Publications by authors named "Hee Chul Shin"

Purpose: Although the breast cancer susceptibility gene -associated invasive breast cancer is well studied, there are limited reports on ductal carcinoma (DCIS) in patients with mutations. This study aims to evaluate the differential prognostic effect of DCIS in breast cancer patients with pathologic variants of genes.

Methods: Breast cancer patients who tested positive for mutations between August 2003 and January 2022 at a single tertiary referral center were retrospectively analyzed.

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Background: The tumor immune microenvironment, particularly tumor-infiltrating lymphocytes (TILs), plays a critical role in disease progression and treatment response in triple-negative breast cancers (TNBCs). This study was aimed to characterize the composition of TILs and investigate their clinicopathological and prognostic significance with a special focus on the spatial distribution of TILs in TNBCs.

Methods: We analyzed TNBC samples through PanCancer Immune Profiling using NanoString nCounter assays to identify immune-related genes that are expressed differentially in relation to TIL levels and evaluated protein expression of selected markers through immunohistochemical staining on tissue microarrays.

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The Korean Breast Cancer Society (KBCS) has collected nationwide registry data on clinicopathologic characteristics and treatment since 1996. This study aimed to analyze the clinical characteristics of breast cancer in Korea and assess changes in breast cancer statistics for 2021 using data from the KBCS registry and the Korean Central Cancer Registry. In 2021, 34,628 women were newly diagnosed with breast cancer.

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Background: Human epidermal growth factor receptor 2 (HER2)-low status has recently gained attention because of the potential therapeutic benefits of antibody-drug conjugates (ADCs) in breast cancer patients. We aimed to investigate the concordance of HER2 status between core needle biopsy (CNB) and subsequent surgical resection specimens focusing on the HER2-low status.

Methods: This retrospective study was conducted in 1,387 patients with invasive breast cancer whose HER2 status was evaluated in both CNB and surgical resection specimens.

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Article Synopsis
  • The study investigates the differences in protein expression in the plasma of breast cancer patients compared to healthy individuals to discover potential biomarkers.
  • Serum samples from 10 breast cancer patients and 10 healthy controls were analyzed using liquid chromatography-mass spectrometry, revealing a total of 891 identified proteins.
  • The analysis highlighted 30 proteins that were upregulated and 100 downregulated in breast cancer patients, with 10 proteins chosen as potential biomarkers, suggesting that plasma proteome profiling could aid in early detection and tailored treatment approaches for breast cancer.
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Article Synopsis
  • The study evaluates whether patients who are predicted to have a pathologic complete response (pCR) after neoadjuvant systemic therapy (NST) for breast cancer can safely skip surgery, using MRI and vacuum-assisted biopsy (VAB) as diagnostic tools.
  • It involves a multicenter trial across 17 hospitals in South Korea, focusing on patients who meet specific criteria, including having a clip marker in the tumor and favorable MRI results post-NST.
  • The research aims to potentially change clinical practices by demonstrating that omitting surgery could lead to a similar 5-year disease-free survival rate, ultimately enhancing the quality of life for patients who respond exceptionally well to treatment.
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Objective: Automated breast ultrasound (ABUS) is a relevant imaging technique for early breast cancer diagnosis and is increasingly being used as a supplementary tool for mammography. This study compared the performance of ABUS and handheld ultrasound (HHUS) in detecting and characterizing the axillary lymph nodes (LNs) in patients with breast cancer.

Materials And Methods: We retrospectively reviewed the medical records of women with recently diagnosed early breast cancer (≤ T2) who underwent both ABUS and HHUS examinations for axilla (September 2017-May 2018).

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(1) Background: Breast core needle biopsy (CNB) is preferred over fine needle aspiration (FNA) as it has higher sensitivity and specificity and enables immunohistochemical evaluation. However, breast FNA remains widely used because of its low cost, minimally invasive nature, and quick results. Studies analyzing the effects of each test on the prognoses of patients with breast cancer are scarce and controversial, and the criteria for test selection remain unknown.

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Background: This study aimed to discuss several surgical approaches for advanced-stage breast cancer-related lymphedema and compared their treatment outcomes.

Methods: The patients who underwent surgery with International Society of Lymphology stage III lymphedema were included in this study. The three surgical methods used here were (1) suction-assisted lipectomy with lymphovenous anastomosis, (2) autologous breast reconstruction with muscle-sparing transverse rectus abdominis muscle flap combined with inguinal lymph node transfer, and (3) vascularized lymph node transfer with free omental flap.

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Background: To develop a breast cancer prediction model for Korean women using published polygenic risk scores (PRS) combined with nongenetic risk factors (NGRF).

Methods: Thirteen PRS models generated from single or multiple combinations of the Asian and European PRSs were evaluated among 20,434 Korean women. The AUC and increase in OR per SD were compared for each PRS.

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Purpose: Several predictive models have been developed to predict the pathological complete response (pCR) after neoadjuvant chemotherapy (NAC); however, few are broadly applicable owing to radiologic complexity and institution-specific clinical variables, and none have been externally validated. This study aimed to develop and externally validate a machine learning model that predicts pCR after NAC in patients with breast cancer using routinely collected clinical and demographic variables.

Methods: The electronic medical records of patients with advanced breast cancer who underwent NAC before surgical resection between January 2017 and December 2020 were reviewed.

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Background: Mammography screening has been proven to detect breast cancer at an early stage and reduce mortality; however, it has low accuracy in young women or women with dense breasts. Blood-based diagnostic tools may overcome the limitations of mammography. This study assessed the diagnostic performance of a three-protein signature in patients with suspicious breast lesions.

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Background: Phyllodes tumor (PT) is a rare fibroepithelial neoplasm of the breast. The proper extent of resection is still under debate. This study aimed to investigate the optimal surgical margin to prevent recurrence after surgery for PT and to evaluate risk factors for local recurrence (LR).

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Background: Nipple-sparing mastectomy (NSM) followed by immediate breast reconstruction (IBR) is the optimal surgical treatment for breast cancer. However, investigations are ongoing to improve the surgical technique to achieve better results. This study aimed to evaluate the outcomes of modified NSM (m-NSM), which preserves the anterior lamellar fat layer, in patients who underwent IBR.

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Purpose: Estrogen receptor (ER) expression in breast cancer plays an essential role in carcinogenesis and disease progression. Recently, tumors with low level (1%-10%) of ER expression have been separately defined as ER low positive (ERlow). It is suggested that ERlow tumors might be morphologically and behaviorally different from tumors with high ER expression (ERhigh).

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Background: The relationship between obesity and breast cancer stage is not well-known in the Korean population. This study aimed to identify the effect of body mass index (BMI) on initial breast cancer stage.

Patients And Methods: Among patients who underwent surgery for breast cancer (stages 0-III) from June 2003 to December 2018, we analyzed 4510 patients for whom there were BMI data.

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Monitoring of patient and tumor during chemotherapy is important to determine whether the chemotherapy is effective to the patient. Variants affect drug enzyme activities and altered enzyme activities can be potential predictors for chemotherapeutic agents including cyclophosphamide and paclitaxel. Response to chemotherapy is primarily based on somatic mutations but germline variants may predict cancer cell sensitivity to chemotherapeutic agents.

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Autologous reconstruction using abdominal flaps remains the most popular method for breast reconstruction worldwide. We aimed to evaluate a prediction model using machine-learning methods and to determine which factors increase abdominal flap donor site complications with logistic regression. We evaluated the predictive ability of different machine learning packages, reviewing a cohort of breast reconstruction patients who underwent abdominal flaps.

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Article Synopsis
  • The study compared a new abbreviated and ultrafast MRI technique with standard MRI to evaluate breast cancer lesions in 56 patients, measuring lesion sizes and characterizing findings using BI-RADS lexicon.
  • Radiologists analyzed correlation between quantitative and semi-quantitative data, finding significant relationships in parameters like the wash-in factor and AUC value, and moderate agreement in lesion size measurements with surgical pathology.
  • The results indicated that the combined MRI protocol demonstrated excellent reliability in both quantitative measurements and BI-RADS classifications, suggesting it may enhance breast cancer screening effectiveness.
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Introduction: Adjuvant endocrine therapy is an integral component of care for hormone-dependent breast cancer. Tamoxifen is a potent inducer of ovarian function and consequent hyperestrogenism in premenopausal women. However, the incidence rate and risk factors associated this phenomenon remain unclear.

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  • A study was conducted to validate a nomogram developed by the Seoul National University Hospital for predicting positive resection margins in breast-conserving surgery, which is crucial for reducing tumor recurrence.
  • The external validation cohort of 419 breast cancer patients revealed a positive resection margin rate of 13.5%, slightly lower than the original study rate of 14.6%, but the nomogram's predictive accuracy was lower than expected.
  • By incorporating surgeon-related factors into the nomogram, its predictive power improved, raising the accuracy score from 0.656 to 0.733, highlighting the importance of individual surgical factors in patient outcomes.
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Purpose: Hereditary cancer syndrome means that inherited genetic mutations can increase a person's risk of developing cancer. We assessed the frequency of germline mutations using an next-generation sequencing (NGS)-based multiple-gene panel containing 64 cancer-predisposing genes in Korean breast cancer patients with clinical features of hereditary breast and ovarian cancer syndrome (HBOC).

Materials And Methods: A total of 64 genes associated with hereditary cancer syndrome were selected for development of an NGS-based multi-gene panel.

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Purpose: We evaluated the risk of contralateral breast cancer (CBC) and ipsilateral breast tumor recurrence (IBTR) and investigated the predictive factors for CBC and IBTR in breast cancer patients with mutations and non-carriers at high-risk of hereditary breast and ovarian cancer (HBOC).

Methods: We analyzed prospectively collected clinical data of patients with unilateral breast cancer who were at high-risk for HBOC and were tested for the mutation between 2003 and 2013.

Results: The cohort comprised 540 patients with 45 carriers, 50 carriers, and 445 non-carriers.

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Background: Several studies have reported a high risk of local disease recurrence (LR) and locoregional disease recurrence (LRR) in patients with breast cancer after neoadjuvant chemotherapy (NCT) and breast-conserving therapy (BCT). The objective of the current study was to identify potential risk factors for LR and LRR after NCT and BCT.

Methods: Individual patient data sets from 9 studies were pooled.

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