Publications by authors named "Sungchan Gwark"

Background: Robot-assisted nipple-sparing mastectomy (RANSM) has transformed breast cancer surgery by offering precise dissection, reduced scarring, and quicker recovery. Single-port RANSM (SP-RANSM) builds on these advancements, with debates surrounding the use of tumescent dissection technique owing to potential complications and increased operative time. This study compares the early postoperative outcomes of the two techniques to guide surgical decision-making and improve patient care.

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Background: Chemo-endocrine therapy can lead to various side effects associated with ovarian dysfunction. Predicting menstrual recovery is necessary to discuss the treatment-related issues regarding fertility and premature menopause with patients.

Methods: In the ASTRRA trial, patients who resumed ovarian function within 2 years after chemotherapy were randomized to receive tamoxifen for 5 years or OFS with tamoxifen for 2 years.

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Introduction: Male breast cancer (MBC) is a rare condition, and recent research has underscored notable distinctions between MBC and breast cancer in women. This study aimed to assess and contrast the long-term survival outcomes and disease patterns of MBC patients with those of their female counterparts.

Methods: We analyzed data from 113,845 patients diagnosed with breast cancer who had undergone curative surgery from the Korean Breast Cancer Registry (KBCR) between January 1990 and August 2014 in Seoul, Korea.

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Article Synopsis
  • - The study aimed to evaluate the effectiveness of abdominal staging CT scans in finding liver metastasis in breast cancer patients initially diagnosed, analyzing a large cohort of 2056 patients over a two-year period.
  • - The diagnostic yield (DY) was found to be low overall at 1.1%, but it significantly increased in patients with stage III cancer (3.9%) and in those with HER2-enriched cancers, suggesting certain groups may benefit more from this imaging technique.
  • - Although the findings indicate that routine abdominal staging CT scans may not be necessary for all breast cancer patients, they are recommended for those with more advanced disease or specific cancer subtypes.
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Importance: Young patients with breast cancer have higher risk for developing contralateral breast cancer (CBC) and have epidemiologic characteristics different from those of older patients.

Objective: To examine the incidence and peak occurrence of CBC according to age at primary breast cancer (PBC) surgery.

Design, Setting, And Participants: This cohort study included patients who were diagnosed with and underwent surgery for unilateral nonmetastatic breast cancer at Asan Medical Center, Korea, between January 1, 1999, and December 31, 2013, with follow-up through December 31, 2018.

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Article Synopsis
  • - The study focused on the effects of mammographic breast density reduction (MDR) on treatment outcomes in premenopausal women with estrogen receptor-positive breast cancer who received either tamoxifen alone or in combination with ovarian function suppression (OFS).
  • - Results from the ASTRRA trial showed that while the rate of MDR positivity was similar in both treatment groups, patients receiving tamoxifen plus OFS who were MDR-positive experienced significantly better disease-free survival compared to those who were MDR-negative.
  • - The findings highlight the potential importance of MDR as a positive prognostic factor specifically in patients treated with tamoxifen and OFS, suggesting a need for tailored treatment approaches based on MDR status.
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Importance: Contralateral breast cancer (CBC) is the most frequently diagnosed primary cancer in patients with breast cancer. Although many studies have reported survival after the development of CBC, results have been inconsistent.

Objective: To investigate whether the development of CBC is associated with survival among patients with breast cancer.

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Article Synopsis
  • Breast-conserving surgery combined with radiotherapy (BCS + RT) shows better survival outcomes than mastectomy in early breast cancer patients, even for those receiving neoadjuvant chemotherapy (NCT).
  • In a study of 1641 Korean women, patients who chose BCS + RT had significantly higher 5-year disease-free survival, distant metastasis-free survival, and overall survival rates compared to those who underwent mastectomy, both before and after adjusting for potential biases.
  • The findings indicate that BCS + RT is a preferable treatment option for breast cancer patients when both surgical methods are viable, as it does not negatively impact survival rates.
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The plasma proteome of 51 non-metastatic breast cancer patients receiving neoadjuvant chemotherapy (NCT) was prospectively analyzed by high-resolution mass spectrometry coupled with nano-flow liquid chromatography using blood drawn at the time of diagnosis. Plasma proteins were identified as potential biomarkers, and their correlation with clinicopathological variables and survival outcomes was analyzed. Of 51 patients, 20 (39.

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Unlabelled: In this study, we aimed to evaluate axillary lymph node dissection (ALND) rates and prognosis in neoadjuvant chemotherapy (NCT) compare with neoadjuvant endocrine therapy (NET) in estrogen receptor-positive (ER+)/human epidermal growth factor receptor 2-negative (HER2-), lymph node (LN)-positive, premenopausal breast cancer patients (NCT01622361). The multicenter, phase 3, randomized clinical trial enrolled 187 women from July 5, 2012, to May 30, 2017. The patients were randomly assigned (1:1) to either 24 weeks of NCT including adriamycin plus cyclophosphamide followed by intravenous docetaxel, or NET involving goserelin acetate and daily tamoxifen.

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Unlabelled: We aimed to evaluate the patient-reported outcomes (PROs) in a prospective phase III clinical trial, comparing neoadjuvant endocrine therapy (NET) with conventional neoadjuvant chemotherapy (NCT) in patients with hormone status positive, lymph node-positive premenopausal breast cancer (NCT01622361). The patients were randomized prospectively to either 24 weeks of NCT with adriamycin plus cyclophosphamide followed by taxane or NET with gonadotropin-releasing hormone agonist and tamoxifen. The patients were examined at the surgery unit of a large tertiary care hospital with a comprehensive cancer center.

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We evaluated the prognostic implications of the circulating tumor cell (CTC) count in non-metastatic, HER2-negative breast cancer patients who failed to achieve pathologic complete response (pCR) after neoadjuvant chemotherapy (NCT). A total of 173, non-metastatic breast cancer patients treated with NCT were prospectively enrolled. CTCs were obtained from blood drawn pre-NCT and post-NCT using a SMART BIOPSY SYSTEM isolation kit (Cytogen Inc.

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Purpose: Restricted shoulder mobility is a major upper extremity dysfunction associated with lower quality of life and disability after breast cancer surgery. We hypothesized that a poloxamer and sodium alginate mixture (Guardix-SG®) applied after axillary lymph node dissection (ALND) would significantly improve shoulder range of motion (ROM) in patients with breast cancer.

Methods: We conducted a double-blind, randomized, prospective study to evaluate the clinical efficacy and safety of Guardix-SG® for the prevention of upper extremity dysfunction after ALND.

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Article Synopsis
  • This study investigates factors that predict long-term outcomes for breast cancer patients who experience isolated locoregional recurrence (ILRR) as their first recurrence event, addressing a gap in existing prognostic tools.
  • A total of 495 patients were analyzed, focusing on tumor characteristics and patient data, with the study finding that lymph node metastasis, a disease-free interval of less than 30 months, and the type of ILRR significantly influence both distant metastasis-free survival and breast cancer-specific survival.
  • The research resulted in a risk stratification system categorizing patients into four risk groups, with varying 5-year post-ILRR distant metastasis-free survival rates, which can guide treatment decisions for better patient management.
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  • The study focused on identifying prognostic factors that predict breast cancer-specific mortality in patients who completed 5 years of tamoxifen treatment, as extending endocrine therapy can improve survival rates.* -
  • Key factors linked to higher late mortality included being younger than 40 or older than 60, having a tumor larger than 2 cm, and showing signs of lymphovascular invasion.* -
  • Patients were categorized into four risk groups (low to extremely high) based on these factors, with higher-risk groups showing significantly greater cumulative risks of breast cancer-specific death over time.*
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Purpose: Mucinous carcinoma (MC) is a rare breast cancer with favorable outcome. Unlike typical breast cancer, the current guidelines do not recommend chemotherapy or anti-human epidermal growth factor receptor 2 (HER2) therapy for hormone receptor (HR)-positive MC, regardless of HER2 status. We evaluated the prognostic implication of HER2 status in HR-positive MC.

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Backgrounds/aims: Gallbladder carcinoma (GBCa) T2 lesions are considered to be advanced tumors showing diverse features in tumor extent. When this T2 lesion does not involve the cystic duct and there is no evidence of lymph node metastasis, we have to consider what is the most reasonable extent of resection - that is, whether to perform concurrent extra-hepatic bile duct resection (EHBD) resection or not. This study intends to evaluate the adequacy of EHBD resection in patients undergoing resection for T2N0 GBCa.

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