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Yu and Hwang: The proper approaches for breast disease
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Korean Journal of Obstetrics & Gynecology

Korean Journal of Obstetrics & Gynecology 2011; 54(2): 67-78.

Published online: 16 February 2011

DOI: https://doi.org/10.5468/KJOG.2011.54.2.67

The proper approaches for breast disease

Jihoon Yu, MD, Intaek Hwang, MD

Department of Obstetrics and Gynecology, Eulji University College of Medicine, Daejeon, Korea.

Corresponding author: Intaek Hwang, MD. Department of Obstetrics and Gynecology, Eulji University Hospital, 1306 Dunsan-dong, Seo-gu, Daejeon 302-120, Korea. Tel: +82-42-611-3370, Fax: +82-42-611-3379, ithwang@eulji.ac.kr

Received 20 September 2010       Accepted 28 December 2010

Copyright © 2011. Korean Society of Obstetrics and Gynecology

(open-access):

This is an Open Access article distributed under the terms of the Creative Commons Attribution Non-Commercial License (http://creativecommons.org/licenses/by-nc/3.0/) which permits unrestricted non-commercial use, distribution, and reproduction in any medium, provided the original work is properly cited.

Abstract

The gynecologists are the primary care physician to women and the breast is an organ of reproduction and reproductive hormones are the most important factors for breast cancer. Therefore it seems logical to accept the position that diseases of the breast are the responsibility of the gynecologists. The breast examination is a part of the through gynecologic examination and the knowledge of the contemporary treatment of breast diseases is an essential components of the current practice of gynecology. In addition to history and physical examination, the gynecologist should be prepared to understand certain diagnostic studies. It seems a logical step that breast cancer patients will be treated by a multidisciplinary team, in which the gynecologist will also take part.

Keywords: Gynecologists, Reproductive factors, Breast diseases

Figures and Tables

Fig. 1
Terminal duct lobular unit.
kjog-54-67-g001
Fig. 2
Sonographic finding of normal breast anatomy.
kjog-54-67-g002
Fig. 3
Investigation of nipple discharge. *Suspicious means discharge that is blood stained or contains moderate or large amounts of blood on testing, is associated with a mass, or is a new development in women older than age 50 and is not thick or cheesy (From Dixon MJ, Bundred NJ. Diagnosis and management of benign breast diseases. In: Harris JR, Lippman ME, Morrow M, et al, editors. Diseases of the breast. 2nd edition. Philadelphia: Lippincott Williams and Wilkins; 2000. p. 48, with permission) [66].
kjog-54-67-g003
Fig. 4
Diagnostic algorithm for patients with palpable breast masses (From Klein S. Am Fam Physician 2005;71:1731-8, with permission the American Academy of Family Physicians) [67].
kjog-54-67-g004
Table 1
Classification of benign breast diseases by the relative risk (RR) for malignancy
kjog-54-67-i001
Table 2
Check list before breast examination
kjog-54-67-i002
Table 3
Investigations of breast sonography
kjog-54-67-i003
Table 4
Million Women Study Collaborators (from Beral V, et al. Lancet 2003;362:419-27, with permission Elsevier) [68]
kjog-54-67-i004

FCI, floated CI.

*Relative to never users, stratified by age, time since menopause, parity and age at first birth, family history of breast cancer, body mass index, region, and deprivation index.

Table 5
Potential adverse effects cytotoxic agent on the foetus
kjog-54-67-i005
Table 6
Summary of randomized trials of adjuvant aromatase inhibitors
kjog-54-67-i006

ATAC, Arimidex, Tamoxifen, Alone or in Combination; BIG, Breast International Group; IES, Intergroup Exemestane Study; ABCSG, Austrian Breast and Colorectal Cancer Study Group; ITA, Italian Tamoxifen Anastrozole; MA, Multinational multiclinical randomized study of Aromatase inhibitor; HR+, hormone receptor-positive; LN+, lymph node-positive; Tam, tamoxifen; DFS, disease-free survival; EFS, event-free survival; PFS, progression-free survival.

Table 7
Histopathologic findings in adnexal masses in women with breast cancer
kjog-54-67-i007

*Two patients had breast metastases with a coexistent benign ovarian mass; one had a serous cyst, and one had a hemorrhagic cyst. †One patient had breast metastases with a coexistent fibrothecoma.

Table 8
Comparison of ovarian histopathologic finding and stage of breast cancer at US*
kjog-54-67-i008

Numbers in parentheses are percentages, with the denominator being the number of patients with known breast cancer stage. The P-value for ovarian histopathologic finding and the stage of breast cancer at the time of US was<0.01. *Based on 51 patients with known breast cancer stage. †Based on 51 patients with known breast cancer stage, ovarian histopathologic finding (benign and ovarian cancer vs. breast metastases), and stage of breast cancer (0, I, II, III, IV).

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