SHIHWA MEDICAL CENTER

Breast·Thyroid Clinic

Breast Clinic

Breast cancer can be cured if detected early.

Unlike benign tumor that stays inside the breast, breast cancer is a malignant tumor that can spread when the cancer cells get into the blood or lymph system and are carried to other parts of the body which can become life-threatening. There are many different types of cells in the breast, and any of them can turn into cancer cells, so there are various types of breast cancer that can occur. Most breast cancers originate from cells in the ducts (the mild ducts) or the lobules (mild-producing glands) and mostly originate from ductal cells. Therefore, in general, breast cancer refers to a cancer that occurs in the epithelial cells (cells that cover the surface of the body or the inner surface of internal organs) of the ducts and lobules in the breast.

Causes of breast cancer

Breast cancer is believed to be caused by both environmental and genetic factors. In particular, there are studies that show the female hormone estrogen plays an important role in the carcinogenesis process.

Westernized
diet
Stress
Environmental pollution
Declining
birthrate
Obesity
Long term use of
birth control
pills
Genetic
factors

Breast self-exam

In principle, breast cancer examination should be started at the age of 35-40. Monthly self-examination and yearly clinical breast exam including mammography (additional ultrasound if necessary) are recommended. For those who are under 35 years of age, screening mammography or ultrasound is performed if necessary after clinical breast exam done by your doctor. This policy is only for asymptomatic women. For those who are symptomatic (palpable lump, lactation, pain, etc.), an immediate consultation with a breast specialist is needed.

Breast self-exam is an inspection of your breasts that you do on your own. Breast self-exam is a simple procedure that can be performed frequently with no cost. Thorough breast self-exam is crucial for early detection of breast cancer. If a new hard lump is felt on the breast during self-examination, breast cancer should be suspected. A cancerous tumor is felt hard and does not move much when shaken by hands. Breast cancer is also suspected when the nipples are caved in differently than before, the surface of the breast is protruded or depressed, or when there is a deformation in the curvature of the breast. If any abnormalities are found during self-examination, an immediate consultation with a specialist is needed.

Step 1Stand in front of a mirror. Look for differences between your breasts including unusual breast shapes, protrusion, dimpling or indentation in the breast tissue.
Step 2Put your hands on top of your head and keep your chest straight. Inspect your breasts again.
Step 3Place your hands on your hips and pull your shoulders and arms forward. Inspect your breasts again.
Step 4Raise your left arm and use the middle and ring fingers of your right hand to palpate your left breast thoroughly. In order not to miss any lesions, move your fingers around your breast in either a circular pattern around the nipple, up-and-down, or wedge motion. Inspecting your armpit is also essential.
Step 5Squeeze the nipple to see if there is any discharge. Repeat Step 4 and 5 on the right breast.
Step 6Lie on your back and examine both breasts in the same way. Placing a pillow under your back under the breast you want to examine will open up the chest, making it easier to find small lumps.

Breast cancer screening tests

유방 검사 테이블입니다.
Mammogram	A mammogram is an X-ray picture of the breast that plays one of the most important roles among breast cancer screening tests for asymptomatic women as it is appropriate test to detect non palpable breast cancer. Basically, two pictures of each breast are taken in different directions. The breast is firmly pressed with a specially designed plastic plate for imaging. The more the breast is flattened, the less radiation exposure and the better the inside of the breast is shown, so even small cancer cells can be detected.
Breast ultrasound	Breast ultrasound is an imaging test that uses sound waves to look at the inside of your breasts and is harmless to human body. It is used for detailed examination of the lesions found on mammography or palpation. It is used, when there is a lump in the breast, to determine whether it is a simple growth of breast tissue that does not require treatment or a tumor. It is also useful in distinguishing whether a tumor is a cystic or a solid tumor. However, since early breast cancer often shows only microcalcifications on mammograms, it is difficult to find these lesions with breast ultrasonography alone. Therefore, ultrasonography alone is not recommended for screening purposes. If it is difficult to determine the degree of malignancy with ultrasonography, follow-up examination with mammography or ultrasound is performed to observe the pattern changes, or if more malignancy is suspected, a biopsy is required.
Breast biopsy	Biopsy is performed in the following cases: In case there is a lump suspected to be malignant on mammography, ultrasonography, or MRI, a lesion with any possibility of malignancy, or a microcalcified deposit suspected of being malignant and in case a benign shape grows rapidly or changes shape. Excisional biopsy : all lumps are removed and examined under a microscope Core needle biopsy : Part of the lump is removed under ultrasound guidance and examined Fine-needle aspiration test : Cells are separated from the lump using an injection needle and cytology is performed. Which method fits better depends on the location, size, shape, number of lesions, the patient's condition, preference, etc.
Mammotome	Mammotome, a vacuum-assisted breast biopsy is a procedure in which a thick needle is inserted into the lesion, a vacuum aspirator is operated to draw tissue into the needle, and then the blade inside the needle is rotated to automatically dissect the lesion and take the tissue out of the breast. Advantages of Mammotome It can be easily performed in an outpatient setting. There is no need for sutures, so there is almost no scar left. You can be discharged from the hospital on the day of the procedure and return to daily life activity. Local anesthesia reduces the physical and psychological pain associated with the surgery. Abnormal lesions (humps, lumps) common to women are easily removed. A marker (MicroMarkII) that can increase the accuracy of the follow-up examination can be inserted. Even with a small incision of 3mm or less, a sufficient amount of tissue can be collected, leading a diagnosis as accurate as a surgical operation. Mammotome procedure 1Prepare the mammotome needle. 2Place the needle near the lesion in the breast. 3Using a vacuum, pull the tissue into the groove in the needle. 4Remove the tissue that has entered the groove with a rotating blade. 5Tissues are removed from the body. Post-mammotome management Avoid taking a shower on the day of the procedure. You should rest for about 1 hour right after the procedure. The area should be fixed with a compression bandage or sports bra for 2-3 days. You can return to daily activities from the day of the procedure. But, avoid heavy works/physical activities for one week after surgery. Avoid drinking alcohol for 3 to 4 days after the procedure as it interferes with wound healing process and dilates blood vessels.

Thyroid Clinic

Thyroid morphology screening and thyroid function tests are performed to prevent thyroid cancer.

There are organs in our body that secrete hormones, which are called endocrine organs, and those hormones allow the organs to achieve their roles. One of the endocrine organs, the thyroid gland, is responsible for producing, storing, and releasing thyroid hormones into the blood when needed. The secretion of hormones from the thyroid gland promotes the body's metabolism and plays a role in maintaining the proper functioning of all organs. Depending on the amount of these hormones secreted by the thyroid gland, diseases may occur such as hyperthyroidism or hypothyroidism.

What is thyroid gland?

Thyroid hormone promotes metabolism of the human body and plays a role in maintaining the proper functioning of all organs.

In addition, it generates heat to maintain a constant body temperature, and it also plays a role in promoting the growth and development of the brain and bones of the fetus and newborn. The normal thyroid gland is located just below the thyroid cartilage called the 'Adam's apple' that protrudes at the front of the neck, between the bronchi and the muscles that go up to the ears. As large as a thumb, one gland is located on each side of the bronchus and is connected by a band-shaped tissue, so it looks like a butterfly. The length is 4-5 cm, the width is 1-2 cm, and the thickness is 2-3 cm and the combined weight of the left and right thyroid glands and connecting parts is about 15-20g.

Abnormalities in thyroid gland function

Division: Hyperthyroidism; Hypothyroidism

Definition: Hyperthyroidism is a disease caused by hyperactive metabolism of the body due to an excess of thyroid hormones in the blood. There are several medical conditions that are relating to this, and an autoimmune disease called Graves' disease is the most common cause of hyperthyroidism.

*Autoimmune disease: Abnormal immune response mistakenly attacks your thyroid gland with antibodies. This makes the thyroid create too much thyroid hormone.; Although there are many causes of hypothyroidism, it can be broadly divided into primary hypothyroidism due to the thyroid gland itself and secondary hypothyroidism due to lack of hormones in the brain. The most common cause of primary hypothyroidism is Hashimoto's thyroiditis, in which genetic and environmental factors combine to produce autoantibodies that attack the thyroid gland, resulting in chronic inflammation of the thyroid gland. This leads to destroying the thyroid tissue and reducing hormone secretion.

Symptoms

Weight loss despite strong appetite.
Excessive sweating and intolerance of heat.
Severe fatigue and general weakness.
Often tired and irritated.
Shortness of breath and heart palpitations.
Bulging or protruding eyeballs.

Tired and lethargic
Intolerance of cold.
Decreased memory and poor concentration.
Dry skin and rough hair.
Swelling and slow pulse rate.
Joint pain, muscle pain, irregular menstrual cycle.

Treatment: Antithyroid drugs are usually administered. If the drug is not effective, radioactive iodine therapy is performed. Although it has the advantage of being relatively simple and low cost, it may cause hypothyroidism and cannot be performed for pregnant women. Surgical treatment is performed if the goiter (enlargement of the thyroid gland in the neck) is very large or radioactive iodine treatment is not preferred.; Treatment for hypothyroidism is to compensate for the lack of thyroid hormones. However, in most cases, hypothyroidism is a lifelong condition, requiring lifetime use of thyroid hormone medication. Of course, in some cases of thyroiditis, a certain period of treatment leads to the recovery of the thyroid function, in which case no hormone medication is necessary.

Diet: Hyperthyroidism can result in weight loss and negative nitrogen balance and muscle loss due to increased metabolism. To prevent this, sufficient calories and protein supply are necessary.; Hypothyroidism can be accompanied by symptoms such as weight gain, constipation, elevated blood cholesterol, and iron deficiency anemia. Those symptoms need to be controlled and balanced diet should be maintained.

Thyroid nodule

Thyroid nodules are enlarged lump formation of thyroid cells in the thyroid gland. The causes is unknown. It can be benign or malignant, and most cases of benign nodules are asymptomatic and are discovered accidentally during examination. When a nodule (or lump) found on thyroid ultrasound is suspected of malignancy. A fine needle aspiration biopsy test should be performed to determine whether it is benign or malignant.

갑상선 결절 테이블입니다.
Fine needle aspiration biopsy	Thyroid fine-needle aspiration biopsy is a simple and safe test in which the nodule is pierced with a fine needle and the cells are examined for malignancy. No anesthesia is needed, and it is a safe and simple test. Rarely, there may be bleeding after the test, causing swelling and pain in the nodule, but these symptoms disappear naturally in 1 to 2 days. In case of using ultrasound when performing this test, not enough cells are visible and a retest may be necessary in about 10% of patients. A retest is highly likely in case of cystic nodules accompanied cystic changes, calcified hard nodules, and very small nodules.
Ultrasonography	With its high resolution, it is the most accurate method for detecting and evaluating thyroid nodules. Since no radiation is involved, it can be repeated whenever necessary, and the examination process is also simple. Because the image is provided in real time, the size and characteristics of the thyroid nodule can be quickly identified. In fine needle aspiration biopsy, it helps to identify the location of the lesion.
Radiofrequency Ablation	This is the latest treatment method to remove the tumor. Ultrasound is used to insert the high-frequency ablation needle into the tumor and then high-frequency waves are passed through it, generating frictional heat of about 100 degrees Celsius at the tip of the needle removing the tumor. Advantages of Radiofrequency Ablation There is no incision involved, thus no scar left on the neck after the procedure. There is much less pain compared to surgery, and recovery is faster. The procedure can be performed under local anesthesia in about 20 minutes, and daily life can be resumed on the same day. Disadvantages of Radiofrequency Ablation It takes some time to reduce the size of the tumor since it has to be burned with high-frequency heat. If the lump is large, the procedure may have to be repeated, and there are rare cases of recurrence.

(15034) 381 Gunjacheon-ro, Siheung-si, Gyeonggi-do, Republic of Korea
(Medical Corporation) Namchon Medical Foundation Shihwa Medical Center

Representative: Choi, Byeong-Chul / Business Registration Number: 807-82-00237

Inquiries: 82-31-5189-0594