Purpose: Oncoplastic surgery has received attention according as the incidence of breast cancer is rising and quality of life including cosmetic result after surgery is regarded as important. The aim of this study is to compare combined reconstructive surgery with standard surgery regarding to oncological safety and survival rate in advanced breast cancer after neoadjuvant chemotherapy (CTx). Method: Thirty-seven patients underwent neoadjuvant CTx and surgery with advanced breast cancer were analyzed from September 2007 to March 2010. Group A (n=12) received combined reconstructive surgery, group B (n=25) had standard surgery. Results: There were no differences in age, size, metastatic LN, stage, ER/PR/Her-2 status, recurrence, metastasis and death between group A and B. Patients with good response in neoadjuvant chemotherapy (26 cases (72.9%)) had CTx-operation-radiation therapy (RTx), cases with poor response (10 cases (27.1%)) underwent CTx-RTx-operation. There was significant difference in order of treatment, eight patients among group A(66.6%) had CTx-RTx-operation, 22 cases in group B(88.0%) received CTx-operation-RTx (p=0.006). Mean follow up period was 22 months, 2 patients (5.2%) experienced local recurrences, 11 cases (34.3%) diagnosed with distant metastasis, and 4 patients (10.5%) expired with breast cancer. Conclusion: Advanced breast cancer with poorly responded in neoadjuvant CTx could be actively treated with sequential CTx-RTx-reconstructive surgery. Combined reconstructive surgery was oncologically safe operation in advanced breast cancer. Citation Information: Cancer Res 2011;71(24 Suppl):Abstract nr P2-16-15.

Backgrounds: Axillary lymph node(ALN) status has been important factor of treatment and prognosis for patients with breast cancer. Even though the better ultrasonographic instruments have been developed, it is still difficult to predict axillary lymh node metastasis (ALNM) with only ultrasonography(US) in T1 breast cancers which most of newly diagnosed breast cancers are recently since T1 breast cancers have low rate and less tumor burden of ALNM. This study evaluated the accuracy of prediction of ALNM in T1 breast cancer with US, contrast-enhanced MRI (cMRI) and contrast-enhanced 18F-FDG PET/CT (cPET/CT) and found out adequate combinations of these modalities. Method: Retrospectively, we reviewed 351 breast cancer patients with tumors(T1) ≤2cm in size between January 2008 and December 2011 who were preoperatively examined with US, cMRI, and cPET/CT and underwent pathologic evaluation of axillary lymph nodes acquired by sentinel lymph node biopsy or axillary dissection. Results: 94(26.8%) patients of 351 had ALNM. The sensitivity, specificity, positive predictive value(PPV), negative predictive value (NPV), and accuracy of ALNM with US were 0.457, 0.887, 0.597, 0.817, 0.772, respectively. cMRI had similar results with US. The sensitivity, specificity, positive predictive value (PPV), negative predictive value (NPV), and accuracy of ALNM with cPET/CT were 0.447, 0.942, 0.737, 0.823, 0.809, respectively. The sensitivity if any one or more modalities were suspicious was 0.563. The specificity if all modalities were suspicious was 0.992. The PPV if cMRI and cPET/CT were suspicious was highest than if other combinations were suspicious. Conclusion: US, cMRI, and cPET/CT are helpful in prediction of ALNM of T1 breast cancers. However, there are no definite modality and combination of modalites to predict ALNM of T1 breast cancers. Citation Information: Cancer Res 2012;72(24 Suppl):Abstract nr P1-01-24.

frequent (57%) type of associated neoplasm followed by intraductal mucinous neoplasm (IPMN) (16%). Among those 38 cases, 29 (76%) had a largest diameter < 5 mm (microadenoma). 16 out of 38 incidental PanNET were classified as nonfunctioning (42%) whereas other 7 cases (18%) were classified as glucagonomas. A median value Ki67 of 1% was measured in 9 incidental PanNET. Patients with incidental PanNET were significantly older (median age: 69 years versus 65.5 years, P=0.003). There was no association between incidental diagnosis of PanNET and gender, operation, and main histological diagnosis. When excluding microadenomas, the median age between patients with incidental PanNET (n=9) and the remaining patients was no statistically different (median age 64 years versus 65.5 years, P>0.05). Conclusion: The frequency of incidental histological diagnosis of PanNETs is considerably high suggesting that their real incidence is probably underestimated.