microscopic examination of surgical specimen. Here, we describe a 47-year-old woman who visited our hospital who had an eczematous lesion on right nipple and areola for over 10 years. The lesion was diagnosed as Paget’s disease by punch biopsy; however, imaging studies demonstrated no breast malignancy or lymph node metastasis. The patient underwent surgery of on the nipple and areola including underlying breast tissue. No underlying malignancy was found upon microscopic examination, except for Paget’s disease. Immunohistochemical stains revealed that the tumor cells were positive for cytokeratin 7, and negativity for p63, cytokeratin 5/6, estrogen receptor, progesterone receptor, and human epidermal growth factor receptor 2. We report a case of MPD without underlying malignancy. To the best of our knowledge, this is the third case reported in Korea.

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‘Eczematous’ dermatitis of the nipple: clinical and histopathological differential diagnosis of Paget disease
Hatice B. Zengin, Puay Hoon Tan, Regina Liu, Bruce R. Smoller
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S. K. Dhariwal, E. Rytina, J. C. Sterling
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Histopathological patterns of skin adnexal tumours in Ibadan, South-West Nigeria
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Hamdan Medical Journal.2021; 14(4): 168. CrossRef
Clinicopathological characteristics of mammary Paget’s disease: A single‐center 25‐year experience in Korea
Young J. Kim, Keon H. Lee, Woo J. Lee, Chong H. Won, Sung E. Chang, Jee H. Choi, Mi W. Lee
The Breast Journal.2020; 26(4): 806. CrossRef

Original Article

The Relationship Between the Expression of Estrogen Receptor beta and Recurrence in Breast Cancer.: Su Hwan Kang, Jung Eun Choi, Soo Jung Lee; Yeungnam Univ J Med. 2011;28(2):153-164. Published online December 31, 2011; DOI: https://doi.org/10.12701/yujm.2011.28.2.153

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Abstract PDF: BACKGROUND
It has been reported that estrogen receptor beta (ERbeta) mRNA expression was down-regulated during carcinogenesis and was inversely related to estrogen receptor alpha (ERalpha) expression in breast cancer. The association of ERbeta mRNA expression to tamoxifen resistance has also been reported. In this study, the expression of ERalpha and ERbeta via immunohistochemistry (IHC) and reverse transcription-polymerase chain reaction (RT-PCR) was prompted, and an attempt was made to find out the relationship between ERbeta expression and recurrence in the hormonal therapy group, and between ERbeta expression and known prognostic factors. METHODS: Tumor specimens were obtained at surgery from 67 female breast cancer patients during the period of September 1995 to December 2000. All the specimens were frozen in liquid nitrogen and kept at -70degrees C until they were used. The medical records were analyzed retrospectively. The expressions of ER were analyzed using IHC and RT-PCR methods. RESULTS: The median follow-up was at 93.0 months (range: 14-157 months). The percentage of ERalpha+/ERbeta+, ERalpha+/ERbeta-, ERalpha-/ERbeta+, and ERalpha-/ERbeta group were 35.9% 9.4%, 47.2%, and 7.5%, respectively, in 53 patients with hormonal therapy. ERbeta was positive in 42 (82.3%) of 51 ER-positive patients. In the hormonal therapy group, the recurrence rates of each group was 15.8%, 0%, 40.0%, and 0%, respectively. In this group, the ERbeta expression tended to recur, but there was no clinical significance (p=0.084). CONCLUSION: The ERbeta expression may be a predictive marker of a poor response to endocrine therapy in breast cancer patients, although this needs to be confirmed in additional studies.

Case Report

Adenoid Cystic Carcinoma of the Breast －A Case Report－: Jun Mo Kim, Mi Soo Hwang, Su Hwan Kang, Soo Jung Lee, Young Kyung Bae; Yeungnam Univ J Med. 2007;24(2 Suppl):S749-754. Published online December 31, 2007; DOI: https://doi.org/10.12701/yujm.2007.24.2S.S749

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Abstract PDF: Adenoid cystic carcinoma (ACC) is a rare malignant neoplasm of the breast accounting for approximately 0.1% of all breast carcinomas with a total 200 cases reported in the literature. In contrast to the aggressive nature of ACC in other organs, ACC of the breast is known to have an excellent prognosis. Recently we experienced the first case of ACC of the breast at Yeungnam University hospital. The case was diagnosed by preoperative fine needle aspiration cytology. We report a case of ACC of the breast managed with breast conserving surgery and review the literature.

Review Article

Methods of Margin Assessment in Breast Conserving Surgery: Young Kyung Bae; Yeungnam Univ J Med. 2007;24(2 Suppl):S262-269. Published online December 31, 2007; DOI: https://doi.org/10.12701/yujm.2007.24.2S.S262

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Abstract PDF

Breast conserving surgery has become the preferred method of treatment for breast cancer. Therefore clear surgical margin is critical to minimize the risk of local recurrence. Although paraffin section of inked surgical margin is the gold standard for margin assessment, this process is time consuming, and results are not available until after the operation. Several methods of intraoperative margin assessment are available including gross evaluation of the tumor specimen, specimen slice radiography, pathologic evaluation with touch preparation cytology or frozen section analysis. Here I review three methods of pathologic evaluation -macroscopic evaluation, touch preparation cytology, and frozen section- and deal with problems and pitfalls that can happen in routine diagnostic fields.

Citations

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A Study on the Quality of a Frozen Section of Breast Resection Margin during Breast-Conserving Surgery
Byung-Il Choi, Su-Sie Chin
The Korean Journal of Clinical Laboratory Science.2021; 53(3): 233. CrossRef

Review

Progress of Techniques in Breast Reconstruction Using Autologous Abdominal Tissue.: Jae Ho Jeong; Yeungnam Univ J Med. 2006;23(1):1-9. Published online June 30, 2006; DOI: https://doi.org/10.12701/yujm.2006.23.1.1

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Abstract PDF: Breast reconstruction provides dramatic improvement for patients with severe deformity. The reconstruction not only restores aesthetically acceptable breast for patients with mastectomy deformity but also recovers psychological trauma of 'losing feminity' after the cancer mastectomy. There are many options for breast reconstruction from simple prosthetic insertion to a flap operation using autologous abdominal tissue. The choice of operation method depends on the physical condition of the patient, smoking habits, and economic status. Among the many options, the method that uses the lower abdominal tissue is known as the TRAM (transverse rectus abdonimis myocutaneous) flap. Since the introduction of the TRAM flap in 1982 by Hartrampf, the art of breast reconstruction using lower abdominal tissue has been progressively refined to pedicle flap, muscle-sparinga TRAM flap, and recently there have been exciting and revolutionary changes associated with the adoption of the concept of perforator flap. This refined method of breast reconstruction utilizes lower abdominal tissue nourished by the deep inferior epigastric perforator (DIEP). With the DIEP free flap, almost all of the rectus muscle and anterior rectus sheath are preserved and the donor morbidity is minimized. Different from previous flap methods using lower abdominal tissue, DIEP free flap method preserves function of the rectus muscle completely. Understanding the entire progression of breast reconstruction methods using lower abdominal tissue is necessary for plastic surgeons; the understanding of each step of the exciting progression and the review of the past history of the TRAM flap may provide insight for future development.

Original Articles

Screening Examination of Breast Cancer: Review of the Recommended Guidelines.: Myung Ho Shin, Mi Soo Hwang, Bok Hwan Park; Yeungnam Univ J Med. 1999;16(2):342-346. Published online December 31, 1999; DOI: https://doi.org/10.12701/yujm.1999.16.2.342

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Abstract PDF: BACKGROUND
Delays in breast cancer diagnosis may occur in young women due to a low index of suspicion. The purpose of this study was to compare mammography and breast sonography in detection of breast cancer and to suggest a reasonable guideline for breast cancer screening examination. MATERIALS AND MATHODS: Among 820 patients, 102 patients were under 35 years and 122 patients were above 60 years of age. We reviewed medical records, mammograms and/or ultrasonography of 49 patients under 35 years and 48 patients above 60 years of age with pathologically-proven breast cancer. Pathological reports were as follows: Invasive ductal carcinoma(IDC) was present 61.2% of patients in the young age group and ductal carcinoma in situ(DCIS) in 16.3%. IDC was present in 66.6% of the patients in the old age group, and DCIS in 8.33%. We analyzed mammography and ultrasonography to evaluate their usefullness in detecting breast cancer in patients under 35 years and over 60 years of age. RESULTS: The mammographic results are as follows: 1) detection rate of lesion: 83.8%(under 35yrs), 100%(over 60yrs) 2) sensitivity of cancer: 67.6%(under 35yrs), 91.2%(over 60yrs) The ultrasonographic results are as follows: 1) detection rate of lesion: 100% 2) sensitivity of cancer: 87.2%(under 35yrs), 96.7%(over 60yrs) The breas cancer detection rate in women under 35 years old was comparable to that of women above 60 years old in our study. CONCLUSION: A striking histologic finding in the two groups was a higher incidence of nuclear Grade II and III tumors. This finding correlates with the reported increased incidence of high grade tumors inyoung women and may correlae with the poorer prognosis of breast cancer in young patients. We conclude that early screening examination is helpful for early detection of breast cancer in women under age 35.

Radiologic Findings of Uncommon Breast Cancer.: Jae Woon Kim, Jae Hong An, Mi Soo Hwang, Jae Kyo Lee, Woo Mok Byun; Yeungnam Univ J Med. 1998;15(1):114-124. Published online June 30, 1998; DOI: https://doi.org/10.12701/yujm.1998.15.1.114

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Abstract PDF: We analyzed the mammographic (n=21) findings (location, margin, shape, cluster microcalcifications, size, multiplicity) and ultrasonographic (n=12) findings (shape, border, internal echo, boundary echo, posterior echo, lateral echo, width/depth ratio) to evaluate specific radiologic findings of histopathologically proved uncommon breast cancer. The mammographic findings (n=21) are as follow; 1) single; 16, multiple; 5 2) margin (smooth; 13, irregular; 4, spiculated; 4) 3) shape (round and ovoid; 9, lobulated; 8, irregular; 4) 4) cluster microcalcifications (abscent; 20, present; 1) 5) size (1-3cm; 18, 3-5cm; 2, 5cm> ; 1) 6) location (UOQ; 13, UIQ; 4, LIQ; 3, LOQ; 1). The ultrasonographic findings (n=12) are as follow; 1) shape (round to oval; 5, lobulated; 5, irregular; 2) 2) border (smooth even; 9, rough uneven; 3) 3) internal echo (fine homogeneous; 5, coarse heterogeneous; 7) 4) boundary echo (regular fine; 4, irregular thick; 8) 5) posterior echo (enhanced; 11, no change; 1) 6) lateral echo (marked; 7, nonexistent; 5) 7) width/depth ratio (1.5> 1, 1.0-1.5; 7, 1.0< ; 4). Uncommon breast cancer show benign nature on mammogram, but malignant nature on ultrasonogram (especially boundary echo, internal echo, width/depth ratio)

Use of Sonography in the Differential Diagnosis between Phylloides Tumor and Giant Fibroadenoma.: Jong Oh Choi, Jae Woon Kim, Won Kyu Park, Mi Soo Hwang, Bok Hwan Park; Yeungnam Univ J Med. 1996;13(2):295-301. Published online December 31, 1996; DOI: https://doi.org/10.12701/yujm.1996.13.2.295

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Abstract PDF: Phylloides tumor is very similar to giant fibroadenoma in that they have benign appearance in breast radiologic image. Fibroadenoma has no malignant potential, but phylloides tumor is locally recurrent, invasive and may occasionally metastasize. It thus appears that evaluation of the differential point of the two tumor groups by radiologic study is very important. We retrospectively compared sonographic find;.ngs of 6 cases of phylloides tumor with those of 4 cases of fibroadenoma, which proved pathologically in Ye mgnam University Hospital from 1984 to 1986. The mean age of the patients were 31.8 years old(from 14 to 41 years old) in phylloides tumor and 28.8 years old (from 17 to 40 years old) in giant fibroadenoma, respectively. The viewpoints of this analysis were size, shape and contour of the masses, internal echo pattern, posterior enhancement, and especially the existence of peripheral cyst or septal band echo. We found that diffenentiation of these two tumors by sonography was difficult. But peripheral cyst was found only in phylloides tumor and septal band echo was found largely in giant fibroadenoma. Although the existence of peripheral cyst or septal band echo in the breast mass was not pathognomonic findings, we suggest that the existence of septal band echo is preferential finding to fibroadenoma, and peripheral cyst is preferential finding to phylloides tumor.

The analysis of ultrasonographic findings in breast carcinoma.: Jin Wook Lee, Mi Soo Hwang, Bok Hwan Park; Yeungnam Univ J Med. 1992;9(2):269-274. Published online December 31, 1992; DOI: https://doi.org/10.12701/yujm.1992.9.2.269

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Abstract PDF: Authors retrospectively analyzed ultrasonographic findings of 12 cases of breast carcinomas which were proven pathologically at Yeungnam University Hospital from March 1992 to August 1992. Classically, breast carcinomas were described as irregular and lobulated hypoechoic solid masses with inhomogeneous internal echoes and frequent attenuation of the sound beam. And other additional ultrasonographic findings were echogenic rim, disruptions of superficial layer, microcalcification, skin thickening and so on. In our studies, not all of these findings of breast carcinomas were found in each case, but most of these findings were noted. However, several studies have demonstrated considerable overlap in the ultrasonographic appearance of benign lesions and carcinoma. Thus, accurate sonographic determination of the type of solid mass is not possible with current ultrasonographic imaging techniques and criteria. For more accurate diagnosis of breast lesions, sonographic and other imaging techniques are interpreted together.

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