Breast Cancer Patients In Korea Research Articles

The Impact of Symptom Burden, Social Support, Self-Efficacy, and eHealth Literacy on the Quality of Life of Patients Undergoing Breast Cancer Treatment: A Cross-Sectional Study

Purpose: The number of breast cancer patients in Korea has steadily increased. However, there are few studies addressing quality of life of patients undergoing breast cancer treatment in Korea. This study aimed to identify predictors of quality of life among patients undergoing breast cancer treatment.Methods: This descriptive, cross-sectional study included 142 patients with breast cancer undergoing treatment in a cancer hospital. Data were collected using the MD Anderson Symptom Inventory, Multidimensional Scale of Perceived Social Support, Breast Cancer Survivors Scale, eHealth Literacy Scale, and the Functional Assessment of Cancer Therapy-Breast Cancer through self-administered questionnaires from January 12 to December 6, 2022. Differences in the level of quality of life according to demographic and clinical variables and correlations among continuous variables were identified using univariate statistics, and hierarchical multiple regression was used to identify predictors of quality of life.Results: Employment status, comorbidities, disease duration, and cancer stage were demographic and clinical variables that showed significant associations with quality of life. Symptom burden, social support, self-efficacy, and eHealth literacy were also significantly associated with quality of life. The predictors of quality of life were employment status (β=.13, p=.009), cancer stage (β=.12, p=.033), symptom severity (β=-.14, p=.044), symptom interference (β=-.30, p<.001), social support (β=.13, p=.025), and self-efficacy (β=.46, p<.001). The explanatory power was approximately 69% (F=26.90, p<.001).Conclusion: Nursing interventions should be implemented for patients undergoing breast cancer treatment to improve their quality of life while reducing the symptom burden and enhancing self-efficacy and social support.

Abstract P1-18-32: A nationwide real-world study for evaluation of efficacy and safety of T-DM1 in patients with HER2-positive locally-advanced unresectable or metastatic breast cancer in Korea (KCSG BR19-15)

Abstract Purpose: T-DM1, an antibody-drug conjugate, has significant antitumor activity in patients with HER2-positive metastatic breast cancer (mBC) patients who had progressed after trastuzumab-based chemotherapy. This study was conducted to investigate the clinical practice and factors related with outcomes of T-DM1 use for HER2-positive mBC patients in the nation-wide real-world setting. Method: This complete enumeration study included the patients with HER2-positive mBC who received T-DM1 as palliative therapy from August 2017 to December 2018 under the registry of Health Insurance Review & Assessment Service in Korea. Safety and outcomes of T-DM1 including overall response rate (ORR), progression-free survival (PFS), and overall survival were evaluated. Factors significant in univariate analysis were analyzed in multivariate model. Result: From the sixty institutions, a total of 824 patients were enrolled. Mean age was 58 years-old, 818 patients (99.3%) were female and 516 patients (62.6%) had relapsed after curative treatment. About 40% patients received T-DM1 as first or second line treatment, 21.5% received it as third line and 37.3% as fourth or over line. During a median follow-up of 16.8 months, the ORR was 32.8%, median PFS was 7.2 months and median OS was not reached. In multivariate analysis, clinical factors associated with the lower PFS were age (< 65 year-old, hazard ratio[HR] 1.53, 95% confidence interval[CI]: 1.214-1.919, p < 0.001), poor ECOG performance status (PS ≥ 2, HR 1.98, 95% CI: 1.493-2.626, p < 0.001), previous pertuzumab use (HR 1.40, 95% CI: 1.118-1.742, p = 0.003) and previous lapatinib use (HR 1.29, 95% CI: 1.047-1.586, p =0.017). The common grade 3-4 adverse events were thrombocytopenia (13.0%), neutropenia (2.9%), and elevation of liver enzyme (2.5%). Hypokalemia (≤ 3.0 mmol/L) and any-grade bleeding event such as epistaxis and gum-bleeding occurred in 25 (3.1%) and 94 patients (11.4%), respectively. Conclusion: This is the first, nationwide, real-world data about T-DM1 use of the HER2-positive metastatic breast cancer patients in Korea. The efficacy and toxicity profile of T-DM1 in the real-world practice were comparable with those of randomized trials. Patients’ factors and previous anti-HER2 therapy could predict the outcomes of T-DM1. Further studies to reveal the subtypes of good responders to T-DM1 and the sequence of anti-HER2 therapy are warranted. Citation Format: Sun Kyung Baek, Jae-Ho Jeong, Yeon-Hee Park, Hee Kyung Ahn, Min Hwan Kim, In Hae Park, Young Ju Suh, Dae-Won Lee, Sung Hoon Sim, Jee Hyun Kim, Hyun-Jeong Shim, Yeesoo Chae, Su-Jin Koh, Hyorak Lee, Jieun Lee, Jae-Ho Byun, Youngmi Seol, Eun Mi Lee, Jin Seok Ahn, Kyung-Hae Jung, Seock-Ah Im, Keun Seok Lee, Joohyuk Sohn, Kyoung Eun Lee. A nationwide real-world study for evaluation of efficacy and safety of T-DM1 in patients with HER2-positive locally-advanced unresectable or metastatic breast cancer in Korea (KCSG BR19-15) [abstract]. In: Proceedings of the 2021 San Antonio Breast Cancer Symposium; 2021 Dec 7-10; San Antonio, TX. Philadelphia (PA): AACR; Cancer Res 2022;82(4 Suppl):Abstract nr P1-18-32.

The Effects of Exercise Intervention for Post-Operative Breast Cancer Patients in Korea: A Systemic Review and Meta-Analysis of Randomized Controlled Trials

The Effects of Exercise Intervention for Post-Operative Breast Cancer Patients in Korea: A Systemic Review and Meta-Analysis of Randomized Controlled Trials

Abstract P2-08-25: The 5-years conditional disease free survival and overal survival for breast cancer patients in Korea

Abstract Background: Most of breast cancer patients survive for a long-term period. The existing assessment of survivors’ prognosis has had some limitations in breast cancer because it is based on an evaluation at the time of diagnosis. Conditional survival reflects change over time after diagnosis and treatment of cancer. Conditional disease-free survival (CDFS) and conditional overall survival (COS) can provide more accurate prognosis to breast cancer patients. In this study, we aimed to determine 5-years CDFS and COS according to disease-free period after diagnosis and treatment of breast cancer in Korea. Method: We retrospectively reviewed clinical data of 5664 patients aged 16 to 86 who underwent curative surgery for breast cancer between January 2000 and December 2008 at Samsung Medical Center, a single tertiary hospital in Korea. The CDFS and COS rates were based on cumulative DFS and OS estimates up to 15 years using the Kaplan-Meier method. Results: At baseline, each 5-years DFS and OS were 88.0% and 93.8%. For patients who kept disease free status from 1 to 9 years after surgery, the 5-years CDFS rates were calculated as 88.7%, 90.7%, 91.6%, 91.1%, 91.5%, 91.0%, 89.5%, 86.1% and 86.1%, respectively. The 5-year COS rates of the patients who had survived from 1 to 9 years after surgical treatment were calculated as 92.6%, 92.1%, 91.2%, 91.0%, 89.4%, 85.6%, 80.7%, 75.3%, and 73.0%, respectively. Conclusion: Our study showed that 5-years CDFS and COS for most patients who have breast cancer in Korea seemed to be good prognosis for a long time. However, cancer recurrence tended to occur after a long period postoperatively. Further study is required to identify risk factors associated with recurrence after several years in Korean breast cancer patients. Citation Format: Jee Hyun Ahn, Seok Jin Nam, Seok Won Kim, Jeong Eon Lee, Byung-Joo Chae, Se Kyung Lee, Jai Min Ryu, Jonghan Yu. The 5-years conditional disease free survival and overal survival for breast cancer patients in Korea [abstract]. In: Proceedings of the 2019 San Antonio Breast Cancer Symposium; 2019 Dec 10-14; San Antonio, TX. Philadelphia (PA): AACR; Cancer Res 2020;80(4 Suppl):Abstract nr P2-08-25.

The Effects of Depression Intervention Programs for Breast Cancer Patients in Korea: A Systematic Review and Meta-Analysis

Purpose: This study aims to investigate and collect literature related to the effects of depression intervention programs on depression of breast cancer patients in Korea, and review these precedent studies on the effectiveness of depression intervention programs through meta-analysis. Method: To achieve a systematic literature review, a review question was defined according to PICO-SD: “How do depression intervention programs affect depression reduction in breast cancer participants compared to the control group?” The subjects of this study were research papers on depression intervention programs, which were released in Korea between 1990 and February 2020. Through the literature quality assessment in accordance with the SIGN (2012) Guidelines on Quality Assessment, a total of 30 pieces were selected as the final subjects of this study. Result: The overall effect size of a total of 30 pieces was -3.92 (95% CI: -4.82, -3.03, p<.001), which indicates that these depression intervention programs have a great effect on depression reduction. Conclusion: Intervention in depression of breast cancer patients in Korea is considered to contribute to improving the quality of their life and the ability to manage their symptoms, thus helping them have a positive meaning of life.

Stress, Social Support, and Sexual Adjustment in Married Female Patients with Breast Cancer in Korea

Objective:This study identified the level of stress, social support, and sexual adjustment in married women with breast cancer in Korea.Methods:This study used a subgroup analysis, prospective, cross-sectional, and descriptive correlation design. Data were obtained using the perceived stress scale, multidimensional scale of perceived social support, and sexual adjustment subscale of the Korean version of the psychosocial adjustment to illness scale. From May 2015 to April 2016, 272 married female patients who had been diagnosed with breast cancer were recruited at a university hospital in Korea. Data were analyzed using SPSS Win 21.0.Results:The mean score of stress level was 17.53 ± 4.13, social support was 5.37 ± 1.07, and sexual adjustment was 6.36 ± 3.29. A significant positive correlation emerged between sexual adjustment and stress (r = 0.161, P = 0.008). Significant negative correlations were observed among sexual adjustment and family support (r = –0.177, P = 0.003) and friends' support (r = –0.205, P = 0.001).Conclusions:The assessment of stress level and social support may be used in planning sexual-adjustment interventions appropriate for married female breast cancer patients in Korea.

Abstract 2531: Genomic landscape of breast cancer patients in Korea: Early data from K-MASTER project

Abstract The K-MASTER cancer precision medicine diagnosis and treatment enterprise (K-MASTER project) is a precision medicine cancer treatment clinical trial platform, which uses NGS assay to screen the actionable mutations in 10,000 patients with refractory solid tumors and assigns the patients to matched treatment. K-MASTER project was initiated in Korea since June 2017. From October 2017, we have analyzed next-generation (NGS)-based cancer panel to detect cancer genomic variations in breast cancer. This study is ongoing with 36 sites. Tumor DNA was analyzed by CancerSCAN (Samsung Genomic Institute) which allows to detect variations of 375 genes. As of October 31 in 2018, total 164 breast cancer patients were submitted and 95 samples were analyzed. The failure rate of sequencing was 4.1% of patients with samples submitted. The mean depth of CancerSCAN was 701x. Average turn-around time (TAT) of CancerSCAN was 3 weeks.In Korean breast cancer patients, variations were mainly identified in TP53 (63.6%), PIK3CA (35.2%), BRCA1 (25.0%), BRCA2 (23.9%), ERBB2 (23.9%), PTCH1 (21.6%), NOTCH1 (19.3%), FGFR1 (12.5%), PTEN (11.4%) and MET (9.1%). Further analysis will confirm amplification and deletion in breast cancer. Until March 2019, we will finish the genomic profiling of 350 breast cancer patients and will be reported. In conclusion, this project is efficient to detect actionable variations in breast cancer. This novel knowledge provides an intriguing background to investigate new target approaches and to progress precision medicine. (This research was supported by a grant of the Korea Health Technology R&amp;D Project through the Korea Health Industry Development Institute (KHIDI), funded by the Ministry of Health &amp;Welfare, Republic of Korea (Grant number: HI17C2206).) Citation Format: Jae Sook Sung, Hee-Joon Chung, Yoon Ji Choi, Won Jin Chang, Jung Yoon Choi, Ju Won Kim, Kyong Hwa Park, Yeul Hong Kim. Genomic landscape of breast cancer patients in Korea: Early data from K-MASTER project [abstract]. In: Proceedings of the American Association for Cancer Research Annual Meeting 2019; 2019 Mar 29-Apr 3; Atlanta, GA. Philadelphia (PA): AACR; Cancer Res 2019;79(13 Suppl):Abstract nr 2531.

Prevalence and oncologic outcomes of BRCA 1/2 mutations in unselected triple-negative breast cancer patients in Korea.

Triple-negative breast cancer (TNBC) accounts for 10-20% of all diagnosed BCs and it is enriched in BRCA1 mutation. Guidelines for Western countries suggest that BRCA 1/2 genetic testing should be done for patients with TNBC diagnosed less than 60 years, but there is lack of evidence supporting genetic testing in Asian populations. We determined the prevalence of germline BRCA 1/2 mutations among unselected Korean patients with TNBC and analyzed oncologic outcomes. From among 1628 women with TNBC who underwent surgery at Samsung Medical Center (SMC) between Jul 2008 and Jan 2016, 999 samples were available in the SMC biobank for testing germline BRCA 1/2 mutations using next-generation DNA sequencing. Overall, 131 Korean patients (13.1%) had BRCA 1/2 mutations: 97 (9.7%) were in BRCA 1, and 35 (3.5%) were in BRCA 2. One patient had both BRCA 1 and BRCA 2 mutations. Overall, 68 distinct pathologic or likely pathogenic variants (43 BRCA1 and 25 BRCA2) were found. Among those diagnosed at ≤ 60 years, the prevalence of BRCA 1/2 mutation was 14.5%. The mean age of diagnosis of BRCA1/2 mutation carriers was significantly younger than that of non-carriers (45.6 vs. 50.1 years, p < 0.0001). The median follow-up duration was 53.6months. There were no significant differences in disease-free survival, overall survival, or breast cancer-specific survival (p = 0.799, 0.092, and 0.124, respectively) between BRCA 1/2 carriers and non-carriers, although BRCA 1/2 carriers showed significantly worse contralateral breast cancer-free survival (p < 0.0001) than non-carriers. In unselected TNBC patients, we found BRCA 1/2 mutations in 13.1% of overall patients and 14.5% of patients ≤ 60years. We suggest that Korean women with TNBC diagnosed at ≤ 60years should be tested for BRCA1/2 mutation.

Radiation-related heart disease after breast cancer radiation therapy in Korean women.

To study the late cardiac toxicity of breast radiation therapy (RT) in Asian women. Female breast cancer patients in Korea who underwent breast conservation surgery followed by RT from 1990-2012 were identified from two large registries at institution and population levels. Cumulative incidences of acute coronary events (ACE) or cardiac mortality were estimated in relation to the laterality of breast cancer using a competing risks analysis. In an analysis of 2577 women from a single institution, 3.7% were obese (body mass index ≥30), and 3.4% were ever-smokers. Patients with a history of hypertension, diabetes, or coronary artery disease were 17.5, 5.7, and 2.8%, respectively. The mean heart doses were 6.2 and 1.5Gy for left- and right-sided tumors, respectively. With a median follow-up of 7 (range 1-23) years, the overall and breast cancer-specific survivals at 10years were 94.9 and 96.5%, respectively. The 10-year cumulative incidence of ACE was 2.96%. The mean time to ACE was 5.2±3.9years (range 1-17). There was no clinically relevant difference in rates of ACE between left-sided and right-sided patients, with an adjusted hazard ratio of 1.16 (CI 0.59-2.29). An analysis of 24,235 women in a nationwide registry validated these negative findings with respect to cardiac mortality, with an adjusted hazard ratio of 1.52 (CI 0.37-6.25). Increasing age, a higher body mass index, and a history of hypertension or ischemic heart disease were identified as risk factors. Our findings reassure that excess risk from breast RT may be small in healthy women, most of who not smoke, weigh less, and have fewer risk factors. A validation using a larger data set of National Health Insurance Corporation is ongoing.

Abstract B23: Examining the psychometric properties of the Functional Assessment of Cancer Therapy-Breast (FACT-B) among Korean American breast cancer survivors

Abstract Background: The 37-item Functional Assessment of Cancer Therapy-Breast (FACT-B) instrument has been validated and widely used in the literature to assess quality of life (QOL) among women with breast cancer. However, validation of the Korean version was conducted among breast cancer patients in Korea, and most studies in the United States have examined multiethnic samples with typically small numbers of Korean Americans (KA). This study examined the psychometric properties of FACT-B and its five subscales (physical well-being (PWB), social well-being (SWB), emotional well-being (EWB), functional well-being (FWB), and breast cancer subscale (BCS)) in a sample of KA breast cancer survivors. Methods: Data for this study are from a seven week randomized control trial aiming to increase QOL and reduce perceived stress among KA breast cancer survivors. Participants completed the FACT-B instrument at baseline, end of the program, and 7-weeks post intervention. In this study, baseline assessments of FACT-B were examined from 61 KA women in the Washington, D.C. metropolitan area with stages 0 to IV breast cancer. Participants' ages ranged from 30 to 83 (mean=56.7; SD=10.2). Principal component analysis (PCA) was conducted to examine FACT-B and its subscales. The factor correlation matrix was examined to determine the appropriate rotation method. Internal reliability was assessed using Cronbach's alpha. Results: Varimax rotation was employed given that factor correlations were mostly less than 0.32, which suggests that the variance between factors do not greatly overlap. The internal reliability of FACT-B in this sample was found to be good (α=.88). Moreover, the internal reliabilities were also good for PWB, SWB, and FWB (α=.85 to .89), but lower for EWB and BCS (α=.69 and α=.67 respectively). In general, these findings are consistent with the literature on White (α=.64-.91), African American (α=.77-.92), and Latina women (α=.72-.91) with breast cancer. Some variations were found between our study on KA women and other literature on breast cancer patients in China, Japan, and Korea. The internal reliability for EWB was lower in KA women (α=.69) as compared to Chinese women (α=.84), Japanese women (α=.74), and women in Korea (α=.79). However, our reliability is the same as that found in the initial FACT-B validation study by Brady et al. (1997) (α=.69). For other subscales, the internal reliabilities were similar or lower than in our sample. The initial PCA with varimax rotation retained 11 factors with eigenvalues above 1. However, 4 factors had only one or two items with factor loadings of at least |0.4|. Thus, 5 factors were specified based on the established number of subscales in the literature. The only item with a factor loading less than .4 was a question that asked how bothered participants were by hair loss. The low loading may be a result of few participants experiencing hair loss at the time of the survey. Interestingly, an item asking participants about how much they worry about dying had a negative loading even after reverse coding (ℓ=-.48), meaning those who worry more tend to have better QOL. One reason may be that concerns regarding death motivate some individuals to reassess priorities and better allocate their time on things that are more valued and enjoyable. Conclusions: Our findings were consistent with those from previous studies examining White, African American, and Latina women with breast cancer. In addition, FACT-B and its subscales had similar or higher internal reliabilities in our sample of KA women with breast cancer as compared to breast cancer patients in China, Japan, and Korea, with the exception of EWB. Overall, FACT-B was found to be reliable in our sample of KA breast cancer survivors providing additional support for its use in this population. Citation Format: Mary Y. Jung, Min Q. Wang, Sunmin Lee. Examining the psychometric properties of the Functional Assessment of Cancer Therapy-Breast (FACT-B) among Korean American breast cancer survivors. [abstract]. In: Proceedings of the Ninth AACR Conference on the Science of Cancer Health Disparities in Racial/Ethnic Minorities and the Medically Underserved; 2016 Sep 25-28; Fort Lauderdale, FL. Philadelphia (PA): AACR; Cancer Epidemiol Biomarkers Prev 2017;26(2 Suppl):Abstract nr B23.

Effects of Mindfulness Meditation Program on the physiological sign and depression in Breast Cancer Patients in Korea

Effects of Mindfulness Meditation Program on the physiological sign and depression in Breast Cancer Patients in Korea

Validity and reliability of EQ-5D-3L for breast cancer patients in Korea.

BackgroundRecently, breast cancer incidence and prevalence has been increasing. Patients' health related quality of life is important considerations in the treatment of breast cancer. The EQ-5D-3L is one of most popular instruments to measure health related quality of life. This study was aimed to evaluate the validity and reliability of EQ-5D-3L in post-operative breast cancer patients from Korea.MethodsA total of 827 patients visiting the ambulatory cancer center of 1 tertiary hospital after breast cancer surgery self-administered the EQ-5D-3L and Functional Assessment of Cancer Therapy-Breast Cancer (FACT-B). We evaluated known-group validity using differences in the EQ-5D-3L index and EQ-VAS score according to demographic and clinical data. The discriminatory ability of the EQ-5D-3L was determined by comparing the mean FACT-B subscale scores between subjects with no problems and subjects with moderate or severe problems in each EQ-5D-3L dimension. Construct validity was evaluated by Pearson correlation coefficients among the EQ-5D-3L index and FACT-B subscales, respectively. Reliability was assessed in terms of test-retest reliability using Cohen’s kappa value and intra-class correlation coefficient (ICC).ResultsThe EQ-5D-3L index and EQ-VAS score were higher in the educated, current radiotherapy and unmarried groups. The correlation of EQ-5D-3L index and subscales for the FACT-B was highest in physical well-being (r = 0.553) and lowest in social well-being (r = 0.199). For reliability, the Kappa values’ range was from 0.32 to 0.70, and ICCs of the EQ-5D-3L index and EQ-VAS scores were 0.70 and 0.48, respectively.ConclusionsThis study indicated that the EQ-5D-3L could be a valid health related quality of life instrument for postoperative breast cancer patients.

The Economic Burden of Breast Cancer in Korea from 2007-2010.

PurposeThis study estimates the socioeconomic cost and burden for breast cancer patients in Korea between 2007 and 2010.Materials and MethodsThis study used a prevalence-based approach to estimate the cost of breast cancer. Breast cancer patients were defined as those who were hospitalized or have visited an outpatient clinic during the period from 2007 to 2010. The socioeconomic costs of breast cancer were subdivided into two costs: direct and indirect.ResultsFrom 2007 to 2010, the prevalence of treated breast cancer increased from 7.9% to 20.4%. The total socioeconomic costs incurred by breast cancer increased by approximately 40.7% from US $668.49 million in 2007 to US $940.75 million in 2010. The direct medical care costs for 2010 were 1.4 times greater (US $399.22 million) than for 2007 (US $278.71 million). The direct non-medical costs rose from US $50.69 million in 2007 to US $75.83 million in 2010, a 49.6% increase. Regarding the economic burden of breast cancer, the total indirect costs were US $339.09 million in 2007 and increased by 37.3% to US $465.70 million in 2010. In the sensitivity analysis, with the annual discount rate for each year ranging from 0%-5%, the costs increased 1.1-1.2 times.ConclusionDue to the growing incidence of breast cancer, the annual prevalence and related costs are increasing. We must strive to reduce the socioeconomic burden of breast cancer through preventive measures and early screening.

Large genomic rearrangement of BRCA1 and BRCA2 genes in familial breast cancer patients in Korea

We screened large genomic rearrangements of the BRCA1 and BRCA2 genes in Korean, familial breast cancer patients. Multiplex ligation-dependent probe amplification assay was used to identify BRCA1 and BRCA2 genomic rearrangements in 226 Korean familial breast cancer patients with risk factors for BRCA1 and BRCA2 mutations, who previously tested negative for point mutations in the two genes. We identified only one large deletion (c.4186-1593_4676-1465del) in BRCA1. No large rearrangements were found in BRCA2. Our result indicates that large genomic rearrangement in the BRCA1 and BRCA2 genes does not seem like a major determinant of breast cancer susceptibility in the Korean population. A large-scale study needs to validate our result in Korea.

A Randomized Trial of Dyadic Peer Support Intervention for Newly Diagnosed Breast Cancer Patients in Korea

At the time of diagnosis, patients with cancer are highly exposed to the risk of psychological morbidity. The effects of psychosocial intervention for newly diagnosed cancer patients have not been extensively studied. The objective of this study was to test the effects of a dyadic peer support intervention on self-efficacy, anxiety, depression, and mental adjustment among newly diagnosed breast cancer patients in Korea. This study used a randomized controlled trial design. One hundred twenty-nine patients were recruited within 1 month of diagnosis with breast cancer in the National Cancer Center in Korea. The study participants were randomly assigned to either experimental (n = 64) or control (n = 65) group. The experimental group underwent dyadic peer support intervention during the 6 weeks after surgery. The control group received the usual care. There was a significant difference in changes in self-efficacy for self-management of breast cancer between the experimental and control groups; however, no significant changes were observed in anxiety, depression, and mental adjustment between the 2 groups. A 6-week dyadic peer support intervention was feasible and effective for increasing self-efficacy for self-management among newly diagnosed breast cancer patients in Korea. However, this intervention did not improve other psychological outcomes. Oncology nurses are optimally positioned to promote adjustment in patients with cancer. Trained peer support partners, supervised by skilled nurses, may be useful in improving self-efficacy of patients newly diagnosed with breast cancer.

Abstract 4226: PIK3CA mutation detection in clinical samples using PNA mediated real-time PCR clamping assay..

Abstract Somatic mutations in the PIK3CA gene have been frequently found in various human cancers, and their presence correlates to therapy response. These somatic mutations within the PIK3CA gene are localized in exon 9 and 20. We have developed a highly sensitive and simple method to detect 13 mutations in exons 9 and 20 of PIK3CA using PNA-mediated real-time PCR clamping, PNAClampTM. PNAClampTM is based on unique properties of PNA probes that PNA oligomers are not recognized by DNA serving as sequence-selective clamps during PCR amplification. This method can also detect 13 mutations through only three tube reactions each with 10 ng of the target DNA. PNAClampTM is simple and reliable with a detection limit of approximately 3% mutant alleles using 10 to 50 ng of normal DNA as a template. The turnaround time for performing this assay was only 2 hours. Furthermore, while direct sequencing method will detect most of PIK3CA samples as having E545A mutation, due to homology in exon 9 in PIK3CA gene, highly specific PNAClampTM Method have overcome this perceived problem. In clinical studies with breast cancer patients in Korea, PIK3CA mutations were detected utilizing PNAClampTM in 60 (35.7 %) of clinical samples, and the results were compared with direct sequencing method. Among 168 patients, 6 (3.6 %) had mutations in codon 542, 23 (13.7 %) had mutations in codon 545 and 31 (18.5 %) had mutations in codon 1047. To confirm these results, the same clinical samples were analyzed with a sequencing assay. Consistent results were obtained from 137 (81.5 %) of the 168 clinical samples between PNAClampTM and the sequencing assay. The results not in agreement with the sequencing numbered 21 (12.5 %) samples. Ten samples did not react by direct sequencing due to quality problems with the target DNA. The remaining samples were initially determined as the wild type by direct sequencing, but they were found to be PIK3CA mutant using PNAClampTM. This result was likely due to the high sensitivity of PNAClampTM. PNAClampTM is a rapid, sensitive and easy to perform tool that can be used for the detection of PIK3CA mutations in the clinical field. [j1]Check this - original was unclear. Is this what you mean? Citation Format: Hysun Kim, Jae Jin Choi, Heekyung Park. PIK3CA mutation detection in clinical samples using PNA mediated real-time PCR clamping assay. [abstract]. In: Proceedings of the 104th Annual Meeting of the American Association for Cancer Research; 2013 Apr 6-10; Washington, DC. Philadelphia (PA): AACR; Cancer Res 2013;73(8 Suppl):Abstract nr 4226. doi:10.1158/1538-7445.AM2013-4226

The prevalence of BRCA mutations among familial breast cancer patients in Korea: results of the Korean Hereditary Breast Cancer study

The primary aim of this study was to estimate the prevalence of BRCA1/2 mutations among familial breast cancer (BC) patients in Korea. We analyzed 775 familial BC patients who were enrolled in the Korean Hereditary Breast Cancer (KOHBRA) study and treated at 36 institutions between May 2007 and May 2010. Patients with familial BC were defined as BC patients with family histories of BC or ovarian cancer (OC) in any relatives. All probands received genetic counseling and BRCA genetic testing was performed after obtaining informed consent. The mean age of BC diagnosis was 43.6 years. The numbers of probands with family histories of BC only and OC only were 682 and 93, respectively. The overall prevalence of the BRCA mutation among familial BC patients was 21.7 % (BRCA1 9.3 % and BRCA2 12.4 %). Subgroup analyses observed prevalences of the BRCA mutation as follows: 19.6 % among patients with BC family history only (BRCA1 7.6 % and BRCA2 12.0 %) and 36.6 % among patients with OC family history only (BRCA1 21.5 % and BRCA2 15.1 %). Most of the subgroups satisfied the 10 % probability criteria to undergo BRCA testing. However, the prevalence of the BRCA mutations among subgroups that had 2 BC patients in a family with both age at diagnosis of more than 50 years old did not reach the 10 % criteria (4.1 %). Korean familial BC patients are good candidates for BRCA testing even when they have family histories of single breast cancers. However, proband age at diagnosis should be carefully considered when selecting patients for testing.

Effects of zoledronic acid on bone mineral density during aromatase inhibitor treatment of Korean postmenopausal breast cancer patients

The age distribution of breast cancer patients in Korea, where most are less than 60 years of age and have recently entered menopause, differs from that in the West. The aim of this study was to evaluate bone mineral density (BMD) changes in Korean breast cancer patients treated with an aromatase inhibitor (AI) either alone or in combination with zoledronic acid (ZA). Changes in BMD of the lumbar spine and hip were evaluated in 107 patients receiving AI treatment, of which 59 were treated in combination with ZA. The mean age of the patients was 54.9 years, and the median follow-up period was 38.2 months. With AI treatment alone, BMD loss was significant (all P < 0.0001) in the lumbar spine and hip 12 months (4.18 and 3.95%, respectively), 24 months (6.28 and 5.44%), and 36 months (8.17 and 6.82%) after treatment. In contrast, the combination treatment resulted in increased BMD in the lumbar spine and hip 12 months (2.45 and 0.89%, respectively), 24 months (3.51 and 1.03%), and 36 months (3.85 and 1.80%) after treatment. BMD loss in the lumbar spine was significantly greater in AI alone-treated women who had entered menopause within the past year compared with those who had entered menopause more than 1 year ago, when measured 12 and 24 months after treatment (P = 0.017 and 0.021, respectively). Importantly, ZA effectively inhibited AI-associated bone loss, independent of the postmenopausal interval. Because the proportion of patients in this study who had recently entered menopause was high, bone loss in Korean breast cancer patients treated with AI alone was higher than data reported from the Arimidex, Tamoxifen Alone or in Combination (ATAC) trial. In conclusion, we have shown that ZA is very effective in preventing AI-induced bone loss in Korean postmenopausal breast cancer patients.

Abstract 3069: One-step sensitive PNA mediated real-time PCR clamping assay to detect PIK3CA mutations

Abstract Phosphatidylinositol 3-kinases (PI3K) are important regulators of cellular growth, transformation, adhesion, apoptosis, survival and motility. Mutations in the PIK3CA oncogene encoding PI3K have been frequently found in various human cancers. The presence of PIK3CA mutations in a tumor has been suggested as a prognostic factor and may predict responses to select treatments. Therefore, detection of PIK3CA mutations may help predict drug responses and prognosis of cancer patients. We have developed a highly sensitive and simple method to detect 11 mutations in exons 9 and 20 of PIK3CA using one-step PNA-mediated real-time PCR clamping, PNAClampTM. PNAClampTM relies on unique properties of PNA probes that PNA oligomers are not recognized by DNA serving as sequence-selective clamps during PCR amplification. This method can also detect 11 mutations through only three tube reactions each with 10 ng of the target DNA. PNAClampTM is simple and reliable with a detection limit of approximately 0.1% mutant alleles using 10 to 50 ng of normal DNA as a template. The turnaround time for performing this assay was only 2 hours. In clinical studies with breast cancer patients in Korea, PIK3CA mutations were detected utilizing PNAClampTM in 12 (35.3%) of clinical samples, and the results were compared with direct sequencing method. Among 34 patients, 1 (2.94%) had mutations in codon 542, 6 (17.65%) had mutations in codon 545 and 5 (14.71%) had mutations in codon 1047. The results will be discussed in detail in this report including the method development and optimization. Citation Format: {Authors}. {Abstract title} [abstract]. In: Proceedings of the 102nd Annual Meeting of the American Association for Cancer Research; 2011 Apr 2-6; Orlando, FL. Philadelphia (PA): AACR; Cancer Res 2011;71(8 Suppl):Abstract nr 3069. doi:10.1158/1538-7445.AM2011-3069

Postoperative treatment strategy and follow up management for breast cancer patients in Korea

배경 및 연구목적 : 유방암은 조기 진단 및 근치적 절제술뿐만 아니라 수술 후 보조요법과 추적관리가 그 어떤 다른 고형암에서 보다 중요하다고 할 수 있다. 하지만, 얼마의 기간 동안, 어떠한 규칙과 검사법으로 추적관리를 해야 하는지에 대해서는 몇몇 국내외적 권고안이 있기는 하지만 통일되어 있지 않고 개별 의사마다 서로 다른 추적관리가 이루어지고 있는 실정이다. 따라서, 본 연구진은 국내에서 발생하는 유방암 암환자의 대부분을 치료하고 있는 한국유방암학회 회원을 대상으로 수술 후 치료전략 및 추적 관리에 대한 설문조사를 통하여 현황을 알아보고자 하였다. 연구방법 : 2008년 12월부터 2009년 2월까지 49개의 종합병원 급 이상의 기관에서 환자진료를 담당하고 있는 한국유방암학회 회원 307명을 대상으로 e-mail과 우편을 통해 동시에 설문지를 발송하였으며 설문지를 회수하고 분석하였다. 설문은 응답자의 개인적인 사항과 추적검사를 시행하는 주체, 치료결정시 참고하는 권고안, 추적일정 등에 대한 질문으로 구성되었다. 연구결과 : 응답자들은 30대부터 50대에 고른 연령분포를 보였으며 대부분 500병상 이상의 대형병원에 근무하고 5년 이상의 임상경력을 가지고 있는 외과의사가 대다수를 차지하고 있었고, 수술 후 추적관리 주체는 항암치료 여부, 호르몬 치료 여부에 상관없이 대부분의 경우 외과인 것으로 나타났으며 보조요법 결정 시에는 응답자 별로 다양한 권고안을 비슷한 비율로 참고하고 있었다. 또한, 추적검사 일정은 수술 후부터 5년 사이에는 6개월 마다, 5년 후에는 1년 마다 한다는 응답이 대다수였고, 검사 항목으로는 단순유방촬영술, 유방초음파, 골스캔을 필수적으로 시행하며 PET CT와 MRI가 선택적으로 시행되고 CA 15-3, CEA 등의 종양표지자와 몇 가지 혈액화학검사를 필수적으로 시행되고 있는 것으로 나타났다. 결론: 국내 유방암 환자의 대부분을 진료하고 있는 유방암학회 정회원을 대상으로 하여 유방암 수술 후 보조요법 결정 및 추적관리 현황에 대한 현황을 조사하여 몇몇 국내의 특징적인 현황들을 발견하였으며 이를 토대로 향후 필요한 연구의 방향을 제시하고 현재의 국내 권고안을 넘어선 추적관리 및 전반적인 치료법의 표준화를 이루기 위한 근거자료로 활용될 수 있을 것으로 생각된다.