ROBOT MASTECTOMY
Mastectomy is a common surgical treatment for breast cancer, but it can lead to body deformities due to the removal of breast tissue, skin, and the nipple. To improve cosmetic outcomes, procedures like skin-sparing and nipple-sparing mastectomy were developed, but they have limitations, such as long scars, skin or nipple necrosis, and complex techniques.
To address these issues, robotic and endoscopic mastectomies were introduced. These procedures offer the advantage of smaller, hidden scars, improving the cosmetic results and quality of life (QoL) for patients. However, robotic and endoscopic surgeries are technically challenging, with robotic systems offering greater ease of use due to their high-resolution 3D cameras and flexible arms. Despite these advantages, the US FDA has not cleared robotic mastectomy due to a lack of clinical evidence, and recommends that patients discuss treatment options with their healthcare providers.
The Severance Robot Mastectomy Program, launched in 2013 at Severance Hospital in Seoul, Korea, began with cadaveric studies and led to the first robotic mastectomy on a live patient in 2016. Since then, over 300 robotic mastectomies have been performed, making Severance Hospital a pioneer in robotic breast surgery.
HBOC Syndrome
Prof. Park has been focused on managing Hereditary Breast and Ovarian Cancer (HBOC) Syndrome and is an active member of the multidisciplinary team at the Cancer Prevention Center (CPC) at Yonsei Cancer Center, Seoul, Korea. The team includes specialists from various fields, such as surgical oncology, gynecology, genetics, and medical oncology, and offers genetic testing for cancer-predisposing genes like BRCA1/2 and others using Sanger, MLPA, and NGS techniques. They provide state-of-the-art genetic counseling based on the latest clinical evidence.
Prof. Park's team made a significant discovery by identifying the pathogenicity of the BRCA1 mutation p.Leu1780Pro (L1780P), which was initially considered a variant of unknown significance. They demonstrated that L1780P is a pathogenic mutation, especially common in the Korean population with HBOC syndrome. This finding was later confirmed by other research groups. Women with this mutation should be managed with appropriate risk-reducing strategies for HBOC syndrome.
The CPC at Yonsei Cancer Center offers various programs, including genetic counseling, cancer survivor support, surveillance, and screening for high-risk patients.
Translational Research
The team developed various preclinical models to advance drug sensitivity testing, drug delivery, N-of-1 trials, biomarker identification, and drug discovery. One key model is the patient-derived xenograft (PDX), which involves implanting patient tumor tissue into mice to replicate the biological and genomic profile of the primary tumor. They established PDX models from 83 breast cancer cases and used them to test chemosensitivity to drugs like olaparib and carboplatin, focusing on triple-negative breast cancer (TNBC) and BRCA1 mutations.
They also collaborate with a bioinformatics laboratory to analyze genomic diversity in PDX models, particularly those with the BRCA1 L1780P mutation, common in Korean patients with hereditary breast cancer. Additionally, primary cancer cells were successfully cultured from PDX tumors with the L1780P mutation, enabling in vitro drug screening.
Organoids, derived from PDX models using 3D culture methods, are used for further in vitro and in vivo research. The removal of mouse cells from organoids is critical for ensuring human-specific results in these studies.