한국인 여성유암의 임상적 고찰

Abstract

[한글]

Clinical Observation of Female Mammary Carcinoma in Korea

Young Sik Lee

Department of Surgery, Graduate School, Yonsei University, Seoul, Korea.

(Directed by Prof. Kyu Chul Whang, M.D., D.M.Sc.)

The clinical observation was performed on 202 cases of female mammary carcinoma

from September, 1955 to December, 1970 at Surgical Department of Yonsei Medical

Center. Analysis of the experiences including late result provided following

results.

1) The percentage ratio of breast cancer to the total number of admitted patients

during the aforementioned period was 0.19%. In fact, the number of mammary cancer

patients has not been increasing according to comparative statistics of each 5

years interval.

2) The peak incidence was in the age group of 40 to 49 and its number of patients

was 87(42.3%). The extreme of age was represented by age of 25 and 78.

3) The most prominent symptom was palpable mass in 201 cases and it was followed

by skin retraction in 56 cases, pain in 37 cases, nipple discharges in 31 cases,

and so on. In 46 cases(70%), visit was done within one year.

4) The left side breast was more affected than the right side breast, represent

by 108 cases in the left and 96 cases in the right. The most frequent site of the

breast cancer was the upper-outer quadrant in 96cases(46.1%), and followed by the

upper-inner quadrant in 35 cases(16.7%), and the center and lower-outer quadrant in

20 cases(12.3%) each, There was 2 cases(1%) of simultaneous bilateral carcinoma.

5) The Manchester's and/or Portman's classification were employed for staging.

The most frequent stage was Stage Ⅰ, 42.6% and it was followed by stage Ⅱ, 37.6%.

6) The classic and/or modified Halsted radical mastectomy was a choice of

surgical procedure for early carcinoma of the breast. Surgery was performed in 191

patient. Among 191 cases, 141 patients underwent radical mastectomy. More radical

method, extended radical mastectomy by Urban's technique was employed in 7 cases

and more conservative method, simple mastectomy with or without irradiation was

performed in 43 cases. As an adjuvant therapy, 66 patients received irradiation and

32 patients underwent oophorectomy. Simple mastectomy performed in stage Ⅰ and Ⅱ

cancer was exceptional for patients with old age or with associated disease,

therefore, it was usually done for palliative purpose.

7) There were 3 hospital deaths; 2 with deseminated terminal cancer and another

due to bleeding after simple mastectomy. None have as yet died from radical

surgery.

8) In radical mastestomy group, followed up was successful in 66% of patients

between 1955 and 1965, while 59% of patients between 1960 and 1970 was a to

contract. Average 5 year survival rate was 75.2% in node negative group(stage Ⅰ)

and 42.2% in node positive group(stage Ⅱ). Therefore over all 5 year survival rate

was obtained in 57%, however, 5 year clinical cure rate was low, recording 29%.

[영문]

The clinical observation was performed on 202 cases of female mammary carcinoma from September, 1955 to December, 1970 at Surgical Department of Yonsei Medical Center. Analysis of the experiences including late result provided following results.

1) The percentage ratio of breast cancer to the total number of admitted patients during the aforementioned period was 0.19%. In fact, the number of mammary cancer patients has not been increasing according to comparative statistics of each 5 years interval.

2) The peak incidence was in the age group of 40 to 49 and its number of patients was 87(42.3%). The extreme of age was represented by age of 25 and 78.

3) The most prominent symptom was palpable mass in 201 cases and it was followed by skin retraction in 56 cases, pain in 37 cases, nipple discharges in 31 cases, and so on. In 46 cases(70%), visit was done within one year.

4) The left side breast was more affected than the right side breast, represent by 108 cases in the left and 96 cases in the right. The most frequent site of the breast cancer was the upper-outer quadrant in 96cases(46.1%), and followed by the upper-inner quadrant in 35 cases(16.7%), and the center and lower-outer quadrant in 20 cases(12.3%) each, There was 2 cases(1%) of simultaneous bilateral carcinoma.

5) The Manchester's and/or Portman's classification were employed for staging. The most frequent stage was Stage Ⅰ, 42.6% and it was followed by stage Ⅱ, 37.6%.

6) The classic and/or modified Halsted radical mastectomy was a choice of surgical procedure for early carcinoma of the breast. Surgery was performed in 191 patient. Among 191 cases, 141 patients underwent radical mastectomy. More radical method, extended radical mastectomy by Urban's technique was employed in 7 cases and more conservative method, simple mastectomy with or without irradiation was performed in 43 cases. As an adjuvant therapy, 66 patients received irradiation and 32 patients underwent oophorectomy. Simple mastectomy performed in stage Ⅰ and Ⅱ cancer was exceptional for patients with old age or with associated disease, therefore, it was usually done for palliative purpose.

7) There were 3 hospital deaths; 2 with deseminated terminal cancer and another due to bleeding after simple mastectomy. None have as yet died from radical surgery.

8) In radical mastestomy group, followed up was successful in 66% of patients between 1955 and 1965, while 59% of patients between 1960 and 1970 was a to contract. Average 5 year survival rate was 75.2% in node negative group(stage Ⅰ) and 42.2% in node positive group(stage Ⅱ). Therefore over all 5 year survival rate

was obtained in 57%, however, 5 year clinical cure rate was low, recording 29%.