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Kayan Tapan T, Çelebi F, Yaghouti K, Ağaçayak F, İlgün S, Soybir G, Alço G, Ak N, Ordu Ç, Özkurt E, Ünal Ç, Kurt S, Öztürk A, İyigün Z, Duymaz T, Özmen V. The Relationship of Pathological Response and Visceral Muscle and Fat Volume in Women With Breast Cancer Who Received Neoadjuvant Chemotherapy. Eur J Breast Health 2024; 20:117-121. [PMID: 38571683 PMCID: PMC10985580 DOI: 10.4274/ejbh.galenos.2024.2023-12-5] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/19/2023] [Accepted: 02/27/2024] [Indexed: 04/05/2024]
Abstract
Objective Differences in individual muscle/fat volumes may change the effectiveness of chemotherapy. In this study, the relationship between trunkal muscle and fat volume and body mass index (BMI) obtained before receiving neoadjuvant chemotherapy (NCT) in patients with breast cancer and complete pathological response (pCR) was investigated. Materials and Methods The volumes of psoas, abdominal and paraspinal muscles, and trunkal subcutaneous and visceral fat were calculated using CoreSlicer AI 2.0 opensource program from the F-18 fluorodeoxyglucose positron emission tomography/computed tomography (CT) and CT images before NCT and postoperative pCR rates to NCT were recorded. Muscle/fat volumes and BMI prior to NCT were compared in terms of pathological pCR rates. Patients were followed up regularly for recurrence and survival. Results Ninety-three patients were included with median (range) values for age, BMI, and body weights of 48 (28-72) years, 27 (16.8-51.6) kg/m2, and 71.94 (43-137) kg, respectively. The median follow-up time was 18.6 (6.7-59.6) months. No significant correlation was found between total muscle or fat volumes of patients with and without pCR. BMI [26.2 (16.8-51.6) kg/m2 vs. 24.6 (20.3-34.3) kg/m2, p = 0.03] and pCR rates in patients with low right-psoas muscle volume [11.74 (7.03-18.51) vs. 10.2 (6.71-13.36), p = 0.025] were significantly greater. A significant relationship was found between right psoas muscle volume and disease-free survival (DFS) (11.74 cm3 (7.03-18.51) vs. 10.2 cm3 (6.71-13.36), p = 0.025). However, no significant relationship was detected between total muscle-fat volume, BMI and overall survival and DFS (p>0.05). Conclusion This is the first published study investigating the relationship between the pCR ratio and body muscle and fat volume measured by CoreSlicer AI 2.0 in patients with breast cancer who received NCT. No correlation was found between the pCR ratio and total muscle plus fat volume. However, these results need to be validated with larger patient series.
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Affiliation(s)
- Tuba Kayan Tapan
- Department of Nutrition and Dietetic, Demiroğlu Bilim University Faculty of Health Sciences, İstanbul, Turkey
| | - Filiz Çelebi
- Department of Radiology, Yeditepe University Faculty of Medicine, İstanbul, Turkey
| | - Kourosh Yaghouti
- Clinic of Radiology, Gayrettepe Florance Nightingale Hospital, İstanbul, Turkey
| | - Filiz Ağaçayak
- Clinic of Radiology, İstanbul Florance Nightingale Hospital, İstanbul, Turkey
| | - Serkan İlgün
- Clinic of Breast Surgeon, Mater Dei Hospital, Central Region, Malta
| | - Gürsel Soybir
- Clinic of General Surgeon, Şişli Memorial Hospital, İstanbul, Turkey
| | - Gül Alço
- Clinic of Radiation Oncology, Gayrettepe Florance Nightingale Hospital, İstanbul, Turkey
| | - Naziye Ak
- Clinic of Oncology, Gayrettepe Florance Nightingale Hospital, İstanbul, Turkey
| | - Çetin Ordu
- Clinic of Oncology, Gayrettepe Florance Nightingale Hospital, İstanbul, Turkey
| | - Enver Özkurt
- Clinic of Breast Surgeon, İstanbul Florance Nightingale Hospital, İstanbul, Turkey
| | - Çağlar Ünal
- Clinic of Oncology, Kartal Dr. Lütfi Kırdar City Hospital, İstanbul, Turkey
| | - Sevgi Kurt
- Clinic of Plastic Surgeon, Gayrettepe Florance Nightingale Hospital, İstanbul, Turkey
| | - Alper Öztürk
- Department of General Surgeon, Biruni University Hospital, Biruni University Faculty of Medicine, İstanbul, Turkey
| | - Zeynep İyigün
- Department of Physical Therapy and Rehabilitation, Göztepe Medicalpark Hospital, Bahçeşehir University Faculty of Medicine, İstanbul, Turkey
| | - Tomris Duymaz
- Department of Physical Therapy and Rehabilitation, İstanbul Bilgi University Faculty of Health Sciences, İstanbul, Turkey
| | - Vahit Özmen
- Department of General Surgery, Breast Surgery, Surgical Oncology, İstanbul University-İstanbul Faculty of Medicine, İstanbul, Turkey
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Costa G, İlgün S, Pisani D, Agius J. A Rare Complication Following Breast Conserving Surgery: Pyoderma Gangrenosum. Eur J Breast Health 2023; 19:331-334. [PMID: 37795007 PMCID: PMC10546801 DOI: 10.4274/ejbh.galenos.2023.2023-6-1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/01/2023] [Accepted: 07/17/2023] [Indexed: 10/06/2023]
Abstract
Pyoderma gangrenosum (PG) after breast-conserving surgery is rare, and its diagnosis is often delayed because of the similarity to wound infection and the broad differential diagnosis for PG, making it a diagnosis of exclusion. A 60-year-old woman who underwent breast conserving surgery and sentinel lymph node biopsy for invasive breast carcinoma presented with increasing erythema, fever and serosanguinous discharge in the lower outer quadrant of the right breast at the site of tumour excision on postoperative day (POD) 9. Fever persisted despite antibiotics and the patient was noted to have leucocytosis (0.9 x 109/L), neutrophilia (37.8 x 109/L) and elevated C-reactive protein levels (136 μg/mL) on POD 16. Microbiology and blood culture results were negative but the breast ulcer continued to expand at a rate of 1-2 cm a day. The patient underwent surgical debridement on POD 21 to rule out necrotising soft tissue infection. Persistent ulcer progression, despite debridement and antibiotics, led to clinical suspicion of PG and the patient was started on prednisolone and cyclosporin. A rapid response was seen with treatment and an optimum healing process was noted over the subsequent three-month follow-up period. Early suspicion, careful macroscopic evaluation of disease progression and appropriate use of immunosuppressive therapy are important for the management of PG. Prompt initiation of immunosuppressive therapy may avoid unnecessary treatment and aggravation of the surgical wound.
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Affiliation(s)
- Glenn Costa
- Department of Surgery, Mater Dei Hospital, Msida, Malta
| | - Serkan İlgün
- Department of Surgery, Mater Dei Hospital, Msida, Malta
| | - David Pisani
- Department of Histopathology, Mater Dei Hospital, Msida, Malta
| | - John Agius
- Department of Surgery, Mater Dei Hospital, Msida, Malta
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Gönüllü D, Demiray O, İlgün S, Yıldız UM, Gedik ML, Er M, İğdem A, Kimiloglu E, Köksoy FN. Gastrointestinal stromal tumors: A clinical and histopathological presentation of 27 cases. Turk J Surg 2018; 34:259-263. [PMID: 30248289 PMCID: PMC6340664 DOI: 10.5152/turkjsurg.2018.4019] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/08/2017] [Accepted: 02/07/2018] [Indexed: 11/22/2022]
Abstract
OBJECTIVE Gastrointestinal stromal tumors (GISTs) are mesenchymal tumors that express type 3 tyrosine kinase receptors and are thought to develop from the neoplastic transformation of the interstitial Cajal cells. The present study was performed to morphologically and immunohistologically evaluate GISTs, to compare their qualities using a GIST risk categorization system, and to identify the diagnostic and prognostic parameters of GISTs. MATERIAL AND METHODS A total of 27 patients with GISTs underwent treatment and were followed up at the Gaziosmanpaşa Taksim Training and Research Hospital. Descriptive statistics was used to calculate the mean and median values. Survival analysis was performed by the Kaplan-Meier method. The analyses were performed using the SPSS version 22.0 software. RESULTS The mean follow-up time was 3.5 (5 months to 13 years) years. The mean age was 60.4 (29-82) years. The tumors were localized in the stomach (62.9%), extraintestinal areas (14.8%), intestine (7.4%), esophagus (7.4%), and rectum (7.4%). Twenty-four patients were classified according to the Fletcher system. Of these patients, 7 (25.9%) were classified as very low risk, 8 (29.6%) as low risk, 7 (25.9%) as intermediate risk, and 2 (7.4%) as high risk. Twenty-four patients underwent surgery. Of the 3 patients who did not undergo surgery, 1 had metastatic disease at the time of diagnosis, and 2 had mini- or micro-GISTs in the stomach. On endoscopic surveillance, all tumors remained stable. Three out of the 27 patients were lost to follow-up. Two patients developed recurrence, and 1 patient died of GIST. CONCLUSION We analyzed the clinical and pathological characteristics of GIST. The most common site of tumor origin was the stomach. The size, mitotic index, and Ki-67 values were to be found high in intermediate- and high-risk groups and metastatic diseases.
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Affiliation(s)
- Doğan Gönüllü
- Department of General Surgery, University of Health Sciences, Gaziosmanpaşa Taksim Training and Research Hospital, İstanbul, Turkey
| | - Okan Demiray
- Department of General Surgery, University of Health Sciences, Gaziosmanpaşa Taksim Training and Research Hospital, İstanbul, Turkey
| | - Serkan İlgün
- Department of General Surgery, University of Health Sciences, Gaziosmanpaşa Taksim Training and Research Hospital, İstanbul, Turkey
| | - Ufuk Mete Yıldız
- Department of General Surgery, University of Health Sciences, Gaziosmanpaşa Taksim Training and Research Hospital, İstanbul, Turkey
| | - Mehmet Lari Gedik
- Department of General Surgery, Ministry of Health, Fatsa State Hospital, Ordu, Turkey
| | - Muzaffer Er
- Department of General Surgery, University of Health Sciences, Gaziosmanpaşa Taksim Training and Research Hospital, İstanbul, Turkey
| | - Ayşenur İğdem
- Department of Pathology, University of Health Sciences, Gaziosmanpaşa Taksim Training and Research Hospital, İstanbul, Turkey
| | - Elife Kimiloglu
- Department of Pathology, University of Health Sciences, Gaziosmanpaşa Taksim Training and Research Hospital, İstanbul, Turkey
| | - Ferda N. Köksoy
- Department of General Surgery, University of Health Sciences, Gaziosmanpaşa Taksim Training and Research Hospital, İstanbul, Turkey
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Ordu C, Pilancı K, Elbüken F, Alço G, Köksal Ü, İlgün S, Sarsenov D, Aydın A, Öztürk A, Erdoğan Z, Ağaçayak F, Tecimer C, Eralp Y, Aktepe F, Özmen V. The prognostic impact of chemotherapy induced amenorrhea in women treated with early stage breast cancer. Ann Oncol 2017. [DOI: 10.1093/annonc/mdx362.022] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/14/2022] Open
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Çelebi F, Pilancı KN, Ordu Ç, Ağacayak F, Alço G, İlgün S, Sarsenov D, Erdoğan Z, Özmen V. The role of ultrasonographic findings to predict molecular subtype, histologic grade, and hormone receptor status of breast cancer. Diagn Interv Radiol 2016; 21:448-53. [PMID: 26359880 DOI: 10.5152/dir.2015.14515] [Citation(s) in RCA: 50] [Impact Index Per Article: 6.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/18/2022]
Abstract
PURPOSE The correlation between imaging findings and pathologic characteristics of tumors may provide information for diagnosis and treatment of cancer. The aim of this study is to determine whether ultrasound features of breast cancer are associated with molecular subtype, histologic grade, and hormone receptor status, as well as assess the predictive value of these features. METHODS A total of 201 consecutive invasive breast cancer patients were reviewed from the database according to the Breast Imaging and Reporting Data System (BI-RADS). Tumor margins were classified as circumscribed and noncircumscribed. Noncircumscribed group was divided into indistinct, spiculated, angular, and microlobulated. The posterior acoustic features were divided into four categories: shadowing, enhancement, no change, and mixed pattern. RESULTS Tumors with posterior shadowing were more likely to be of nontriple negative subtype (odds ratio [OR], 7.42; 95% CI, 2.10-24.99; P = 0.002), low histologic grade (grade 1 or 2 vs. grade 3: OR, 2.42; 95% CI, 1.34-4.35; P = 0.003) and having at least one positive receptor (OR, 3.36; 95% CI, 1.55-7.26; P = 0.002). Tumors with circumscribed margins were more often triple-negative subtype (OR, 6.72; 95% CI, 2.56-17.65; P < 0.001), high grade (grade 3 vs. grade 1 or 2: OR, 5.42; 95% CI, 2.66-11.00; P < 0.001) and hormone receptor negative (OR, 4.87; 95% CI, 2.37-9.99; P < 0.001). CONCLUSION Sonographic features are strongly associated with molecular subtype, histologic grade, and hormone receptor status of the tumor. These findings may separate triple-negative breast cancer from other molecular subtypes.
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Affiliation(s)
- Filiz Çelebi
- Department of Radiology, Florence Nightingale Hospital, İstanbul, Turkey.
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Çelebi F, Köksal Ü, Pilancı KN, Ordu Ç, Sarsenov D, İlgün S, Çabuk FK, Alço G, Özdil G, Erdoğan Z, Özmen V. PET-MRI Findings of Two Patients with Breast Carcinoma before Treatment. J Breast Health 2016; 12:88-90. [PMID: 28331741 DOI: 10.5152/tjbh.2016.2867] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 11/28/2015] [Accepted: 02/09/2016] [Indexed: 11/22/2022]
Abstract
Integrated positron-emission tomography-magnetic resonance imaging (PET-MRI) is a new hybrid simultaneous imaging modality with higher soft tissue contrast and lower radiation doses compared with PET-CT. Two patients who were referred to our hospital with left breast masses that were pathologically diagnosed as invasive ductal carcinoma. The women were then scanned using the first PET-MRI system in Turkey, which was established in our department. In this case report, we aimed to determine the advantages of PET-MRI in staging, follow-up, neoadjuvant chemotherapy response, and to compare the usefulness of this modality with PET-CT and dynamic contrast-enhanced breast MRI.
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Affiliation(s)
- Filiz Çelebi
- Clinic of Radiology, Gayrettepe Florence Nightingale Hospital, İstanbul, Turkey
| | - Ülkühan Köksal
- Department of Oncology, İstanbul Bilim University School of Medicine, İstanbul, Turkey
| | - Kezban Nur Pilancı
- Department of Oncology, İstanbul Bilim University School of Medicine, İstanbul, Turkey
| | - Çetin Ordu
- Department of Oncology, İstanbul Bilim University School of Medicine, İstanbul, Turkey
| | - Dauren Sarsenov
- Clinic of General Surgery, Florence Nightingale Hospital, İstanbul, Turkey
| | - Serkan İlgün
- Clinic of General Surgery, Florence Nightingale Hospital, İstanbul, Turkey
| | - Fatmagül Kuşku Çabuk
- Department of Pathology, İstanbul Bilim University School of Medicine, İstanbul, Turkey
| | - Gül Alço
- Clinic of Radiation Oncology, Gayrettepe Florence Nightingale Hospital, İstanbul, Turkey
| | - Güzide Özdil
- Department of Radiology, İstanbul Bilim University School of Medicine, İstanbul, Turkey
| | - Zeynep Erdoğan
- Department of Physical Therapy and Reanimation, İstanbul Bilim University School of Medicine, İstanbul, Turkey
| | - Vahit Özmen
- Clinic of General Surgery, Florence Nightingale Hospital, İstanbul, Turkey
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İyigün ZE, Pilancı KN, Çabuk FK, İlgün S, Ordu Ç, Duymaz T, Alço G, Çelebi F, Sarsenov D, İzci F, Öztürk A, Ağaçayak F, Köksal Üİ, Aktepe F, Eralp Y, Özmen V. The Relationship between Bone Mineral Density and Estrogen Receptor Positivity in Patients with Breast Cancer. J Breast Health 2016; 12:119-122. [PMID: 28331747 DOI: 10.5152/tjbh.2016.2961] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 02/04/2016] [Accepted: 03/07/2016] [Indexed: 11/22/2022]
Abstract
OBJECTIVE The effect of estrogen on bone mineral density (BMD) and breast cancer has been known for a long time. The aim of this study was to compare of the BMD of patients with breast cancer and healthy individuals, and to investigate the degree of correlation of estrogen receptor (ER) with BMD. MATERIALS AND METHODS Seventy-one patients with postmenopausal breast cancer and 79 healthy dividuals were included in the study. The patient demographics (age, menopause age, body mass index, number of children, BMD, Z scores, and estrogen status for breast cancer patients) were taken from hospital records. RESULTS No significant difference was detected between the case and control groups in lumbar region Z scores (p=0.074). At the femur neck, the control group Z scores was higher than patient group (p=0.002). BMI was higher in the patients with breast cancer (p=0.001). There was no statistically significant correlation between ER positivity, BMD, and BMI in ER-positive patients (p=0.495, p=0.8, p=0.846, respectively). There was no difference between the Z scores when the patients were divided into two groups as ER positive and negative (p=0.156, p=0.335, respectively). CONCLUSION This study revealed that there is no difference in lumbar region Z scores between patients with breast cancer and heathy controls; however, the Z scores were higher in the femur neck in the control group, and the BMI was lower in the patient group. Tumor ER positivity does not positively affect BMD.
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Affiliation(s)
| | | | | | - Serkan İlgün
- Florence Nightingale Breast Study Group, İstanbul, Turkey
| | - Çetin Ordu
- Florence Nightingale Breast Study Group, İstanbul, Turkey
| | - Tomris Duymaz
- Florence Nightingale Breast Study Group, İstanbul, Turkey
| | - Gül Alço
- Florence Nightingale Breast Study Group, İstanbul, Turkey
| | - Filiz Çelebi
- Florence Nightingale Breast Study Group, İstanbul, Turkey
| | | | - Filiz İzci
- Florence Nightingale Breast Study Group, İstanbul, Turkey
| | - Alper Öztürk
- Florence Nightingale Breast Study Group, İstanbul, Turkey
| | - Filiz Ağaçayak
- Florence Nightingale Breast Study Group, İstanbul, Turkey
| | | | - Fatma Aktepe
- Florence Nightingale Breast Study Group, İstanbul, Turkey
| | - Yeşim Eralp
- Florence Nightingale Breast Study Group, İstanbul, Turkey
| | - Vahit Özmen
- Florence Nightingale Breast Study Group, İstanbul, Turkey
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