Publications by authors named "Hyuk Jae Shin"

5 Publications

  • Page 1 of 1

Physicians' Awareness of the Breast Cancer Survivors' Unmet Needs in Korea.

J Breast Cancer 2021 Feb;24(1):85-96

Department of Surgery, Research Institute of Clinical Medicine, Jeonbuk National University Hospital, Jeonbuk National University and Biomedical Research Institute, Jeonju, Korea.

Purpose: Physicians' awareness of their cancer patients' unmet needs is an essential element for providing effective treatment. This study investigated the accuracy of physicians' awareness of breast cancer survivors' unmet needs in Korea.

Methods: A cross-sectional interview survey was performed among 106 physicians and 320 Korean breast cancer survivors. The Comprehensive Needs Assessment Tool was administered to physicians and cancer survivors after obtaining their written informed consent to participate. Data were analyzed using -test, analysis of variance, and multiple regression analysis.

Results: The level of unmet needs was highest in the hospital service domain (mean ± standard deviation: 2.19 ± 0.82), and the top-ranked unmet need item was "wished my doctor to be easy, specific, and honest in his/her explanation" (2.44 ± 0.93). Higher unmet needs were correlated with the presence of a genetic counseling clinic. They were not associated with age, sex, marital status, religion, department, working period, type of institution, number of staff, and number of operations. In multiple regression analysis, the presence of a genetic counseling clinic was associated with a higher level of recognition for psychological problems, social support, hospital service, and information and education needs. Physicians overestimated breast cancer survivors' unmet needs in all domains, compared to their self-reported unmet needs. The discordance in the perceived unmet needs was highest in the 'family/personal relationship problems' domain.

Conclusions: Physicians who treat Korean breast cancer survivors rated the level of unmet needs of breast cancer survivors as highest in the hospital service domain. The presence of a genetic counseling clinic in physicians' institutions was associated with a higher perception of survivors' unmet needs. Physicians overestimated the level of unmet needs in Korean breast cancer survivors. Efforts to reduce these discordances are needed to implement optimal survivorship care.
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http://dx.doi.org/10.4048/jbc.2021.24.e3DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC7920866PMC
February 2021

Robot-assisted Nipple-sparing Mastectomy with Immediate Breast Reconstruction: An Initial Experience of the Korea Robot-Endoscopy Minimal Access Breast Surgery Study Group (KoREa-BSG).

Ann Surg 2020 Sep 15. Epub 2020 Sep 15.

Department of Surgery, Yonsei University College of Medicine, Seoul, Korea.

Objective: The aim of this study was to present the results of early experience of RANSM.

Background: Robot-assisted nipple-sparing mastectomy (RANSM) improves cosmetic outcomes over conventional nipple-sparing mastectomy (CNSM). However, data on the feasibility and safety of the RANSM are limited.

Methods: Patients who underwent RANSM with immediate breast reconstruction (IBR) as part of the Korea Robot-Endoscopy & Minimal Access Breast Surgery Study Group (KoREa-BSG) from November 2016 to January 2020 were enrolled. Clinicopathologic characteristics, perioperative complications, and operation time were collected.

Results: Overall, 73 women underwent 82 RANSM procedures conducted by 11 breast surgeons at eight institutions. The median patient age was 45.0 years old (20-66 years), and 52 (63.4%) patients were premenopausal. Invasive breast cancer was noted in 55 cases (40 cases were stage I, 11 cases were stage II, and four cases were stage III, respectively) and ductal carcinoma in-situ was recorded in 20 cases. Of those, three patients with BRCA1/2 mutation carriers underwent contralateral risk-reducing RANSM. The median length of hospitalization was 11.7 days (5.0-24.0 days). The incision location was the mid-axillary line and the median incision length was 46.3 mm (30.0-60.0 mm). Median total operation time, median total mastectomy time, and median reconstruction time was 322.0 minutes (163.0-796.0 minutes), 190.8 minutes (97.5-325.0 minutes), and 133.6 minutes (45.0-689.0 minutes). Only two cases (2.5%) required re-operation. Nipple ischemia was found in nine cases (10.9%) but only one case (1.2%) required nipple excision given that eight cases (9.7%) resolved spontaneously. Skin ischemia was observed in five cases (6.1%) and only two (2.4%) cases needed skin excision whereas three cases (3.6%) resolved spontaneously. There was no conversion to open surgery or cases of mortality. The mean time for mastectomy among surgeons who performed more than 10 cases was 182.3 minutes (± 53.7, minutes) and 195.4 minutes (± 50.4, minutes).

Conclusion: This was the first report of RANSM conducted in the KoREa-BSG. RANSM is technically feasible and acceptable with a short learning curve. Further prospective research to evaluate surgical and oncologic outcomes is needed.
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http://dx.doi.org/10.1097/SLA.0000000000004492DOI Listing
September 2020

Unmet needs and related factors of Korean breast cancer survivors: a multicenter, cross-sectional study.

BMC Cancer 2019 Aug 27;19(1):839. Epub 2019 Aug 27.

Department of Surgery, Research Institute of Clinical Medicine, Chonbuk National University Hospital, Chonbuk National University and Biomedical Research Institute, 20, Geonji-ro, Deokjin-gu, Jeonju-si, Jeollabuk-do, Korea.

Background: Identification of specific needs in patients with cancer is very important for the provision of patient-centered medical service. The aim of this study was to investigate the unmet needs and related factors of Korean breast cancer survivors.

Methods: A multicenter, cross-sectional, interview survey was performed among 332 Korean breast cancer survivors. The Comprehensive Needs Assessment Tool for cancer patients was administered to survivors who gave written informed consent to participate. Data were analyzed using t-test, ANOVA and multiple regression analysis.

Results: The level of unmet needs was highest in the domain 'Information and education' (mean ± SD; 1.70 ± 1.14) and the item with the highest level of unmet needs was 'Needed help in coping with fear of recurrence' (2.04 ± 1.09). Unmet needs were correlated with age, stage, multiplicity, HER2, treatment state, marital status, employment, psychosocial status, and problems in EQ-5D dimensions. In multiple regression analysis, the 50-59 age group showed a higher level of recognition for physical symptom needs and the unemployed group expressed greater needs for information and education. Survivors with multiplicity had greater needs in the domains of healthcare staff and physical symptom. The stress group showed high levels of needs in all domains except religious support. The group with thoughts of suicide showed higher levels of unmet needs for physical symptom.

Conclusion: Most prevalent unmet needs in Korean breast cancer survivors were found in the 'information and education' domain. The 50-59 age group, unemployment, multiplicity, stress and suicidal thoughts were associated with higher levels of unmet needs among Korean breast cancer survivors. Our findings revealed more vulnerable breast cancer survivors with unmet needs and physicians should take a precision approach to satisfy unmet needs of these survivors.
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http://dx.doi.org/10.1186/s12885-019-6064-8DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC6712787PMC
August 2019

Genomic alterations identified by array comparative genomic hybridization as prognostic markers in tamoxifen-treated estrogen receptor-positive breast cancer.

BMC Cancer 2006 Apr 12;6:92. Epub 2006 Apr 12.

Department of Surgery, Seoul National University College of Medicine, Seoul, Korea.

Background: A considerable proportion of estrogen receptor (ER)-positive breast cancer recurs despite tamoxifen treatment, which is a serious problem commonly encountered in clinical practice. We tried to find novel prognostic markers in this subtype of breast cancer.

Methods: We performed array comparative genomic hybridization (CGH) with 1,440 human bacterial artificial chromosome (BAC) clones to assess copy number changes in 28 fresh-frozen ER-positive breast cancer tissues. All of the patients included had received at least 1 year of tamoxifen treatment. Nine patients had distant recurrence within 5 years (Recurrence group) of diagnosis and 19 patients were alive without disease at least 5 years after diagnosis (Non-recurrence group).

Results: Potential prognostic variables were comparable between the two groups. In an unsupervised clustering analysis, samples from each group were well separated. The most common regions of gain in all samples were 1q32.1, 17q23.3, 8q24.11, 17q12-q21.1, and 8p11.21, and the most common regions of loss were 6q14.1-q16.3, 11q21-q24.3, and 13q13.2-q14.3, as called by CGH-Explorer software. The average frequency of copy number changes was similar between the two groups. The most significant chromosomal alterations found more often in the Recurrence group using two different statistical methods were loss of 11p15.5-p15.4, 1p36.33, 11q13.1, and 11p11.2 (adjusted p values < 0.001). In subgroup analysis according to lymph node status, loss of 11p15 and 1p36 were found more often in Recurrence group with borderline significance within the lymph node positive patients (adjusted p = 0.052).

Conclusion: Our array CGH analysis with BAC clones could detect various genomic alterations in ER-positive breast cancers, and Recurrence group samples showed a significantly different pattern of DNA copy number changes than did Non-recurrence group samples.
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http://dx.doi.org/10.1186/1471-2407-6-92DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC1459182PMC
April 2006

A haplotype analysis of HER-2 gene polymorphisms: association with breast cancer risk, HER-2 protein expression in the tumor, and disease recurrence in Korea.

Clin Cancer Res 2005 Jul;11(13):4775-8

Department of Surgery, Seoul National University College of Medicine, and DNA Link Inc., Seoul, Korea.

Purpose: A single-nucleotide polymorphism (SNP) in codon 655 of HER-2 has been extensively studied with inconclusive results. The purpose of this study was to investigate the association between common variants of HER-2 and breast cancer risk, HER-2 expression, and survival using a haplotype-based stepwise approach.

Experimental Design: Twenty-nine SNPs listed in the National Center for Biotechnology Information database were screened to identify novel polymorphisms of HER-2 gene in 90 healthy Korean women. Six of 29 SNPs were polymorphic and had greater than 10% of minor allele frequencies. Using these six SNPs, linkage disequilibrium and haplotype patterns were characterized. We tested association between the haplotypes and breast cancer in a large case-control study (n=1,039 cases and 995 controls). Six-hundred two breast cancer patients with follow-up at least 24 months were analyzed for outcome in relation to haplotype. Expression of HER-2 protein was determined by immunohistochemistry in 1,094 cases of invasive breast cancer.

Results: All six SNPs showed a strong linkage disequilibrium pattern and were considered to belong to one haplotype block. Two haplotype-tagging SNPs (I655V and P1170A) for three common haplotypes (>5%) were genotyped in cases and controls. The haplotypes and individual SNPs were not associated with breast cancer risk. In patients with at least one copy of haplotype I (the most common haplotype), HER-2 expression was 1.5 times higher (P = 0.009) and the prognosis was worse (P = 0.032) compared with patients without having that haplotype.

Conclusions: Our results suggest that the currently identified genetic polymorphisms of HER-2 are not associated with an increased risk of breast cancer in Korean women, whereas one haplotype does affect protein expression of the tumor and disease outcome.
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http://dx.doi.org/10.1158/1078-0432.CCR-04-2208DOI Listing
July 2005