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Article: Reply on "Prognosis according to the timing of recurrence in breast cancer" (Ann Surg Treat Res 2023;104:1-9).

Jung, Seung Pil / Lee, Young Joo / Bae, Soo Youn

Annals of surgical treatment and research

2024 Volume 106, Issue 4, Page(s) 239–240

Language	English
Publishing date	2024-03-29
Publishing country	Korea (South)
Document type	Journal Article
ZDB-ID	3012234-X
ISSN	2288-6796 ; 2288-6575
ISSN (online)	2288-6796
ISSN	2288-6575
DOI	10.4174/astr.2024.106.4.239
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Article ; Online: Microbiologic Profile of Nipple Swab Culture and its Association With Postoperative Complications in Prosthetic Breast Reconstruction.

Moon, Yi-Jun / Chung, Jae-Ho / Lee, Hyung-Chul / Jung, Seung-Pil / Yoon, EulSik

Aesthetic surgery journal

2024

Abstract: Background: In breast surgeries, lactiferous duct heading to lactic glands of breast parenchyma allows direct contamination of normal bacterial flora of nipple-areolar complex. Complete blockage of nipple flora to the intraoperative field is almost ... ...

Abstract	Background: In breast surgeries, lactiferous duct heading to lactic glands of breast parenchyma allows direct contamination of normal bacterial flora of nipple-areolar complex. Complete blockage of nipple flora to the intraoperative field is almost impossible. Objectives: Therefore, we aimed to analyze the microbiological profile of nipple flora of breast cancer patients who underwent an implant-based immediate breast reconstruction after a total mastectomy; and evaluate the association of nipple bacterial flora with postoperative complications. Methods: A retrospective chart review was performed for patients who underwent an implant-based immediate breast reconstruction after a total mastectomy. A nipple swab culture was performed preoperatively. Patient demographics, surgical characteristics, and complications were compared between positive and negative nipple swab culture groups. Microbiological profile data including antibacterial resistance were collected. Results: Among 128 breasts, 60 cases (46.9%) had positive preoperative nipple swab culture results. Staphylococcus epidermidis accounted for 41.4% of microorganisms isolated. A multivariate logistic regression analysis of postoperative complications revealed that the presence of nipple bacterial flora was a risk factor of capsular contracture. Seven cases of postoperative infection were analyzed. In 2 cases (40% of pathogen-proven infection), the causative pathogen matched with the patient's nipple bacterial flora, which was methicillin-resistant S. epidermidis in both cases. Conclusions: Nipple bacterial flora was associated with an increased risk of capsular contracture. Preoperative analysis of nipple bacterial flora can be an informative source for treating clinically diagnosed postoperative infections. More studies are needed to find out the effectiveness of active antibiotic decolonization of the nipple.
Language	English
Publishing date	2024-02-16
Publishing country	England
Document type	Journal Article
ZDB-ID	2087022-X
ISSN	1527-330X ; 1090-820X ; 1084-0761
ISSN (online)	1527-330X
ISSN	1090-820X ; 1084-0761
DOI	10.1093/asj/sjae021
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Article: Assessing the preventive effect of immediate lymphatic reconstruction on the upper extremity lymphedema.

Chung, Jae-Ho / Kwon, Sang-Ho / Jung, Seung-Pil / Park, Seung-Ha / Yoon, Eul-Sik

Gland surgery

2023 Volume 12, Issue 3, Page(s) 334–343

Abstract: Background: An immediate lymphatic reconstruction (ILR) combining axillary reverse lymphatic mapping (ARLM) and lymphovenous anastomosis (LVA) has been gradually in the spotlight as a novel surgical technique to prevent lymphedema. In this study, we ... ...

Abstract	Background: An immediate lymphatic reconstruction (ILR) combining axillary reverse lymphatic mapping (ARLM) and lymphovenous anastomosis (LVA) has been gradually in the spotlight as a novel surgical technique to prevent lymphedema. In this study, we investigate the preventive effect of ILR for the risk of upper extremity lymphedema. We will compare the incidence of postoperative lymphedema between the ILR treatment group and the no-try or failure group during the same period with analysis of the effects of different variables. Methods: In this retrospective cohort study, we analyzed 213 patients who had undergone mastectomy for node-positive unilateral breast cancer in our institution between November 1, 2019 and February 28, 2021. To assess the effect of preventive ILR, we divided the patients into a treatment group (n=30) and a control group (n=183). Univariate and multivariate Cox proportional hazards regression models were used to evaluate the association between ILR and lymphedema occurrence. Results: Of the 30 patients who were attempted, we successfully performed ILRs in 26 patients (86.7%). During a mean follow-up of 14 months, one patient (3.8%) was confirmed to have upper extremity lymphedema in the treatment group, whereas 14 out of 183 patients (7.7%) were diagnosed in the control group. In multivariate analysis, ILR success showed a borderline significant decrease in risk of lymphedema [hazard ratio (HR) =0.174; 95% confidence interval (CI): 0.022-1.374; P=0.097]. Conclusions: Our results suggested that ILR may be a promising surgical treatment to prevent postoperative lymphedema. There is a need for larger studies with longer follow-up to confirm the findings obtained in our study.
Language	English
Publishing date	2023-02-24
Publishing country	China (Republic : 1949- )
Document type	Journal Article
ZDB-ID	3016969-0
ISSN	2227-8575 ; 2227-684X
ISSN (online)	2227-8575
ISSN	2227-684X
DOI	10.21037/gs-22-554
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Article: Tumor Heterogeneity of Breast Cancer Assessed with Computed Tomography Texture Analysis: Association with Disease-Free Survival and Clinicopathological Prognostic Factor.

Yoo, Hyeongyu / Cho, Kyu Ran / Song, Sung Eun / Cho, Yongwon / Jung, Seung Pil / Sung, Kihoon

Diagnostics (Basel, Switzerland)

2023 Volume 13, Issue 23

Abstract: Breast cancer is a heterogeneous disease, and computed tomography texture analysis (CTTA), which reflects the tumor heterogeneity, may predict the prognosis. We investigated the usefulness of CTTA for the prediction of disease-free survival (DFS) and ... ...

Abstract	Breast cancer is a heterogeneous disease, and computed tomography texture analysis (CTTA), which reflects the tumor heterogeneity, may predict the prognosis. We investigated the usefulness of CTTA for the prediction of disease-free survival (DFS) and prognostic factors in patients with invasive breast cancer. A total of 256 consecutive women who underwent preoperative chest CT and surgery in our institution were included. The Cox proportional hazards model was used to determine the relationship between textural features and DFS. Logistic regression analysis was used to reveal the relationship between textural features and prognostic factors. Of 256 patients, 21 (8.2%) had disease recurrence over a median follow-up of 60 months. For the prediction of shorter DFS, higher histological grade (hazard ratio [HR], 6.12;
Language	English
Publishing date	2023-11-29
Publishing country	Switzerland
Document type	Journal Article
ZDB-ID	2662336-5
ISSN	2075-4418
ISSN	2075-4418
DOI	10.3390/diagnostics13233569
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Article ; Online: Ultrasonographic assessment of rectus abdominis muscle adaptation after deep inferior epigastric artery perforator (DIEP) flap surgery: Single institution retrospective study.

Kim, Haneul / Lee, Hyung Chul / Chung, Jae-Ho / Jung, Seung Pil / Yoon, Eul-Sik

Medicine

2023 Volume 102, Issue 35, Page(s) e34721

Abstract: The impact of deep inferior epigastric artery perforator (DIEP) flap on abdominal wall integrity has been the topic of an ongoing debate with previous studies having reported conflicting results using various imaging modalities. Ultrasonography is a ... ...

Abstract	The impact of deep inferior epigastric artery perforator (DIEP) flap on abdominal wall integrity has been the topic of an ongoing debate with previous studies having reported conflicting results using various imaging modalities. Ultrasonography is a noninvasive, cost-effective, and readily available method for evaluating the changes to the rectus muscle after DIEP flap surgery. In the present study, we aimed to compare rectus abdominis muscle thickness between the operated and non-operated sides using ultrasound imaging. The muscle thickness was measured at the cross point of the midclavicular line and the level of the umbilicus and anterior superior iliac spine using real-time B-mode ultrasonography. The muscle anteroposterior diameters of the pedicle-dissected side and the control side were compared using paired t test. In total 31 patients with a mean follow-up of 70.18 weeks were included. The mean diameters at the level of the umbilicus of the operated and non-operated sides were 8.16 ± 1.83 and 8.14 ± 1.43 mm, respectively (P = .94). The mean thicknesses at the anterior superior iliac spine level were 7.74 ± 1.85 on the flap harvested side and 8.04 ± 1.84 mm on the control side (P = .35). There was no statistically significant difference between the 2 groups. Ultrasonography can be a reliable, inexpensive, and easily usable modality for evaluating donor site complication following DIEP flap. DIEP flap seems to have minimal impact on the abdominal donor site, and it may be safe and versatile to reconstruct the breast after mastectomy.
MeSH term(s)	Humans ; Female ; Rectus Abdominis/diagnostic imaging ; Retrospective Studies ; Breast Neoplasms ; Epigastric Arteries/diagnostic imaging ; Mastectomy ; Crassulaceae ; Oculomotor Muscles ; Mammaplasty/adverse effects
Language	English
Publishing date	2023-09-01
Publishing country	United States
Document type	Journal Article
ZDB-ID	80184-7
ISSN	1536-5964 ; 0025-7974
ISSN (online)	1536-5964
ISSN	0025-7974
DOI	10.1097/MD.0000000000034721
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Article ; Online: Value of Breast MRI and Nomogram After Negative Axillary Ultrasound for Predicting Axillary Lymph Node Metastasis in Patients With Clinically T1-2 N0 Breast Cancer.

Song, Sung Eun / Cho, Kyu Ran / Cho, Yongwon / Jung, Seung Pil / Park, Kyong-Hwa / Woo, Ok Hee / Seo, Bo Kyoung

Journal of Korean medical science

2023 Volume 38, Issue 34, Page(s) e251

Abstract: Background: There are increasing concerns about that sentinel lymph node biopsy (SLNB) could be omitted in patients with clinically T1-2 N0 breast cancers who has negative axillary ultrasound (AUS). This study aims to assess the false negative result ( ... ...

Abstract	Background: There are increasing concerns about that sentinel lymph node biopsy (SLNB) could be omitted in patients with clinically T1-2 N0 breast cancers who has negative axillary ultrasound (AUS). This study aims to assess the false negative result (FNR) of AUS, the rate of high nodal burden (HNB) in clinically T1-2 N0 breast cancer patients, and the diagnostic performance of breast magnetic resonance imaging (MRI) and nomogram. Methods: We identified 948 consecutive patients with clinically T1-2 N0 cancers who had negative AUS, subsequent MRI, and breast conserving therapy between 2013 and 2020 from two tertiary medical centers. Patients from two centers were assigned to development and validation sets, respectively. Among 948 patients, 402 (mean age ± standard deviation, 57.61 ± 11.58) were within development cohort and 546 (54.43 ± 10.02) within validation cohort. Using logistic regression analyses, clinical-imaging factors associated with lymph node (LN) metastasis were analyzed in the development set from which nomogram was created. The performance of MRI and nomogram was assessed. HNB was defined as ≥ 3 positive LNs. Results: The FNR of AUS was 20.1% (81 of 402) and 19.2% (105 of 546) and the rates of HNB were 1.2% (5/402) and 2.2% (12/546), respectively. Clinical and imaging features associated with LN metastasis were progesterone receptor positivity, outer tumor location on mammography, breast imaging reporting and data system category 5 assessment of cancer on ultrasound, and positive axilla on MRI. In validation cohorts, the positive predictive value (PPV) and negative predictive value (NPV) of MRI and clinical-imaging nomogram was 58.5% and 86.5%, and 56.0% and 82.0%, respectively. Conclusion: The FNR of AUS was approximately 20% but the rate of HNB was low. The diagnostic performance of MRI was not satisfactory with low PPV but MRI had merit in reaffirming negative AUS with high NPV. Patients who had low probability scores from our clinical-imaging nomogram might be possible candidates for the omission of SLNB.
MeSH term(s)	Humans ; Female ; Breast Neoplasms/diagnostic imaging ; Lymphatic Metastasis ; Axilla ; Nomograms ; Magnetic Resonance Imaging ; Lymph Nodes/diagnostic imaging
Language	English
Publishing date	2023-08-28
Publishing country	Korea (South)
Document type	Journal Article
ZDB-ID	639262-3
ISSN	1598-6357 ; 1011-8934
ISSN (online)	1598-6357
ISSN	1011-8934
DOI	10.3346/jkms.2023.38.e251
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Article: Prognosis according to the timing of recurrence in breast cancer.

Lee, Young Joo / Jung, Seung Pil / Bae, Jeoung Won / Yang, Sun Moon / You, Ji Young / Bae, Soo Youn

Annals of surgical treatment and research

2023 Volume 104, Issue 1, Page(s) 1–9

Abstract: Purpose: Clinically, breast cancer can be divided into 4 subtypes based on the presence of hormone receptors, human epidermal growth factor receptor 2 (HER2), and Ki-67. Because the pattern and time of recurrence vary according to the subtype, we ... ...

Abstract	Purpose: Clinically, breast cancer can be divided into 4 subtypes based on the presence of hormone receptors, human epidermal growth factor receptor 2 (HER2), and Ki-67. Because the pattern and time of recurrence vary according to the subtype, we evaluated whether there was a difference in overall survival (OS) among the subtypes according to the time and type of recurrence. Methods: A total of 2,730 patients who underwent breast cancer surgery were analyzed. Early and late recurrence were defined as recurrence within and after 5 years of diagnosis, respectively. Recurrence type was categorized as locoregional recurrence or systemic recurrence. Results: Hormone receptor-positive tumors were significantly more frequent in the late recurrence group than in the early recurrence group (estrogen receptor positive, 47.8% [early] Conclusion: The luminal B subtype had a high rate of late recurrence, and late recurrence was a poor prognostic factor for OS only in this subgroup. Therefore, further targeted treatments for luminal B breast cancer are needed and patients with this subtype require close long-term surveillance.
Language	English
Publishing date	2023-01-02
Publishing country	Korea (South)
Document type	Journal Article
ZDB-ID	3012234-X
ISSN	2288-6796 ; 2288-6575
ISSN (online)	2288-6796
ISSN	2288-6575
DOI	10.4174/astr.2023.104.1.1
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Article: Differences in prognosis by p53 expression after neoadjuvant chemotherapy in triple-negative breast cancer.

Bae, Soo Youn / Lee, Jeong Hyeon / Bae, Jeoung Won / Jung, Seung Pil

Annals of surgical treatment and research

2020 Volume 98, Issue 6, Page(s) 291–298

Abstract: Purpose: Our previous studies suggested that p53-positive triple-negative breast cancer (TNBC) should be more sensitive to chemotherapy than p53-negative TNBC. The aim of this study was to determine whether p53 expression in TNBC could predict response ... ...

Abstract	Purpose: Our previous studies suggested that p53-positive triple-negative breast cancer (TNBC) should be more sensitive to chemotherapy than p53-negative TNBC. The aim of this study was to determine whether p53 expression in TNBC could predict response to neoadjuvant chemotherapy and the resulting prognosis. Methods: From January 2009 to December 2017, TNBC patients who underwent neoadjuvant chemotherapy were reviewed, including a total of 31 TNBC patients who had clinical lymph node metastasis. The status of p53 expression in patients before and after chemotherapy was evaluated. Results: Two patients (22.2%, 2 of 9) achieved pCR in p53(+) TNBC and 4 patients (50%, 5 of 10) achieved pCR in p53(-) TNBC. There was no correlation between pCR rate and p53 expression (P = 0.350). Based on prechemotherapy p53 expression, there was no significant difference in disease-free survival (DFS) between p53(+) TNBC and p53(-) TNBC (P = 0.335). However, after chemotherapy, p53(+) TNBC had shown higher DFS than p53(-) TBNC (P = 0.099). Based on prechemotherapy p53 expression, p53(+) TNBC had better overall survival (OS) than p53(-) TNBC, but the difference was not statistically significant (P = 0.082). After chemotherapy, p53(+) TNBC showed significantly better OS than p53(-) TNBC (P = 0.018). Conclusion: Immunohistochemically detected p53 expression in TNBC could not predict the response to neoadjuvant chemotherapy. However, p53(+) TNBC had a better OS than p53(-) TNBC in patients who underwent neoadjuvant chemotherapy.
Language	English
Publishing date	2020-05-28
Publishing country	Korea (South)
Document type	Journal Article
ZDB-ID	3012234-X
ISSN	2288-6796 ; 2288-6575
ISSN (online)	2288-6796
ISSN	2288-6575
DOI	10.4174/astr.2020.98.6.291
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Article ; Online: Correction of malrotation in two-stage breast reconstruction: outcomes and risk-factor analysis.

Lee, Jaemin / Lee, Hyung Chul / Park, Seung-Ha / Jung, Seung Pil / Yoon, Eul-Sik

Journal of plastic surgery and hand surgery

2021 Volume 55, Issue 1, Page(s) 6–12

Abstract: Although an anatomical implant is no longer recommended in practice, frequent use of the implants in the past decade left apprehension to surgeons, and malrotation is one of the concerns. However, a limited amount of literature has focused on malrotation ...

Abstract	Although an anatomical implant is no longer recommended in practice, frequent use of the implants in the past decade left apprehension to surgeons, and malrotation is one of the concerns. However, a limited amount of literature has focused on malrotation to date, especially in breast reconstruction, and there also exists a lack of consensus regarding the correction of malrotation. Given that implant-based reconstruction has increased in frequency and there remain many potential patients who have used earlier models of anatomical implants, this study sought to analyze predisposing risk factors and approaches to correct implant malrotation. A total of 132 implants in 118 patients who underwent expander/implant reconstruction were identified and retrospectively reviewed. Seventeen (12.9%) implants showed malrotation. The results of multivariate logistic regression revealed that tissue expander malrotation in the first stage and capsular contracture were significant risk factors associated with malrotation in two-stage implant-based breast reconstruction (both
MeSH term(s)	Adolescent ; Adult ; Aged ; Breast/diagnostic imaging ; Breast Implants/adverse effects ; Female ; Humans ; Implant Capsular Contracture/complications ; Implant Capsular Contracture/surgery ; Mammaplasty/adverse effects ; Mammaplasty/methods ; Middle Aged ; Retrospective Studies ; Risk Assessment ; Tissue Expansion/adverse effects ; Tissue Expansion Devices ; Ultrasonography ; Young Adult
Language	English
Publishing date	2021-01-20
Publishing country	Sweden
Document type	Journal Article
ZDB-ID	2551921-9
ISSN	2000-6764 ; 2000-656X
ISSN (online)	2000-6764
ISSN	2000-656X
DOI	10.1080/2000656X.2020.1817752
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Article: Analysis of oncological safety of autologous fat grafting after immediate breast reconstruction.

Chung, Jae-Ho / Kim, Ki-Jae / Jung, Seung Pil / Park, Seung-Ha / Yoon, Eul-Sik

Gland surgery

2021 Volume 10, Issue 2, Page(s) 584–594

Abstract: Background: Fat grafting is now a common procedure for breast reconstruction. Many clinical studies have reported its aesthetic efficacy and oncological safety, but some experimental studies raise about the recurrence risk because of its regenerating ... ...

Abstract	Background: Fat grafting is now a common procedure for breast reconstruction. Many clinical studies have reported its aesthetic efficacy and oncological safety, but some experimental studies raise about the recurrence risk because of its regenerating property. This study aims to investigate the possibility of cancer recurrence associated with fat grafting. Methods: In this retrospective cohort study, we analyzed a total of 339 patients who had undergone immediate reconstructive surgery after nipple-sparing mastectomy (NSM) or skin-sparing mastectomy (SSM) in our institution between February 28, 2009 and March 23, 2019. Patients who had undergone breast conserving surgery, radical mastectomy, or delayed reconstruction were excluded. We used univariate and multivariate Cox proportional hazards regression models to evaluate the association between fat grafting and cancer recurrence. Results: Among the 339 patients during a median follow-up of 52 months, 27 patients (8.0%) were confirmed to have recurrent cancer. Of 67 patients who had undergone fat grafting, 10 patients were confirmed to have cancer recurrence. In multivariate analyses, fat grafting [hazard ratio (HR), 2.52; 95% CI, 1.005-6.317; P=0.0488] was independently associated with cancer recurrence. Conclusions: In population of breast cancer patient who underwent immediate reconstruction in our institution, fat grafting showed significant higher risk of cancer recurrence. Although these results are at odds with many existing studies, it suggests that more careful follow-up may be necessary for patients who had undergone fat grafting after reconstructive surgery.
Language	English
Publishing date	2021-02-15
Publishing country	China (Republic : 1949- )
Document type	Journal Article
ZDB-ID	3016969-0
ISSN	2227-8575 ; 2227-684X
ISSN (online)	2227-8575
ISSN	2227-684X
DOI	10.21037/gs-20-645
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