Cancer Research and Treatment

Original Articles

Novel Breast Cancer Risk Assessment Tools for Pre- and Post-Menopausal Asian Women: Development and Validation in a Nationwide Mammographic Screening Cohort: Wonyoung Jung, Yong-Moon Mark Park, Sang Hyun Park, Kyungdo Han, Junhee Park, Yohwan Yeo, Jung Kwon Lee, Dale P. Sandler, Dong Wook Shin; Received September 4, 2024 Accepted January 30, 2025 Published online January 31, 2025; DOI: https://doi.org/10.4143/crt.2024.861 [Accepted]

Abstract PDF: Purpose
Widely used breast cancer risk-prediction tools are based on data from Western countries, but risk factors may differ for Asian women. Hence, we aimed to develop a risk assessment tool for breast cancer in Asian women using a nationwide, population-based mammographic screening cohort.
Materials and Methods
Women aged ≥40 years who underwent breast cancer screening and general health examination in 2009 were included. Age, body mass index (BMI), breast density, lifestyle and reproductive factors, and comorbidities were used to develop 5-year breast cancer risk-prediction models for premenopausal (n=771,856) and postmenopausal (n=1,108,047) women at baseline. The best-fit risk prediction model was constructed using backward stepwise selection in a Cox proportional hazards model and was transformed into a risk score nomogram. The performance was assessed by discrimination and calibration.
Results
In premenopausal women, high BMI, low parity, short breastfeeding period, early age at menarche, high breast density, a history of benign breast masses, and family history of breast cancer contributed to the risk prediction of breast cancer. In postmenopausal women, age, diabetes mellitus, dyslipidemia, late-onset menopause, and hormone replacement therapy use were additional risk predictors of breast cancer. Our risk-prediction model showed a concordant statistic of 0.58 (0.57–0.59) for premenopausal women and 0.64 (0.63–0.65) for postmenopausal women. The calibration plot demonstrated good correlations for both models.
Conclusion
Our breast cancer risk-prediction model demonstrated performance comparable to that of Western countries, especially among postmenopausal women. This provides a foundation for implementing risk-based screening recommendations in Asian women.

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Breast cancer

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

Abstract PDF PubReader ePub

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.

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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.2025; 210(1): 105. CrossRef
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

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Prevalence of Women with Dense Breasts in Korea: Results from a Nationwide Cross-sectional Study: Hye-Mi Jo, Eun Hye Lee, Kyungran Ko, Bong Joo Kang, Joo Hee Cha, Ann Yi, Hae Kyoung Jung, Jae Kwan Jun, on behalf of the Alliance for Breast Cancer Screening in Korea (ABCS-K); Cancer Res Treat. 2019;51(4):1295-1301. Published online January 29, 2019; DOI: https://doi.org/10.4143/crt.2018.297

Abstract PDF Supplementary Material PubReader ePub

Purpose
Women with dense breast are known to be at high risk for breast cancer, but their prevalence and number of Korean women are unknown. The current study was to investigate the distribution of mammographic breast density by age of women undergoing screening mammography, and to estimate the prevalence of Korean women with dense breasts, quantitatively.
Materials and Methods
For obtaining a nationwide representative sample, 6,481 mammograms were collected from 86 screening units participated in the National Cancer Screening Program for breast cancer. Based on the American College of Radiology Breast Imaging Reporting and Data System classification, breast density was evaluated by six breast radiologists, qualitatively. We applied these breast density distributions to age-specific counts of the Korean women population derived to mid-year 2017 to estimate the number of Korean women with dense breasts.
Results
Overall, 54.4% (95% confidence interval [CI], 52.9% to 55.8%) of women 40 to 69 years of age had heterogeneously or extremely dense breasts, and this proportion was inversely associated with age. Based on the age distribution of Korean women, we estimated that 6,083,000 women (95% CI, 5,919,600 to 6,245,600) age 40-69 years in Korean have dense breasts. Women aged 40-49 years (n=3,450,000) accounted for 56.7% of this group.
Conclusion
More than half of Korean women aged 40 and over have dense breasts. To prevent breast cancer effectively and efficiently, it is necessary to develop a new personalized prevention strategy considering her status of breast density.

Citations

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Development and validation of nomograms using photoacoustic imaging and 2D ultrasound to predict breast nodule benignity and malignancy
Jing Chen, Zhibin Huang, Hui Luo, Guoqiu Li, Zhimin Ding, Hongtian Tian, Shuzhen Tang, Sijie Mo, Jinfeng Xu, Huaiyu Wu, Fajin Dong
Postgraduate Medical Journal.2024; 100(1183): 309. CrossRef
Screening mammography performance according to breast density: a comparison between radiologists versus standalone intelligence detection
Mi-ri Kwon, Yoosoo Chang, Soo-Youn Ham, Yoosun Cho, Eun Young Kim, Jeonggyu Kang, Eun Kyung Park, Ki Hwan Kim, Minjeong Kim, Tae Soo Kim, Hyeonsoo Lee, Ria Kwon, Ga-Young Lim, Hye Rin Choi, JunHyeok Choi, Shin Ho Kook, Seungho Ryu
Breast Cancer Research.2024;[Epub] CrossRef
Enhancing Breast Cancer Risk Prediction with Machine Learning: Integrating BMI, Smoking Habits, Hormonal Dynamics, and BRCA Gene Mutations—A Game-Changer Compared to Traditional Statistical Models?
Luana Conte, Emanuele Rizzo, Emanuela Civino, Paolo Tarantino, Giorgio De Nunzio, Elisabetta De Matteis
Applied Sciences.2024; 14(18): 8474. CrossRef
Assessment of the Breast Density Prevalence in Swiss Women with a Deep Convolutional Neural Network: A Cross-Sectional Study
Adergicia V. Kaiser, Daniela Zanolin-Purin, Natalie Chuck, Jennifer Enaux, Daniela Wruk
Diagnostics.2024; 14(19): 2212. CrossRef
A Large Cohort Study of Height and Mammographic Density in Relation to Breast Cancer Risk among Korean Women
Ga Eun Park, Sung Hun Kim, Kyungdo Han
Cancer Epidemiology, Biomarkers & Prevention.2024; 33(11): 1484. CrossRef
Association of Breast Cancer Family History With Breast Density Over Time in Korean Women
Thi Xuan Mai Tran, Yoosoo Chang, Soyeoun Kim, Huiyeon Song, Seungho Ryu, Boyoung Park
JAMA Network Open.2023; 6(3): e232420. CrossRef
Screening Outcomes of Supplemental Automated Breast US in Asian Women with Dense and Nondense Breasts
Mi-ri Kwon, Ji Soo Choi, Mi Yeon Lee, Sinae Kim, Eun Sook Ko, Eun Young Ko, Boo Kyung Han
Radiology.2023;[Epub] CrossRef
Deep Learning Analysis of Mammography for Breast Cancer Risk Prediction in Asian Women
Hayoung Kim, Jihe Lim, Hyug-Gi Kim, Yunji Lim, Bo Kyoung Seo, Min Sun Bae
Diagnostics.2023; 13(13): 2247. CrossRef
Understanding of Dense Breast and Perception of Breast Cancer Risk of Nurses with or without Dense Breast Notification
Seon Mi Yoon, Jeong Hee Kang
Asian Oncology Nursing.2023; 23(2): 75. CrossRef
Artificial Intelligence for Breast Cancer Screening in Mammography (AI-STREAM): A Prospective Multicenter Study Design in Korea Using AI-Based CADe/x
Yun-Woo Chang, Jin Kyung An, Nami Choi, Kyung Hee Ko, Ki Hwan Kim, Kyunghwa Han, Jung Kyu Ryu
Journal of Breast Cancer.2022; 25(1): 57. CrossRef
Breast cancer detection across dense and non-dense breasts: Markers of diagnostic confidence and efficacy
Ibrahim Hadadi, William Rae, Jillian Clarke, Mark McEntee, Ernest Ekpo
Acta Radiologica Open.2022;[Epub] CrossRef
Association of Mammographic Density and Benign Breast Calcifications Individually or Combined with Hypertension, Diabetes, and Hypercholesterolemia in Women ≥40 Years of Age: A Retrospective Study
Maha Al-Mohaissen, Arwa Alkhedeiri, Ohoud Al-Madani, Terry Lee, Anas Hamdoun, Mohammad Al-Harbi
Journal of Investigative Medicine.2022; 70(5): 1308. CrossRef
Mammographic breast density, body mass index and risk of breast cancer in Korean women aged 75 years and older
Thi Xuan Mai Tran, Soyeoun Kim, Huiyeon Song, Boyoung Park
International Journal of Cancer.2022; 151(6): 869. CrossRef
The mammographic breast density distribution of Finnish women with breast cancer and comparison of breast density reporting using the 4th and 5th editions of the Breast Imaging-Reporting and Data System
Aki Nykänen, Hidemi Okuma, Anna Sutela, Amro Masarwah, Ritva Vanninen, Mazen Sudah
European Journal of Radiology.2021; 137: 109585. CrossRef
Impact of Awareness of Breast Density on Perceived Risk, Worry, and Intentions for Future Breast Cancer Screening among Korean Women
Anh Thi Ngoc Tran, Ji Hae Hwang, Eunji Choi, Yun Yeong Lee, Mina Suh, Chan Wha Lee, Yeol Kim, Kui Son Choi
Cancer Research and Treatment.2021; 53(1): 55. CrossRef
Digital Mammography as a Screening Tool in Korea
Soo Yeon Song, Seri Hong, Jae Kwan Jun
Journal of the Korean Society of Radiology.2021; 82(1): 2. CrossRef
Clinical Implications of Geometric and Dosimetric Uncertainties of Inter- and Intra-Fractional Movement during Volumetric Modulated Arc Therapy for Breast Cancer Patients
Jason Joon Bock Lee, Ik Jae Lee, Yeonho Choi, Mi Jin Jeon, Il Hun Jung, Ho Lee
Cancers.2021; 13(7): 1651. CrossRef
Fatty liver disease and changes in dense breasts in pre- and postmenopausal women: the Kangbuk Samsung Health Study
Yoosun Cho, Yoosoo Chang, Hyun-Suk Jung, Chan-Won Kim, Hyungseok Oh, Eun Young Kim, Hocheol Shin, Sarah H. Wild, Christopher D. Byrne, Seungho Ryu
Breast Cancer Research and Treatment.2021; 190(2): 343. CrossRef
Multifocality and Multicentrality in Breast Cancer: Comparison of the Efficiency of Mammography, Contrast-Enhanced Spectral Mammography, and Magnetic Resonance Imaging in a Group of Patients with Primarily Operable Breast Cancer
Katarzyna Steinhof-Radwańska, Andrzej Lorek, Michał Holecki, Anna Barczyk-Gutkowska, Anna Grażyńska, Joanna Szczudło-Chraścina, Oskar Bożek, Justyna Habas, Karol Szyluk, Paweł Niemiec, Iwona Gisterek
Current Oncology.2021; 28(5): 4016. CrossRef
The Relationship Between Breast Density Change During Menopause and the Risk of Breast Cancer in Korean Women
Danbee Kang, Ji-Yeon Kim, Ji-Young Kim, Han Song Mun, Sook Ja Yoon, Jieun Lee, Gayeon Han, Young-Hyuck Im, Soo-Young Shin, Se Kyung Lee, Jong-Han Yu, Kyung-Hyun Lee, Mincheol Kim, Dohyun Park, Yoon-Ho Choi, Ok Soon Jeong, Jean Hyoung Lee, Se Yong Jekal, J
Cancer Prevention Research.2021; 14(12): 1119. CrossRef
Clinical Application of Automated Breast Ultrasound
Sung Hun Kim
Clinical Ultrasound.2021; 6(2): 35. CrossRef
Association of the Interaction Between Mammographic Breast Density, Body Mass Index, and Menopausal Status With Breast Cancer Risk Among Korean Women
Thi Xuan Mai Tran, Seong-Geun Moon, Soyeoun Kim, Boyoung Park
JAMA Network Open.2021; 4(12): e2139161. CrossRef
Association of Screening by Thyroid Ultrasonography with Mortality in Thyroid Cancer: A Case–Control Study Using Data from Two National Surveys
Jae Kwan Jun, Soon-Young Hwang, Seri Hong, Mina Suh, Kui Son Choi, Kyu-Won Jung
Thyroid.2020; 30(3): 396. CrossRef
Prevalencia de tejido mamario denso en una población en la ciudad de Bucaramanga, Colombia
María Alejandra Baquero Serrano , Luis Andrés López Martínez , Silvia Nathalia Vera Campos, Sergio Andrés Rosales Rueda , Natalia Jaramillo Botero, Miguel Ochoa Vera
Revista Colombiana de Cancerología.2020; 24(3): 119. CrossRef

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Reproductive and Hormonal Factors Associated with Fatty or Dense Breast Patterns among Korean Women: Jei-Hun Jeon, Jung-Hyun Kang, Yeonju Kim, Hoo-Yeon Lee, Kui Son Choi, Jae Kwan Jun, Dong-Kwan Oh, Chang Yoon Lee, Kyungran Ko, Eun-Cheol Park; Cancer Res Treat. 2011;43(1):42-48. Published online March 31, 2011; DOI: https://doi.org/10.4143/crt.2011.43.1.42

Abstract PDF PubReader ePub

PURPOSE
Dense breasts have been suggested as a risk factor for breast cancer, but controversy still remains. This study evaluates the association of reproductive and hormonal factors with dense breasts among Korean women.
MATERIALS AND METHODS
Using a cross-sectional design, 516 women were recruited and classified for breast density patterns as being either fatty or dense, using the Breast Imaging Reporting and Data System (BI-RADS) of the American College of Radiology. Univariate and multivariate logistic regression models were used for statistical analysis.
RESULTS
In univariate logistic regression, older age, higher body mass index, older age at menarche, and oral contraceptive use were associated with more fatty breasts. On the contrary, longer duration of education, alcohol consumption, lower parity, menopause and use of hormone replacement therapy were associated with dense breasts. After adjustment, age and body mass index were inversely associated with breast density (p-value for trend <0.01, respectively), whereas nulliparous and premenopausal status were positively associated. Compared to women who had > or =2 children, nulliparous women had an 11.8-fold increase of dense breasts (p-value for trend <0.01). Compared to postmenopausal women, premenopausal women had 2.4-fold increase of dense breasts (odds ratio, 2.42; 95% confidence interval, 1.36 to 4.32).
CONCLUSION
Young age, lower body mass index, lower parity, and premenopausal status were significantly associated with dense breasts in Korea.

Citations

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Parity and breastfeeding are contributing factors for geographical differences in breast cancer risk
Boon Hong Ang, Shivaani Mariapun, Farahida Mohd Farid, Imelda Suhanti Ishak, Muhammad Faiz Md Taib, Asfarina Ab Rahim, Lenjai Anak Jembai, Tania Islam, Kartini Rahmat, Farhana Fadzli, Nur Aishah Mohd Taib, Cheng Har Yip, Weang-Kee Ho, Soo-Hwang Teo
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Time‐specific impact of trace metals on breast density of adolescent girls in Santiago, Chile
Claire E. Kim, Ana Pereira, Alexandra M. Binder, Chitra Amarasiriwardena, John A. Shepherd, Camila Corvalan, Karin B. Michels
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Dong-Man Ye, Xiaoru Bai, Shu Xu, Ning Qu, Nannan Zhao, Yang Zheng, Tao Yu, Huijian Wu
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Associations of Oral Contraceptives with Mammographic Breast Density in Premenopausal Women
Lusine Yaghjyan, Carmen Smotherman, John Heine, Graham A. Colditz, Bernard Rosner, Rulla M. Tamimi
Cancer Epidemiology, Biomarkers & Prevention.2022; 31(2): 436. CrossRef
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Tomohiro Ochi, Hiroko Tsunoda, Hideko Yamauchi, Osamu Takahashi
BMC Women's Health.2022;[Epub] CrossRef
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Survival Rates of Breast Cancer Patients Aged 40 to 49 Years according to Detection Modality in Korea: Screening Ultrasound versus Mammography
So Yeon Won, Hyung Seok Park, Eun-Kyung Kim, Seung Il Kim, Hee Jung Moon, Jung Hyun Yoon, Vivian Youngjean Park, Seho Park, Min Jung Kim, Young Up Cho, Byeong-Woo Park
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Evaluation of the Value of Multiplex MicroRNA Analysis as a Breast Cancer Screening in Korean Women under 50 Years of Age with a High Proportion of Dense Breasts
Ji Young Jang, Eun Young Ko, Ji Soo Jung, Kyung Nam Kang, Yeon Soo Kim, Chul Woo Kim
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Shadi Azam, Katja Kemp Jacobsen, Arja R. Aro, Elsebeth Lynge, Zorana Jovanovic Andersen
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The implications of increased mammographic breast density for breast screening in Jordan
Dana S. Al‐Mousa, Maram Alakhras, Kelly M. Spuur, Haytham Alewaidat, Mostafa Abdelrahman, Mohammad Rawashdeh, Patrick C. Brennan
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Associations between Breast Density on Mammography and Lifestyle Related Disease
Dae Yeon Hwang, Yu Lee Kim, Bong Woon Hwang, Kwang Hyun Kim, Ji Young Lym
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Inyoung Youn, SeonHyeong Choi, Shin Ho Kook, Yoon Jung Choi
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Zoe Quandt, Julie D Flom, Parisa Tehranifar, Diane Reynolds, Mary Beth Terry, Jasmine A McDonald
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Reliability of the Percent Density in Digital Mammography with a Semi-Automated Thresholding Method
Guiyun Sohn, Jong Won Lee, Sung Won Park, Jihoon Park, Jiyoung Woo, Hwa Jung Kim, Hee Jung Shin, Hak Hee Kim, Kyung Hae Jung, Joohon Sung, Seung Wook Lee, Byung Ho Son, Sei-Hyun Ahn
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Kyung Lan Ko, In Suk Shin, Ji Young You, So-Youn Jung, Jungsil Ro, Eun Sook Lee
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Marilene Alícia Souza, Angela Maggio Fonseca, Vicente R. Bagnoli, Nestor de Barros, Solange O.B. Franzolin, Katia C. Carvalho, José Maria Soares-Jr, Edmund C. Baracat
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Current Breast Cancer Reports.2013; 5(3): 208. CrossRef
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Trends of Mammography Use in a National Breast Cancer Screening Program, 2004-2008: Sun Mi Lim, Hoo-Yeon Lee, Kui Son Choi, Jae Kwan Jun, Eun-Cheol Park, Yeonju Kim, Mi Ah Han, Dong Kwan Oh, Jung Im Shim; Cancer Res Treat. 2010;42(4):199-202. Published online December 31, 2010; DOI: https://doi.org/10.4143/crt.2010.42.4.199

Abstract PDF PubReader ePub

Purpose

Korea started breast cancer screening as part of the National Cancer Screening Program (NCSP) in 1999. In order to identify under-served groups, we investigated mammography uptake in the National Breast Cancer Screening Program.

Materials and Methods

The study population was participants in the National Breast Cancer Screening Program from 2004 to 2008. We analyzed participation rates by insurance type, age group, and area of residence.

Results

Total participation rates for breast cancer screening increased from 18.2% in 2004 to 35.0% in 2008. The participation rate in the group aged 60 to 69 years showed the greatest increase, 21.3%, among the four age groups. Although the screening rate increased continuously, the participation rate of the Medical Aid Program (MAP) group was low compared to the National Health Insurance (NHI) group. Moreover, the increasing trend of mammography uptake in the MAP group was much lower than that of the NHI group.

Conclusion

The participation rate for breast cancer screening in the NCSP in Korea has increased. However, the participation rate in mammography among MAP recipients is still lower than that of NHI beneficiaries. To increase mammography uptake, it is important to make it available to everyone by ensuring inclusion of all population subgroups.

Citations

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Factors associated with attendance at screening for breast cancer: a systematic review and meta-analysis
Rebecca Mottram, Wendy Lynn Knerr, Daniel Gallacher, Hannah Fraser, Lena Al-Khudairy, Abimbola Ayorinde, Sian Williamson, Chidozie Nduka, Olalekan A Uthman, Samantha Johnson, Alexander Tsertsvadze, Christopher Stinton, Sian Taylor-Phillips, Aileen Clarke
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Spectrum of very early breast cancer in a setting without organised screening
N Bhoo-Pathy, S Subramaniam, N A Taib, M Hartman, Z Alias, G-H Tan, R I Ibrahim, C-H Yip, H M Verkooijen
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Factors Associated with Organized and Opportunistic Cancer Screening: Results of the Korea National Health and Nutrition Examination Survey (KNHANES) 2007-2011
Minsun Kang, Ki-Bong Yoo, Eun-Cheol Park, Kisung Kwon, Gaeun Kim, Doo Ree Kim, Jeoung A Kwon
Asian Pacific Journal of Cancer Prevention.2014; 15(7): 3279. CrossRef
Attendance of the fourth (2008–2009) screening round of the Hungarian organized, nationwide breast cancer screening program
Imre Boncz, Lajos Döbrőssy, Zoltán Péntek, Attila Kovács, András Budai, László Imre, Réka Vajda, Andor Sebestyén
Orvosi Hetilap.2013; 154(50): 1975. CrossRef
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Jiyoung Kim, SeKyung Lee, SooYoun Bae, Min-Young Choi, Jeonghui Lee, Seung Pil Jung, Sangmin Kim, Jun-Ho Choe, Jung-Han Kim, Jee Soo Kim, Jeong Eon Lee, Seok Jin Nam, Jung-Hyun Yang
Breast Cancer Research and Treatment.2012; 131(2): 527. CrossRef
Satisfaction in the National Cancer Screening Program for Breast Cancer with and without Clinical Breast Examination
Mi-Ah Han, Jae-Kwan Jun, Kui-Son Choi, Eun-Cheol Park, Hoo-Yeon Lee
Asian Pacific Journal of Cancer Prevention.2012; 13(1): 63. CrossRef
Time to follow up after an abnormal finding in organized gastric cancer screening in Korea
Hoo-Yeon Lee, Kui Son Choi, Jae Kwan Jun, Myung-Il Hahm, Eun-Cheol Park
BMC Cancer.2012;[Epub] CrossRef
Risk Factors and Control Strategies for the Rapidly Rising Rate of Breast Cancer in Korea
Sue K. Park, Yeonju Kim, Daehee Kang, En-Joo Jung, Keun-Young Yoo
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Breast Cancer Detected by Screening Mammography: Byung Ho Son, Jung Mi Park, Gyeong Yeop Gong, Se Hyun Ahn; J Korean Cancer Assoc. 1999;31(3):499-508.

Abstract PDF: PURPOSE
The early detection of breast cancer by screening mammography is important to reduce breast cancer mortality rate. The purpose of this study was to investigate the characteristics of breast cancer patients detected by screening mammography.
MATERIALS AND METHODS
Surgically treated 1,265 patients at Asan Medical Center from Jul. 1989 to Dec. 1997 were evaluated. Among them, 119 patients (9.4%) were detected by screening mammography. These patients were compared with clinically detected symptomatic breast cancer group.
RESULTS
The characteristics of breast cancer patients detected by screening mammography were as follows: The most common finding of mammography was microcalcifications (62.2%); The less invasive or more conservative minimal and non-destructive surgical treatments such as breast conserving surgery (21.0%), simple mastectomy (8.4%), breast reconstruction (8.4%) were performed more frequently; The median tumor size of invasive cancers was 16 mm; Node-negative cancers (83.2%) were more frequent; The early breast cancer of stage 0 and I was 70.6%; DCIS (29.4%) was highly proportionated; and The 5-year overall (95.8%) and 5-year disease-free survival rate (92.0%) were significantly higher than in clinically detected symptomatic breast cancer patients.
CONCLUSION
The screening mammography was significant for detecting non-palpable, early stage breast cancer. Ultrasonography was needed as an adjunct for the accurate detection in dense breast or young women. According to early detection, the 5-year survival rate was high.

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Microcalcification Classifications on Mammography and Breast Cancer Incidences: Jeoung Won Bae, Jin Kim, Min Young Cho, Jae Bok Lee, Bum Hwan Koo; J Korean Cancer Assoc. 1999;31(2):275-281.

Abstract PDF: PURPOSE
Since needle localization biopsy was introduced, it is widely performed for nonpalpable microcalcified breast lesions, but there are many controversies in determining the disease characteristics and guidelines of the biopsy for microcalcifications detected mammographically in the absence of any palpable mass. This study was designed to detennine the breast cancers according to microcalcification types.
MATERIALS AND METHODS
We reviewed 91 patients, who underwent breast biopsies between January 1995 and June 1998 for only microcalcified lesions detected by mammography at the Department of Surgery, Korea University Hospitals. Microcalcifications were defined as calcifications less than 1.0 mm. The needle localization biopsy was performed only on patients who were found to have five or more microcalcifications. We classified the mictocalcifications into three types; casting type, crushed-stone-like type, and amorphous type.
RESULTS
The mean age was 49 years (25 82 years). Sixteen patients (17.6%) among the 91 patients were diagnosed with the breast cancer; four (22.2%) of 18 patients with casting type, eight (21.6%) of 37 patients with crushed-stone-like type, and four (11.1%) of 36 patients with amorphous type microcalcifications. Breast cancers were more prevalent in casting and crushed-stone-like types than in amorphous types. There was no difference in the size of microcalcifiations between benign and malignant lesions 13.11+-10.89 rnm vs 13.13+-9.51 mm.
CONCLUSIONS
The patients who have more than 5 microcalcifications clustered within 1 cm circle detected at mammographic evaluation, especially in case of casting or crushed-stone-like type, should be advised to have localization biopsy to detect early breast cancer.

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Relation Between Hormone Receptor (Enzyme-Immunoassay and Immunohistochemistry), Histologic Grade and Mammographic Findings in Patients with Primary Breast Cancer: Byung Chul Kang, Ki Keun Oh, Jae Keun Kim, Woo Hee Jung, Hy De Lee, Kyung Soon Song; J Korean Cancer Assoc. 1997;29(1):53-61.

Abstract PDF: PURPOSE
To evaluate the relationship between the hormone receptor status, histologic grade and, the film-mammographic findings in primary breast cancer.
MATERIALS AND METHODS
198 breast cancer patients with hormonal receptor assay were included in this study. Estrogen receptor (ER) and progesterone receptor (PR) were determined by immunohistochemical method and enzyme-immunoassay. And film-mammographic findings were evaluated to disclose the relationship among the three variables (film-mmamographic findings, histologic grade and hormonal receptor status). Film- mammographic findings of the breast cancer are classified as spiculation, increased parenchymal density, calcification and mass.
RESULTS
There is no correlation between estrogen receptor and histologic grade in 154 patients. Some correlation between estrogen receptor by enzyme-immunoassay and by immunohistochemistrical methods with 28 available data were observed (R=0.428). Among high estrogen receptor (ER) patients, there is a high possibility of spiculation or mass in mammography with 79 available data (Modified t-test, P<0.01).
CONCLUSION
Spiculation or/and mass of the mammography can be related to the high possibile factor of the positive estrogen receptor or high level of estrogen receptor in primary breast cancer.

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