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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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Kurt S, İlgün AS, Özkurt E, Soybir G, Alço G, Ünal Ç, Çelebi FE, Duymaz T, Tapan TK, Ak N, Ordu Ç, Özmen V. Outcomes of reconstructive techniques in breast cancer using BCCT. core software. World J Surg Oncol 2024; 22:82. [PMID: 38519998 PMCID: PMC10960372 DOI: 10.1186/s12957-024-03343-3] [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] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/03/2023] [Accepted: 02/14/2024] [Indexed: 03/25/2024] Open
Abstract
BACKGROUND Surgery remains a priority for breast cancer treatment. This study aimed to compare the cosmetic outcomes of oncoplastic patients who had undergone breast-conserving surgery, mini-LDF (latissimus dorsi flap), and immediate implant reconstruction using both the Japanese scale and the BCCT.core (The Breast Cancer Conservative Treatment cosmetic results software) program and to validate this program. PATIENTS AND METHODS Patients who underwent surgery for breast cancer between 1997 and 2021 were retrospectively studied. Patients were divided into three groups: 1-those who had undergone breast-conserving surgery (245 patients, 71.3%), 2-those who had undergone mini-LDF after lumpectomy (38 patients, 11.02%), and 3- those who underwent reconstruction with implants after nipple-sparing mastectomy (61 patients, 17.68%). The patients were called for a follow-up examination, and their photos were taken. The photographs were shown to an independent breast surgeon and a plastic surgeon who was not included in the surgeries, and they were asked to evaluate and rate them according to the Japanese cosmetic evaluation scale. The same images were transferred to the computer and scored using BCCT.core. RESULTS The plastic and breast surgeon evaluation results showed no significant difference between the three cosmetic techniques (p = 0.99, 0.98). The results of BCCT.core software measurements were similar to the results of plastic and breast surgeons (p: 0.43). CONCLUSION Patients are more knowledgeable about cosmetic outcomes and expect more objective data. In this study, we used 3 different cosmetic evaluation scales. We found that these techniques give results that are compatible with each other in terms of evaluating the work done in a more concrete way. For this reason, we recommend the use of such software, which offers objective results in a subjective field such as aesthetics and is very easy to apply.
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Affiliation(s)
- Sevgi Kurt
- Department of Plastic, Reconstructive and Aesthetic Surgery, Istanbul Florence Nightingale Hospital, Istanbul, Turkey.
| | | | - Enver Özkurt
- Department of General Surgery, Istanbul Florence Nightingale Hospital, Istanbul, Turkey
| | - Gürsel Soybir
- Department of General Surgery, Memorial Şişli Hospital, Istanbul, Turkey
| | - Gül Alço
- Department of Radiation Oncology, Gayrettepe Florence Nightingale Hospital, Istanbul, Turkey
| | - Çağlar Ünal
- Division of Medical Oncology, Department of Internal Medicine, Kartal Dr. Lütfi Kırdar City Hospital, Istanbul, Turkey
| | | | - Tomris Duymaz
- Department of Physiotherapy and Rehabilitation, Faculty of Health Sciences, Istanbul Bilgi University, Istanbul, Turkey
| | - Tuğba Kayan Tapan
- Department of Nutrition and Dietetics, Istanbul Florence Nightingale Hospital, Istanbul, Turkey
| | - Naziye Ak
- Division of Medical Oncology, Department of Internal Medicine, Istanbul Florence Nightingale Hospital, Istanbul, Turkey
| | - Çetin Ordu
- Division of Medical Oncology, Department of Internal Medicine, Gayrettepe Florence Nightingale Hospital, Istanbul, Turkey
| | - Vahit Özmen
- Department of General Surgery, Istanbul Florence Nightingale Hospital, Istanbul, Turkey
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Ünal Ç, Ordu Ç, Özmen T, İlgun AS, Çelebi F, Baysal B, Özkurt E, Duymaz T, Erdoğan İyigün Z, Kurt S, Öztürk MA, Pilancı KN, Alço G, Yararbaş K, Kayan Tapan T, Güven DC, Soybir G, Özmen V. Evaluation of Anti-Mullerian Hormone Levels, Antral Follicle Counts, and Mean Ovarian Volumes in Chemotherapy-Induced Amenorrhea among Breast Cancer Patients: A Prospective Clinical Study. Curr Oncol 2023; 30:9217-9229. [PMID: 37887566 PMCID: PMC10605884 DOI: 10.3390/curroncol30100666] [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] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/20/2023] [Revised: 10/14/2023] [Accepted: 10/17/2023] [Indexed: 10/28/2023] Open
Abstract
Estradiol (E2), a follicle-stimulating hormone (FSH), AMH, and inhibin B levels, along with AFC and MOV, are used to determine ovarian reserve in pre-menopausal women. Studies have shown that AMH levels are more sensitive than those of E2, FSH, and inhibin B and that AFC and MOV can be used to evaluate ovarian reserve. AMH, AFC, and MOV measurements were performed before and after adjuvant SC in 3-month periods for one year. Patients were classified as experiencing chemotherapy-induced amenorrhea (CIA) if they did not have menstrual cycles for a period of six months or longer following the conclusion of their chemotherapy treatment. We aimed to evaluate the factors affecting chemotherapy-induced amenorrhea in breast cancer patients treated with adjuvant chemotherapy and the performance of baseline measurements of AMH, AFC, and MOV to predict chemotherapy-induced amenorrhea. The effects of different chemotherapy regimens on the AMH level, AFC, and MOV in CIA patients were investigated. Seventy-one patients were eligible for this study, and the median age was 38 years (range: 23-45). The median follow-up was 37 months (range: 20-51), and CIA developed in 62% of the patients. The AMH level and AFC were significantly decreased one year after SC (p < 0.0001), whereas MOV was not (p = 0.507). AMH levels before chemotherapy (median: 1.520 vs. 0.755, p = 0.001) and at the end of the first year (median: 0.073 vs. 0.010, p = 0.030) and pre-treatment AFC (median: 12 vs. 4.50, p = 0.026) were lower in patients with CIA compared to those without CIA. The AMH levels before SC were the most valuable and earliest factor for predicting CIA development. In addition, there was no difference between the chemotherapy regimens (including or not including taxane) in terms of CIA development.
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Affiliation(s)
- Çağlar Ünal
- Division of Medical Oncology, Department of Internal Medicine, Kartal Dr. Lütfi Kırdar City Hospital, Istanbul 34865, Turkey
| | - Çetin Ordu
- Division of Medical Oncology, Department of Internal Medicine, Gayrettepe Florence Nightingale Hospital, Istanbul 34349, Turkey
| | - Tolga Özmen
- Division of Gastrointestinal and Oncologic Surgery, Harvard Medical School, Boston, MA 02115, USA
- Division of Gastrointestinal and Oncologic Surgery, Massachusetts General Hospital, Boston, MA 02114, USA
| | | | - Filiz Çelebi
- Department of Radiology, Yeditepe University Hospital, Istanbul 34755, Turkey
| | - Bülent Baysal
- Department of Obstetrics and Gynecology, İstanbul Florence Nightingale Hospital, Istanbul 34381, Turkey
| | - Enver Özkurt
- Department of General Surgery, İstanbul Florence Nightingale Hospital, Istanbul 34381, Turkey
| | - Tomris Duymaz
- Department of Physiotherapy and Rehabilitation, Faculty of Health Sciences, Istanbul Bilgi University, Istanbul 34060, Turkey
| | - Zeynep Erdoğan İyigün
- Department of Physical Theraphy and Rehabilitation, Göztepe Medical Park Hospital, Istanbul 34732, Turkey
| | - Sevgi Kurt
- Department of Plastic Surgery, İstanbul Florence Nightingale Hospital, Istanbul 34381, Turkey
| | | | - Kezban Nur Pilancı
- Division of Medical Oncology, Department of Internal Medicine, Memorial Bahçelievler Hospital, Istanbul 34180, Turkey
| | - Gül Alço
- Department of Radiation Oncology, Gayrettepe Florence Nightingale Hospital, Istanbul 34349, Turkey
| | - Kanay Yararbaş
- Department of Medical Genetics, Demiroglu Bilim University, Istanbul 34394, Turkey
| | - Tuba Kayan Tapan
- Department of Nutrition and Dietetic, Faculty of Health Science, Demiroglu Bilim University, Istanbul 34394, Turkey
| | - Deniz Can Güven
- Division of Medical Oncology, Department of Internal Medicine, Elazıg Fethi Sekin City Hospital, Elazıg 23280, Turkey
| | - Gürsel Soybir
- Department of General Surgery, Memorial Şişli Hospital, Istanbul 34384, Turkey
| | - Vahit Özmen
- Department of General Surgery, İstanbul School of Medicine, İstanbul University, Istanbul 34093, Turkey
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Ünal Ç, Özmen T, Ordu Ç, Uras C, Kara H, Gökmen E, Özdoğan M, Demircan O, Pilancı KN, Duymaz T, Özmen V. Assessment High-Risk Breast Cancer in Older Patients: A Comparative Analysis of PREDICT Scores and TAILORx Risk Categorization. Eur J Breast Health 2023; 19:325-330. [PMID: 37795003 PMCID: PMC10546806 DOI: 10.4274/ejbh.galenos.2023.2023-8-5] [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: 09/04/2023] [Accepted: 09/25/2023] [Indexed: 10/06/2023]
Abstract
Objective This study aimed to evaluate the relationship between PREDICT tool overall survival (OS) scores and high-risk patients according to TAILORx risk categorization in elderly hormone reseptor (HR) positive human epidermal growth factor negative early breast-cancer patients. Materials and Methods We conducted a retrospective study, extracting data from medical records of 64 patients diagnosed with breast cancer. A retrospective analysis was performed on all patients who had Oncotype Dx Recurrence Scores across five medical centers between 2017 and 2022. PREDICT scores were defined as calculated 10-year OS rates via PREDICT tool. Results The median age of the patients was 67, with a range between 65-75 years. Low-risk patients had a slightly higher two PREDICT scores compared to high-risk patients (78% vs. 73%), (81% vs. 77%), which were statistically significant. The progesterone receptor (PR) level was significantly lower in the high-risk group (3.5% vs. 80%). A unit decrease in the PREDICT scores was associated with a 11% increase in the odds of being in the high-risk group. However, these effects weren't statistically significant in the multivariate analysis. A unit decrease in the PR level was significantly associated with increased odds (by 5% in the multivariate analysis) of being in the high-risk group. Conclusion Our study underscores the importance of using a combination of tools, including the PREDICT tool, PR levels, and TAILORx risk categorization, for a comprehensive risk assessment in these patients, especially in the older population. Accurate risk assessment is crucial for tailoring the treatment and optimizing outcomes in this vulnerable population. Future studies are warranted to further validate these findings in larger cohorts and to explore additional biomarkers and genomic signatures that may aid in the risk assessment and management of breast cancer in older patients.
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Affiliation(s)
- Çağlar Ünal
- Division of Medical Oncology, Department of Internal Medicine, Kartal Dr. Lütfi Kırdar City Hospital, İstanbul, Turkey
| | - Tolga Özmen
- Department of Gastrointestinal and Oncologic Surgery, Harvard Medical School, Massachusetts, USA
- Department of Gastrointestinal and Oncologic Surgery, Massachusetts General Hospital, Massachusetts, USA
| | - Çetin Ordu
- Division of Medical Oncology, Department of Internal Medicine, Gayrettepe Florence Nightingale Hospital, İstanbul, Turkey
| | - Cihan Uras
- Department of General Surgery, Acıbadem University Faculty of Medicine, İstanbul, Turkey
| | - Halil Kara
- Department of General Surgery, Acıbadem University Faculty of Medicine, İstanbul, Turkey
| | - Erhan Gökmen
- Division of Medical Oncology, Department of Internal Medicine, Ege University Faculty of Medicine, İzmir, Turkey
| | - Mustafa Özdoğan
- Division of Medical Oncology, Department of Internal Medicine, Akdeniz University Faculty of Medicine, Antalya, Turkey
| | - Orhan Demircan
- Department of General Surgery, Çukurova University Faculty of Medicine, Adana, Turkey
| | - Kezban Nur Pilancı
- Division of Medical Oncology, Department of Internal Medicine, Bahçelievler Memorial Hospital, İstanbul, Turkey
| | - Tomris Duymaz
- Department of Physiotherapy and Rehabilitation, İstanbul Bilgi University Faculty of Health Sciences, İstanbul, Turkey
| | - Vahit Özmen
- Department of General Surgery, İstanbul University İstanbul Faculty of Medicine, İstanbul, Turkey
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Ünal Ç, Özmen T, İlgün AS, Ordu Ç, Özkurt E, Ak N, Alço G, Erdoğan İyigün Z, Kurt S, Duymaz T, Öztürk MA, Elbüken Çelebi F, Yararbaş K, Soybir G, Aktepe F, Özmen V. MCM-2 Levels as a Potential Biomarker for Predicting High-Risk Breast Cancer Patients According to TAILORx Classification. Breast Cancer (Dove Med Press) 2023; 15:659-669. [PMID: 37674872 PMCID: PMC10478780 DOI: 10.2147/bctt.s421535] [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] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 05/17/2023] [Accepted: 08/11/2023] [Indexed: 09/08/2023]
Abstract
Background The minichromosome maintenance protein-2 (MCM-2) is a more sensitive proliferation marker than Ki-67. This study aimed to evaluate the relationship between MCM-2 and Oncotype DX recurrence score (ODX-RS) and determine an MCM-2 cutoff value in high-risk patients according to TAILORx risk categorization. Methods Hormone receptor (HR) positive HER-2 negative early-stage breast cancer patients (pT1-2, pN0-N1, M0) who had ODX-RS were included in the study. According to the TAILORx trial, patients were divided into two groups with high (ODX-RS ≥26) and low risk (ODX-RS <26) in terms of ODX-RS. Formalin-fixed-paraffin-embedded tissues of patients were re-evaluated, and 3 µm sections were prepared for MCM-2 immuno-histochemical staining. The relationship between ODX-RS and the percentage of MCM-2 staining was evaluated in two groups. The ROC curve analysis was performed to determine the MCM-2 cut-off value for the TAILORx high-risk group (ODX-RS ≥26). Results The mean MCM-2 value was significantly higher in the high-risk group [(60.2 ± 11.2 vs 34.4 ± 13.8, p < 0.001)]. In the multivariate analysis, MCM-2 (OR: 1.27, 95% CI: 1.08-1.49, p = 0.003) and progesterone receptor (PR) levels ≤10% (OR: 60.9, 95% CI: 4.1-89.7, p = 0.003) were found to be independent factors indicating a high-risk group. A one-unit increase in MCM-2 level increased the likelihood of being in the high-risk group by 1.27 times. In the ROC curve analysis, the optimal MCM-2 cut-off level was 50 (AUC: 0.921, sensitivity: 86.7%, specificity: 96.0%, p < 0.001). Conclusion Our study is the first study in the literature to investigate the relationship between ODX-RS and MCM-2 levels in HR-positive HER-2 negative early breast-cancer patients. In this study, MCM-2 was an independent risk factor in identifying high-risk patients according to TAILORx risk classification. MCM 2 cut-off value (50) may help the decision on adjuvant chemotherapy in patients where the Oncotype DX test cannot be performed.
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Affiliation(s)
- Çağlar Ünal
- Division of Medical Oncology, Department of Internal Medicine, Kartal Dr. Lütfi Kırdar City Hospital, İstanbul, Turkey
| | - Tolga Özmen
- Division of Gastrointestinal and Oncologic Surgery, Harvard Medical School, Boston, MA, USA
- Division of Gastrointestinal and Oncologic Surgery, Massachusetts General Hospital, Boston, MA, USA
| | | | - Çetin Ordu
- Division of Medical Oncology, Department of Internal Medicine, Gayrettepe Florence Nightingale Hospital, İstanbul, Turkey
| | - Enver Özkurt
- Department of General Surgery, Istanbul Florence Nightingale Hospital, İstanbul, Turkey
| | - Naziye Ak
- Division of Medical Oncology, Department of Internal Medicine, Istanbul Florence Nightingale Hospital, İstanbul, Turkey
| | - Gül Alço
- Department of Radiation Oncology, Gayrettepe Florence Nightingale Hospital, İstanbul, Turkey
| | - Zeynep Erdoğan İyigün
- Department of Physical Therapy and Rehabilitation, Göztepe Medical Park Hospital, İstanbul, Turkey
| | - Sevgi Kurt
- Department of Plastic Surgery, Istanbul Florence Nightingale Hospital, İstanbul, Turkey
| | - Tomris Duymaz
- Department of Physiotherapy and Rehabilitation, Faculty of Health Sciences, Istanbul Bilgi University, Istanbul, Turkey
| | | | | | - Kanay Yararbaş
- Department of Medical Genetics, Demiroglu Bilim University, Istanbul, Turkey
| | - Gürsel Soybir
- Department of General Surgery, Memorial Şişli Hospital, İstanbul, Turkey
| | - Fatma Aktepe
- Department of Pathology, Memorial Şişli Hospital, İstanbul, Turkey
| | - Vahit Özmen
- Department of General Surgery, Istanbul University Istanbul School of Medicine, İstanbul, Turkey
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6
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Scheer L, Lodi M, Özmen T, Alghamdi K, Anyanwu S, Birendra J, Boubnider M, Costa M, Dian D, Elder E, Gebrim LH, Guo X, Heitz D, Imoto S, Ioannidou-Mouzaka L, Kaufman C, Liu H, Mbodj M, Meka E, Mundinger A, Novelli J, Ojuka D, Orda R, Ostapenko V, Pieńkowski T, Podolski P, Vogel T, Yin J, Özmen V, Schneebaum S, Mathelin C. Current Challenges and Perspectives in Breast Cancer in Elderly Women: The Senologic International Society (SIS) Survey. Eur J Breast Health 2023; 19:201-209. [PMID: 37415654 PMCID: PMC10320638 DOI: 10.4274/ejbh.galenos.2023.2023-5-1] [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: 05/02/2023] [Accepted: 05/16/2023] [Indexed: 07/08/2023]
Abstract
Objective Mammographic screening and management of breast cancer (BC) in elderly women are controversial and continue to be an important health problem. To investigate, through members of the Senologic International Society (SIS), the current global practices in BC in elderly women, highlighting topics of debate and suggesting perspectives. Materials and Methods The questionnaire was sent to the SIS network and included 55 questions on definitions of an elderly woman, BC epidemiology, screening, clinical and pathological characteristics, therapeutic management in elderly women, onco-geriatric assessment and perspectives. Results Twenty-eight respondents from 21 countries and six continents, representing a population of 2.86 billion, completed and submitted the survey. Most respondents considered women 70 years and older to be elderly. In most countries, BC was often diagnosed at an advanced stage compared to younger women, and age-related mortality was high. For this reason, participants recommended that personalized screening be continued in elderly women with a long life expectancy.In addition, this survey highlighted that geriatric frailty assessment tools and comprehensive geriatric evaluations needed to be used more and should be developed to avoid undertreatment. Similarly, multidisciplinary meetings dedicated to elderly women with BC should be encouraged to avoid under- and over-treatment and to increase their participation in clinical trials. Conclusion Due to increased life expectancy, BC in elderly women will become a more important field in public health. Therefore, screening, personalized treatment, and comprehensive geriatric assessment should be the cornerstones of future practice to avoid the current excess of age-related mortality. This survey described, through members of the SIS, a global picture of current international practices in BC in elderly women.
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Affiliation(s)
- Louise Scheer
- Service des équipes transverses et d’oncogériatrie, ICANS, Strasbourg, France
| | - Massimo Lodi
- Strasbourg University Hospital, Strasbourg, France; Institut de Cancérologie Strasbourg Europe (ICANS), Strasbourg Cedex, France; Institut de Génétique et de Biologie Moléculaire et Cellulaire (IGBMC), CNRS, Université de Strasbourg, Illkirch-Graffenstaden, France
| | - Tolga Özmen
- Massachusetts General Hospital, Boston, United States
| | | | - Stanley Anyanwu
- Institute of Oncology, Nnamdi Azikiwe University Nnewi Campus, Nnewi, Nigeria
| | - Joshi Birendra
- Tribhuvan University Teaching Hospital, Kathmandu, Nepal
| | | | | | | | | | | | - Xiaojing Guo
- Tianjin Medical University Cancer Institute & Hospital, Tianjin, China
| | - Damien Heitz
- Institut de cancérologie Strasbourg Europe (ICANS), Strasbourg Cedex, France
| | | | | | - Cary Kaufman
- University of Washington, Seattle, Washington, USA
| | - Hong Liu
- Tianjin Medical University Cancer Institute & Hospital, Tianjin, China
| | | | | | - Alexander Mundinger
- Breast Imaging and Interventions; Breast Centre Osnabrück; FHH Niels-Stensen-Kliniken; Franziskus-Hospital Harderberg, Georgsmarienhütte, Germany
| | | | | | - Ruben Orda
- Chairman of the International School of Senology of Sis, Israel
| | | | | | | | - Thomas Vogel
- Department of Geriatric, Strasbourg University Hospital, 1 place de l’hôpital, Strasbourg, France
| | - Jian Yin
- Tianjin Medical University Cancer Institute & Hospital, Tianjin, China
| | - Vahit Özmen
- Istanbul Florence Nightingale Hospital, İstanbul, Turkey
| | - Schlomo Schneebaum
- Department of Surgery, Tel Aviv Sourasky Medical Center, Tel Aviv Yafo, Israel
| | - Carole Mathelin
- Strasbourg University Hospital, Strasbourg, France; Institut de Cancérologie Strasbourg Europe (ICANS), Strasbourg Cedex, France; Institut de Génétique et de Biologie Moléculaire et Cellulaire (IGBMC), CNRS, Université de Strasbourg, Illkirch-Graffenstaden, France
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Oner G, Önder S, Karatay H, Ak N, Tükenmez M, Müslümanoğlu M, İğci A, Dincçağ A, Özmen V, Aydiner A, Yavuz E, Cabioğlu N. Correction: Clinical impact of PD-L1 expression in triple-negative breast cancer patients with residual tumor burden after neoadjuvant chemotherapy. World J Surg Oncol 2023; 21:54. [PMID: 36810121 PMCID: PMC9942286 DOI: 10.1186/s12957-023-02931-z] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/24/2023] Open
Affiliation(s)
- Gizem Oner
- grid.9601.e0000 0001 2166 6619Department of General Surgery, Istanbul Faculty of Medicine, Istanbul University, Istanbul, Turkey ,grid.411414.50000 0004 0626 3418Multidisciplinary Oncologic Centre Antwerp (MOCA), Antwerp University Hospital, Edegem, Belgium ,grid.5284.b0000 0001 0790 3681Center for Oncological Research (CORE), University of Antwerp, Wilrijk, Belgium
| | - Semen Önder
- grid.9601.e0000 0001 2166 6619Department of Pathology, Istanbul Faculty of Medicine, Istanbul University, Istanbul, Turkey
| | - Hüseyin Karatay
- grid.9601.e0000 0001 2166 6619Department of Pathology, Istanbul Faculty of Medicine, Istanbul University, Istanbul, Turkey
| | - Naziye Ak
- grid.9601.e0000 0001 2166 6619Department of Medical Oncology, Institute of Oncology, Istanbul University, Istanbul, Turkey
| | - Mustafa Tükenmez
- grid.9601.e0000 0001 2166 6619Department of General Surgery, Istanbul Faculty of Medicine, Istanbul University, Istanbul, Turkey
| | - Mahmut Müslümanoğlu
- grid.9601.e0000 0001 2166 6619Department of General Surgery, Istanbul Faculty of Medicine, Istanbul University, Istanbul, Turkey
| | - Abdullah İğci
- grid.9601.e0000 0001 2166 6619Department of General Surgery, Istanbul Faculty of Medicine, Istanbul University, Istanbul, Turkey
| | - Ahmet Dincçağ
- grid.9601.e0000 0001 2166 6619Department of General Surgery, Istanbul Faculty of Medicine, Istanbul University, Istanbul, Turkey
| | - Vahit Özmen
- grid.9601.e0000 0001 2166 6619Department of General Surgery, Istanbul Faculty of Medicine, Istanbul University, Istanbul, Turkey
| | - Adnan Aydiner
- grid.9601.e0000 0001 2166 6619Department of Medical Oncology, Institute of Oncology, Istanbul University, Istanbul, Turkey
| | - Ekrem Yavuz
- grid.9601.e0000 0001 2166 6619Department of Pathology, Istanbul Faculty of Medicine, Istanbul University, Istanbul, Turkey
| | - Neslihan Cabioğlu
- Department of General Surgery, Istanbul Faculty of Medicine, Istanbul University, Istanbul, Turkey.
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Mathelin C, Domínguez-Gil B, Özmen V, Lodi M. European Guidelines Concerning the Transplantation of Organs from Donors with a History of Breast Cancer. Eur J Breast Health 2023; 19:106-109. [PMID: 36605470 PMCID: PMC9806936 DOI: 10.4274/ejbh.galenos.2022.2022-12-3] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/09/2022] [Accepted: 12/09/2022] [Indexed: 12/28/2022]
Affiliation(s)
- Carole Mathelin
- Department of Surgery, ICANS (Institut de Cancérologie Strasbourg Europe), Strasbourg, France,* Address for Correspondence: E-mail:
| | | | - Vahit Özmen
- Istanbul University, Istanbul Faculty of Medicine, Department of Surgery, Istanbul, Turkey
| | - Massimo Lodi
- Institut de Cancérologie Strasbourg Europe (ICANS), Strasbourg Cedex, France
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İlgün AS, Özmen V. The Impact of the COVID-19 Pandemic on Breast Cancer Patients. Eur J Breast Health 2022; 18:85-90. [DOI: 10.4274/ejbh.galenos.2021.2021-11-5] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/14/2021] [Accepted: 12/26/2021] [Indexed: 12/01/2022]
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Özkurt E, Emiroğlu S, Cabioğlu N, Karanlık H, Önder S, Tükenmez M, İğci A, Özmen V, Müslümanoğlu M. Metaplastic Breast Cancer: Mesenchymal Subtype Has Worse Survival Outcomes. Breast Care (Basel) 2022; 17:554-560. [PMID: 36590148 PMCID: PMC9801396 DOI: 10.1159/000525324] [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: 04/14/2022] [Accepted: 05/31/2022] [Indexed: 01/04/2023] Open
Abstract
Background Metaplastic breast carcinoma (MBC) is a rare type of breast cancer that accounts for 0.2-1% of all breast cancers. To date, there are only few institutional studies comparing survival rates between different subtypes. In this retrospective cohort study, we aim to evaluate factors effecting survival rates of different subtypes of MBC. Methods This retrospective cohort study observed 118 nonmetastatic MBC patient records extracted from 15,244 breast cancer cases between December 2000 and December 2020. In order to analyze factors effecting survival rates of mesenchymal subtype of MBC, all cases are classified as mesenchymal (n = 45) and other (n = 48). Twenty-five cases could not be sub-classified due to the missing data. Univariate and multivariate logistic regression analyses were performed to define factors associated with survival rates. Results Of the 15,244 cases, 118 (0.8%) were nonmetastatic MBC. 105 were triple negative and 12 were nonluminal HER2. There was no significant difference between mesenchymal and other subgroups for age, median tumor size, AJCC staging, and type of surgery. Of the five local recurrences with known subgroup, four of them had mesenchymal subtype. It is demonstrated that mesenchymal subtype was significantly associated with worse 5-year disease-free survival and disease-specific survival (HR: 2.35 [1.01-5.48], p = 0.049, and HR: 3.16 [1.06-9.47], p = 0.040 with 95% CI, respectively). Conclusion This study is one of the few studies presenting the survival outcomes of subtypes of MBCs. Nonetheless, it is the only study demonstrating that mesenchymal subtype had worse survival outcomes. Further studies are needed to determine the outcome of different subtypes of MBCs.
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Affiliation(s)
- Enver Özkurt
- Department of General Surgery, Başarı Hospital, Istanbul, Turkey
| | - Selman Emiroğlu
- Department of General Surgery, Istanbul Faculty of Medicine, Istanbul, Turkey
| | - Neslihan Cabioğlu
- Department of General Surgery, Istanbul Faculty of Medicine, Istanbul, Turkey
| | - Hasan Karanlık
- Department of General Surgery, Istanbul Faculty of Medicine, Istanbul, Turkey
| | - Semen Önder
- Department of Pathology, Istanbul Faculty of Medicine, Istanbul, Turkey
| | - Mustafa Tükenmez
- Department of General Surgery, Istanbul Faculty of Medicine, Istanbul, Turkey
| | - Abdullah İğci
- Department of General Surgery, Istanbul Faculty of Medicine, Istanbul, Turkey
| | - Vahit Özmen
- Department of General Surgery, Istanbul Faculty of Medicine, Istanbul, Turkey
| | - Mahmut Müslümanoğlu
- Department of General Surgery, Istanbul Faculty of Medicine, Istanbul, Turkey
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11
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Nakipoğlu C, Erdoğan İyigün Z, Kayan Tapan T, Özmen V, Soybir GR, İlgün AS. Evaluation of Abdominal Fat Ratio in Patients with Breast Cancer-Related Lymphedema: A Controlled Study. Lymphat Res Biol 2022; 21:130-134. [PMID: 36037063 DOI: 10.1089/lrb.2022.0008] [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] [Indexed: 11/13/2022] Open
Abstract
Background: This study aimed to investigate the possible relationship between breast cancer-related lymphedema and central obesity, which is known to be effective in metabolic syndrome and chronic inflammation. Methods and Results: Thirty-six patients (18 lymphedemas, 18 control) enrolled in the study. There was no statistically significant difference in demographic data between the two groups except body mass index (BMI) distribution (p = 0.008). Although 50% of the patients in the study group were obese, this rate was 5.6% in the control group. Although there was a significant difference between the study and control groups in terms of abdominal circumference measurement, there was no significant difference between total and abdominal fat amount and ratios. When BMI and abdominal circumference measurements were evaluated together to predict lymphedema, the area under the curve in abdominal circumference measurement was higher than BMI (0.715 vs. 0.659). In receiver operating characteristic curve analysis, 107 cm of abdominal circumference measurement was determined as cutoff value for lymphedema, with 55% sensitivity and 89% specificity (Youden index: 0.44). Conclusion: Abdominal circumference measurement can be evaluated together with BMI in determining the risk of lymphedema.
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Affiliation(s)
- Cansu Nakipoğlu
- Department of Physical Therapy and Rehabilitation, Health Science Faculty, Demiroglu Bilim University, Istanbul, Turkey
| | - Zeynep Erdoğan İyigün
- Department of Physical Therapy and Rehabilitation, Health Science Faculty, Demiroglu Bilim University, Istanbul, Turkey
| | - Tuba Kayan Tapan
- Department of Physical Therapy and Rehabilitation, Health Science Faculty, Demiroglu Bilim University, Istanbul, Turkey
| | - Vahit Özmen
- Department of Physical Therapy and Rehabilitation, Health Science Faculty, Demiroglu Bilim University, Istanbul, Turkey
| | - Gürsel Remzi Soybir
- Department of Physical Therapy and Rehabilitation, Health Science Faculty, Demiroglu Bilim University, Istanbul, Turkey
| | - Ahmet Serkan İlgün
- Department of Physical Therapy and Rehabilitation, Health Science Faculty, Demiroglu Bilim University, Istanbul, Turkey
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12
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Mathelin C, Lodi M, Alghamdi K, Arboleda-Osorio B, Avisar E, Anyanwu S, Boubnider M, Costa MM, Elder E, Elonge T, Gebrim L, Hao X, Imoto S, Meka E, Mouelle M, Mundinger A, Ostapenko V, Özbaş S, Özmen T, Özmen V, Pienkowski T, Sarria G, Selim A, Semiglazov V, Schneebaum S. The Senologic International Society Survey on Ductal Carcinoma <i>In Situ</i>: Present and Future. Eur J Breast Health 2022; 18:205-221. [DOI: 10.4274/ejbh.galenos.2022.2022-4-3] [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] [Received: 04/07/2022] [Accepted: 06/08/2022] [Indexed: 12/01/2022]
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Oner G, Önder S, Karatay H, Ak N, Tükenmez M, Müslümanoğlu M, İğci A, Dincçağ A, Özmen V, Aydiner A, Yavuz E, Cabioğlu N. Clinical impact of PD-L1 expression in triple-negative breast cancer patients with residual tumor burden after neoadjuvant chemotherapy. World J Surg Oncol 2021; 19:264. [PMID: 34474671 PMCID: PMC8414710 DOI: 10.1186/s12957-021-02361-9] [Citation(s) in RCA: 19] [Impact Index Per Article: 6.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/31/2021] [Accepted: 08/05/2021] [Indexed: 12/31/2022] Open
Abstract
BACKGROUND Studies on PD-L1 expression in breast cancer have gained importance in recent years, especially in triple-negative breast cancer (TNBC). Our aim was to analyze the differential expression of PD-L1 to explore its correlation with response to neoadjuvant chemotherapy (NACT) and patient survival. METHODS PD-L1 expression was evaluated immunohistochemically (Ventana SP263 clone kit) by staining tumor specimen. PD-L1 positivity was defined as membranous staining > 1%, > 5%, > 10%, and > 20% on either tumor cell (TC) and /or immune cell (IC). RESULTS Fifty patients with locally advanced TNBC, who had a partial response to NACT, were included in the study. PD-L1 staining was observed in TCs in 25 patients (50%) and in ICs in 23 patients (46%) when PD-L1 > 1% was considered positive. Patients with PD-L1 positivity on ICs were more likely to respond to chemotherapy as measured by "MD Anderson Cancer Center Residual Cancer Burden Index" (14/22, 63.6% vs. 10/27, 37%, p = 0.064). The 5-year disease-free survival (DFS) and disease-specific survival (DSS) rates were 46.3% and 51.4%, respectively. A high (> 20%) tumoral PD-L1 positivity was associated with a better DFS and DSS. CONCLUSIONS Studies in the literature mostly focused on PD-L1 expression in inflammatory cells. However, our results suggest that patients with a high PD-L1 expression on TCs were more likely to have a better outcome. Since patients with residual tumor burden who express PD-L1 on TILs were more likely to respond to NACT, an immune checkpoint inhibitor therapy in addition to NACT would be an important option for TNBC with locally advanced disease.
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Affiliation(s)
- Gizem Oner
- grid.9601.e0000 0001 2166 6619Department of General Surgery, Istanbul Faculty of Medicine, Istanbul University, Istanbul, Turkey ,grid.411414.50000 0004 0626 3418Multidisciplinary Oncologic Centre Antwerp (MOCA), Antwerp University Hospital, Edegem, Belgium ,grid.5284.b0000 0001 0790 3681Center for Oncological Research (CORE), University of Antwerp, Wilrijk, Belgium
| | - Semen Önder
- grid.9601.e0000 0001 2166 6619Department of Pathology, Istanbul Faculty of Medicine, Istanbul University, Istanbul, Turkey
| | - Hüseyin Karatay
- grid.9601.e0000 0001 2166 6619Department of Pathology, Istanbul Faculty of Medicine, Istanbul University, Istanbul, Turkey
| | - Naziye Ak
- grid.9601.e0000 0001 2166 6619Department of Medical Oncology, Institute of Oncology, Istanbul University, Istanbul, Turkey
| | - Mustafa Tükenmez
- grid.9601.e0000 0001 2166 6619Department of General Surgery, Istanbul Faculty of Medicine, Istanbul University, Istanbul, Turkey
| | - Mahmut Müslümanoğlu
- grid.9601.e0000 0001 2166 6619Department of General Surgery, Istanbul Faculty of Medicine, Istanbul University, Istanbul, Turkey
| | - Abdullah İğci
- grid.9601.e0000 0001 2166 6619Department of General Surgery, Istanbul Faculty of Medicine, Istanbul University, Istanbul, Turkey
| | - Ahmet Dincçağ
- grid.9601.e0000 0001 2166 6619Department of General Surgery, Istanbul Faculty of Medicine, Istanbul University, Istanbul, Turkey
| | - Vahit Özmen
- grid.9601.e0000 0001 2166 6619Department of General Surgery, Istanbul Faculty of Medicine, Istanbul University, Istanbul, Turkey
| | - Adnan Aydiner
- grid.9601.e0000 0001 2166 6619Department of Medical Oncology, Institute of Oncology, Istanbul University, Istanbul, Turkey
| | - Ekrem Yavuz
- grid.9601.e0000 0001 2166 6619Department of Pathology, Istanbul Faculty of Medicine, Istanbul University, Istanbul, Turkey
| | - Neslihan Cabioğlu
- Department of General Surgery, Istanbul Faculty of Medicine, Istanbul University, Istanbul, Turkey.
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Cabioğlu N, Gürdal SÖ, Kayhan A, Özaydın N, Şahin C, Can Ö, Özçınar B, Aykuter G, Vatandaş G, Aribal E, Özmen V. Poor Biological Factors and Prognosis of Interval Breast Cancers: Long-Term Results of Bahçeşehir (Istanbul) Breast Cancer Screening Project in Turkey. JCO Glob Oncol 2021; 6:1103-1113. [PMID: 32678710 PMCID: PMC7392766 DOI: 10.1200/go.20.00145] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/15/2022] Open
Abstract
PURPOSE The Turkish Bahçeşehir Breast Cancer Screening Project was a 10-year, organized, population-based screening program carried out in Bahçeşehir county, Istanbul. Our aim was to examine the biologic features and outcome of screen-detected and interval breast cancers during the 10-year study period. METHODS Between 2009 and 2019, 2-view mammograms were obtained at 2-year intervals for women aged 40 to 69 years. Clinicopathological characteristics including ER, PR, HER2-neu, and Ki-67 status were analyzed for those diagnosed with breast cancer. RESULTS In 8,758 screened women, 131 breast cancers (1.5%) were detected. The majority of patients (82.3%) had prognostic stage 0-I disease. Contrarily, patients with interval cancers (n = 15; 11.4%) were more likely to have a worse prognostic stage (II-IV disease; odds ratio [OR], 3.59, 95% CI, 0.9 to 14.5) and high Ki-67 scores (OR, 3.14; 95% CI, 0.9 to 11.2). Interval cancers detected within 1 year were more likely to have a luminal B (57.1% v 31.9%) and triple-negative (14.3% v 1%) subtype and less likely to have a luminal A subtype (28.6% v 61.5%; P = .04). Patients with interval cancers had a poor outcome in 10-year disease-specific (DSS) and disease-free survival (DFS) compared with those with screen-detected cancers (DSS: 68.2% v 98.1%, P = .002; DFS: 78.6% v 96.5%, P = .011). CONCLUSION Our findings suggest the majority of screen-detected breast cancers exhibited a luminal A subtype profile with an excellent prognosis. However, interval cancers were more likely to have aggressive subtypes such as luminal B subtype or triple-negative cancers associated with a poor prognosis requiring other preventive strategies.
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Affiliation(s)
- Neslihan Cabioğlu
- Department of Surgery, Istanbul University, Istanbul Medical Faculty, Istanbul, Turkey
| | - Sibel Özkan Gürdal
- Department of Surgery, Namık Kemal University, Faculty of Medicine, Tekirdag, Turkey
| | - Arda Kayhan
- Department of Radiology, Erzincan Binali Yıldırım University Faculty of Medicine, Erzincan, Turkey
| | - Nilüfer Özaydın
- Department of Public Health, Marmara University, Faculty of Medicine, Istanbul, Turkey
| | - Cennet Şahin
- Department of Radiology, Şişli Etfal Research and Teaching Hospital, Istanbul, Turkey
| | - Ömür Can
- MEMEDER Screening Center, Bahçeşehir, Istanbul, Turkey
| | - Beyza Özçınar
- Department of Surgery, Istanbul University, Istanbul Medical Faculty, Istanbul, Turkey
| | - Gönül Aykuter
- MEMEDER Screening Center, Bahçeşehir, Istanbul, Turkey
| | | | - Erkin Aribal
- Department of Radiology, Acıbadem University, Faculty of Medicine, Istanbul, Turkey
| | - Vahit Özmen
- Department of Surgery, Istanbul University, Istanbul Medical Faculty, Istanbul, Turkey
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Mathelin C, Ame S, Anyanwu S, Avisar E, Boubnider WM, Breitling K, Anie HA, Conceição JC, Dupont V, Elder E, Elfgen C, Elonge T, Iglesias E, Imoto S, Ioannidou-Mouzaka L, Kappos EA, Kaufmann M, Knauer M, Luzuy F, Margaritoni M, Mbodj M, Mundinger A, Orda R, Ostapenko V, Özbaş S, Özmen V, Pagani O, Pieńkowski T, Schneebaum S, Shmalts E, Selim A, Pavel Z, Lodi M, Maghales-Costa M. Breast Cancer Management During the COVID-19 Pandemic: The Senologic International Society Survey. Eur J Breast Health 2021; 17:188-196. [PMID: 33870120 DOI: 10.4274/ejbh.galenos.2021.2021-1-4] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.7] [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: 01/25/2021] [Accepted: 03/09/2021] [Indexed: 01/19/2023]
Abstract
Objective In early 2020, the spread of coronavirus disease-2019 (COVID-19) led the World Health Organization to declare this disease a pandemic. Initial epidemiological data showed that patients with cancer were at high risk of developing severe forms of COVID-19. National scientific societies published recommendations modifying the patients' breast cancer (BC) management to preserve, in theory, quality oncologic care, avoiding the increased risk of contamination. The Senology International Society (SIS) decided to take an inventory of the actions taken worldwide. This study investigates COVID-19-related changes concerning BC management and analyzes the will to maintain them after the pandemic, evaluating their oncological safety consequences. Materials and Methods SIS network members participated in an online survey using a questionnaire (Microsoft® Forms) from June 15th to July 31st, 2020. Results Forty-five responses from 24 countries showed that screening programs had been suspended (68%); magnetic resonance imagines were postponed (73%); telemedicine was preferred when possible (71%). Surgeries were postponed: reconstructive (77%), for benign diseases (84%), and in patients with significant comorbidities (66%). Chemotherapy and radiotherapy protocols had been adapted in 28% of patients in both. Exception for telemedicine (34%), these changes in practice should not be continued. Conclusion The SIS survey showed significant changes in BC's diagnosis and treatment during the first wave of the COVID-19 pandemic, but most of these changes should not be maintained. Indeed, women have fewer severe forms of COVID-19 and are less likely to die than men. The risk of dying from COVID-19 is more related to the presence of comorbidities and age than to BC. Stopping screening and delaying treatment leads to more advanced stages of BC. Only women aged over 65 with BC under treatment and comorbidities require adaptation of their cancer management.
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Affiliation(s)
- Carole Mathelin
- Institut de Cancérologie Strasbourg Europe (ICANS), Strasbourg Cedex, France.,Immediate the Senology International Society (SIS) Past President, France
| | - Shanti Ame
- Institut de Cancérologie Strasbourg Europe (ICANS), Strasbourg Cedex, France
| | - Stanley Anyanwu
- The Senology International Society Vice-President for Africa, Nigeria
| | - Eli Avisar
- Miller School of Medicine, University of Miami, USA
| | | | | | | | | | | | - Elisabeth Elder
- Westmead Breast Cancer Institute, University of Sydney, Australia
| | | | | | - Edelmiro Iglesias
- The Senology International Society (SIS) Vice-President for Europe, Spain
| | | | | | - Elisabeth A Kappos
- Breast Center and Department of Plastic, Reconstructive, Aesthetic and Handsurgery, University Hospital Basel, Switzerland
| | | | - Michael Knauer
- Breast Center Eastern Switzerland, St. Gallen, Switzerland
| | - Franck Luzuy
- Department of Breast Surgery, Hirslanden Clinic, Geneva, Switzerland
| | | | - Mamadou Mbodj
- Department of Nuclear Medicine, General Hospital Idrissa POUYE, Dakar, Senegal
| | | | - Ruben Orda
- The Senology International Society (SIS) International School of Senology, Israel
| | | | | | - Vahit Özmen
- The Senology International Society (SIS) Standing Committee, Turkey
| | - Olivia Pagani
- Department of Oncology, Breast Unit and Institute of Oncology of Southern Switzerland
| | | | | | - Ekaterina Shmalts
- Department of Oncology, Multi-field Clinical Medical Centre "Medical City", Tyumen, Russia
| | - Ashraf Selim
- Department of Radiology, Cairo University, Egypt
| | - Zotov Pavel
- Department of Oncology, Tyumen State Medical University, Russia
| | - Massimo Lodi
- Institut de Cancérologie Strasbourg Europe (ICANS), Strasbourg Cedex, France
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Soran A, Özbaş S, Doğan L, Sezgin E, Özmen V, Beriwal S, Brufsky A. Loco-Regional Treatment for Intact Primary Tumor in Patient with De Novo Metastatic Breast Cancer; Comments and Concerns of ECOG-ACRIN 2108 Trial. Eur J Breast Health 2020; 16:158-159. [PMID: 32656512 DOI: 10.5152/ejbh.2020.080620] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/01/2020] [Accepted: 06/07/2020] [Indexed: 11/22/2022]
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17
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İzci F, Özdem G, İlgün AS, Ağaçayak F, Duymaz T, Erdoğan Z, Alço G, Elbüken F, Öztürk A, Ordu Ç, Ateşal KC, Doğan Öİ, Aktepe F, Özmen V. Pre-Treatment and Post-Treatment Anxiety, Depression, Sleep and Sexual Function Levels in Patients with Breast Cancer. Eur J Breast Health 2020; 16:219-225. [PMID: 32656524 DOI: 10.5152/ejbh.2020.5259] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [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: 10/24/2019] [Accepted: 03/05/2020] [Indexed: 12/20/2022]
Abstract
Objective In the phase of diagnosis and treatment of breast cancer cases, patients can usually experience sexual dysfunctions, sleep disorders and psychiatric disorders such as anxiety and depression. The main objective of our research is to study of the pre-treatment and post-treatment anxiety, depression, sleep and sexual function levels in the patients with breast cancer. Materials and Methods Fifty-six patients with breast cancer and 52 healthy women have participated in our study. In order to determine the anxiety, depression, sleep and sexual function levels, Sociodemographic and Clinical Data Form, Hospital Anxiety Depression Scale (HADS), Pittsburgh Sleep Quality Scale (PSQI) and Arizona Sexual Experiences Scale (ASEX) scores are utilized at pre-treatment and post-treatment phases for patients with breast cancer and our control group. Results According to scale scores applied to patients and control group, it has been determined that patients with breast cancer HADS sexual and sleep disorders, that their HADS and PSQI scores were higher and that ASEX scores decreased significantly (p<0.05). According to the scale scores calculated before and after treatment, there was a significant decrease in HADS and PSQI scores, whereas SEX scores have been increased significantly (p<0.05). Conclusion According to the findings of our study, anxiety, depression, sexual dysfunction and sleep disorders in patients with breast cancer are far more explicit in the pre-treatment phase than post-treatment phase. Therefore, it is crucial to psycho-socially support patients with breast cancer in the early periods before starting the treatment after diagnosis.
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Affiliation(s)
- Filiz İzci
- Department of Psychiatry, İstanbul Erenköy Training and Research Hospital, İstanbul, Turkey
| | - Gözdem Özdem
- İstanbul Florence Nightangale Hospital, Breast Health Center, İstanbul, Turkey
| | - Ahmet Serkan İlgün
- Department of General Surgery, İstanbul Taksim Training and Research Hospital, İstanbul, Turkey
| | - Filiz Ağaçayak
- İstanbul Florence Nightangale Hospital, Breast Health Center, İstanbul, Turkey
| | - Tomris Duymaz
- Department of Physiotherapy and Rehabilitation, İstanbul Bilgi University Faculty of Health Sciences, İstanbul, Turkey
| | - Zeynep Erdoğan
- İstanbul Florence Nightangale Hospital, Breast Health Center, İstanbul, Turkey
| | - Gül Alço
- Gayrettepe Florence Nightingale Hospital, Breast Health Center, İstanbul, Turkey
| | - Filiz Elbüken
- Gayrettepe Florence Nightingale Hospital, Breast Health Center, İstanbul, Turkey
| | - Alper Öztürk
- Department of General Surgery, Biruni University School of Medicine, İstanbul, Turkey
| | - Çetin Ordu
- Gayrettepe Florence Nightingale Hospital, Breast Health Center, İstanbul, Turkey
| | - Kübra Ceren Ateşal
- Department of Psychiatry, İstanbul Erenköy Training and Research Hospital, İstanbul, Turkey
| | - Özge İpek Doğan
- Department of Psychiatry, İstanbul Erenköy Training and Research Hospital, İstanbul, Turkey
| | - Fatma Aktepe
- Gayrettepe Florence Nightingale Hospital, Breast Health Center, İstanbul, Turkey
| | - Vahit Özmen
- Department of General Surgery, İstanbul University İstanbul Faculty of Medicine, İstanbul, Turkey
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Gemici AA, Arıbal E, Özaydın AN, Gürdal SÖ, Özçınar B, Cabioğlu N, Özmen V. Comparison of Qualitative and Volumetric Assessments of Breast Density and Analyses of Breast Compression Parameters and Breast Volume of Women in Bahcesehir Mammography Screening Project. Eur J Breast Health 2020; 16:110-116. [PMID: 32285032 DOI: 10.5152/ejbh.2020.4943] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [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: 01/22/2018] [Accepted: 12/25/2019] [Indexed: 11/22/2022]
Abstract
Objective We aimed to compare visual and quantitative measurements of breast density and to reveal the density profile with compression characteristics. Materials and Methods Screening mammograms of 1399 women between May 2014 and May 2015 were evaluated by using Volpara 4th and 5th version. First 379 mammograms were assessed according to ACR BI-RADS 4th edition and compared to Volpara. We categorized the breast density in two subgroups as dens or non-dens. Two radiologists reviewed the images in consensus. Agreement level between visual and volumetric methods and volumetric methods between themselves assessed using weighted kappa statistics. Volpara data such as fibroglandular volume (FGV), breast volume (BV), compression thickness (CT), compression force (CF), compression pressure (CP) were also analyzed with relation to the age. Results 1399 mammograms were distributed as follows: 12.7% VDG1, 39.3% VDG2, 34.1% VDG3, 13.9% VDG4 according to the 4th edition of Volpara; 1.2% VDG1, 46% VDG2, 36.8% VDG3, 15.9% VDG4 according to the 5th edition of Volpara. The difference between two editions was 4.7% increase in dense category. 379 mammograms, according to ACR BI-RADS 4th edition, were distributed as follows: 25.9% category A, 50.9% category B, 19.8% category C, 3.4% category D. The strength of agreement between the Volpara 4th and 5th editions was found substantial (k=0.726). The agreements between visual assessment and both Volpara editions were poor (k=-0.413, k=-0.399 respectively). There was a 142% increase in dense group with the VDG 4th edition and 162% with the VDG 5th edition when compared to visual assessment. Compression force decreased while compression pressure increased with increasing Volpara Density Grade (VDG) (p for trend <0.001 for both). Compression thickness and breast volume decreased with increasing VDG (p for trend <0.001 for both). The FGV decreases with age and the breast volume increases with increasing age (p<0.001). Conclusion Visual assessment of breast density doesn't correlate well with volumetric assessments. Obtaining additional information about physical parameters and breast profile by the results of quantified methods is important for breast cancer risk assessments and prevention strategies.
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Affiliation(s)
- Ayşegül Akdoğan Gemici
- Department of Radiology, Health Science University, Bakırköy Dr. Sadi Konuk Training and Research Hospital, İstanbul, Turkey
| | - Erkin Arıbal
- Department of Radiology, Acıbadem Mehmet Aydınlar University School of Medicine, İstanbul, Turkey
| | - Ayşe Nilüfer Özaydın
- Department of Public Health, Marmara University School of Medicine, İstanbul, Turkey
| | - Sibel Özkan Gürdal
- Department of General Surgery, Namık Kemal University School of Medicine, Tekirdağ, Turkey
| | - Beyza Özçınar
- Department of General Surgery, İstanbul University İstanbul School of Medicine, İstanbul, Turkey
| | - Neslihan Cabioğlu
- Department of General Surgery, İstanbul University İstanbul School of Medicine, İstanbul, Turkey
| | - Vahit Özmen
- Department of General Surgery, İstanbul University İstanbul School of Medicine, İstanbul, Turkey
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19
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Çakmak GK, Özmen V. Sars-CoV-2 (COVID-19) Outbreak and Breast Cancer Surgery in Turkey. Eur J Breast Health 2020; 16:83-85. [PMID: 32285026 DOI: 10.5152/ejbh.2020.300320] [Citation(s) in RCA: 12] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/25/2020] [Accepted: 03/31/2020] [Indexed: 11/22/2022]
Affiliation(s)
| | - Vahit Özmen
- İstanbul University İstanbul Faculty of Medicine, İstanbul, Turkey
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20
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Çelebi F, Ordu Ç, Ilgün S, Oztürk A, Erdoğan Iyigün Z, Alço G, Duymaz T, Aktepe F, Soybir G, Baysal B, Özmen V. The Effect of Systemic Chemotherapy on Ovarian Function: A Prospective Clinical Trial. Eur J Breast Health 2020; 16:177-182. [PMID: 32656517 DOI: 10.5152/ejbh.2020.5114] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [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: 07/17/2019] [Accepted: 11/25/2019] [Indexed: 11/22/2022]
Abstract
Objective Premenopausal women with breast cancer are at risk of developing ovarian failure after chemotherapy. The aim of this study was to investigate the negative effects of systemic chemotherapy on ovarian function in premenoupausal women with breast cancer. Materials and Methods Thirty-one premenopausal women with operable breast cancer aged between 26-48 years were enrolled in this prospective cohort study to investigate preliminary results. Additional 69 patients' data will be included after the completion of all five measurements. The change in serum Antimullerian Hormone (AMH) levels, mean ovarian volumes (MOV) and antral follicle counts (AFCs) at 3-month intervals were recorded to evaluate ovarian function. Women who had at least one pretreatment and four post-treatment measurements in one year follow-up period were included in the study. Decision of chemotherapy regimen was taken by the Tumor Board. Results Thirty-one patients had all five AMH, MOV and AFCs results. There was a statistically significant negative correlation between 1st - 5th AMH levels (p=0.006) and 1st - 5th AFCs during the follow-up period (p<0.0001). However pre- and post-chemotherapy measurements of MOVs did not demonstrate any significant correlation (p=0.799). BMI, parity, lactation, histopathology and molecular subtypes of breast cancer, alcohol intake, smoking and type of chemotherapy regimen were not significantly correlated with AMH, AFC and MOV. Conclusion Pretreatment AMH levels and AFC were shown to have a significant role in early prediction of ovarian-reserve after chemotherapy.
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Affiliation(s)
- Filiz Çelebi
- Department of Radiology, Gayrettepe Florence Nightingale Hospital, İstanbul, Turkey
| | - Çetin Ordu
- Department of Oncology, Gayrettepe Florence Nightingale Hospital, İstanbul, Turkey
| | - Serkan Ilgün
- Department of General Surgery, Demiroğlu Bilim University School of Medicine, İstanbul, Turkey
| | - Alper Oztürk
- Department of General Surgery, Biruni University Hospital, İstanbul, Turkey
| | - Zeynep Erdoğan Iyigün
- Department of Physical Therapy and Rehabilitation, Demiroğlu Bilim University School of Medicine, İstanbul, Turkey
| | - Gül Alço
- Department of Radiation Oncology, Gayrettepe Florence Nightingale Hospital, İstanbul, Turkey
| | - Tomris Duymaz
- Department of Physical Therapy and Rehabilitation, Bilgi University, İstanbul, Turkey
| | - Fatma Aktepe
- Department of Pathology, Gayrettepe Florence Nightingale Hospital, İstanbul, Turkey
| | - Gürsel Soybir
- Department of General Surgery, Memorial Etiler Hospital, İstanbul, Turkey
| | - Bülent Baysal
- Department of Obstetrics and Gynecology, İstanbul Florence Nightingale Hospital, İstanbul, Turkey
| | - Vahit Özmen
- Department of General Surgery, İstanbul Florence Nightingale Hospital, İstanbul, Turkey
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21
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Özmen V. Editorial. Eur J Breast Health 2019; 15:1. [PMID: 32181444 PMCID: PMC7057393] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 06/10/2023]
Affiliation(s)
- Vahit Özmen
- Professor of Surgery, Editor-in-Chief, The European Journal of Breast Health
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22
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Duymaz T, İyigün ZE, İlgün AS, Ordu Ç, Üçüncü M, Alço G, Öztürk A, Elbüken F, Aktepe F, Özmen V. The Effect of Mini-Latissimus Dorsi Flap (MLDF) Reconstruction on Shoulder Function in Breast Cancer Patients. Eur J Breast Health 2019; 15:158-162. [PMID: 31312791 DOI: 10.5152/ejbh.2019.4727] [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: 02/05/2019] [Accepted: 04/01/2019] [Indexed: 11/22/2022]
Abstract
Objective The aim of this study is to investigate the effect of mini latissimus dorsi flap (MLDF) reconstruction on ipsilateral shoulder functions. Materials and Methods Those included in the study are the patients aged between 23 and 73, who were operated with the diagnosis of early breast cancer (cT1-3)N0). The first group includes the patients who had sentinel lymph node biopsy (SLNB) with partial mastectomy. The second group consists of the patients who had axillary lymph nodule dissection (ALND) with partial mastectomy. The third group includes the patients who had SLNB and MLDF with partial mastectomy. The fourth group includes the patients who had ALND and MLDF with partial mastectomy. Patients' Quick Disabilities of the Arm, Shoulder and Hand (Q-DASH) score work model point were recorded. Results 174 patients were included in this study. According to Q-DASH score, no functional change was detected in 69.5% of the patients, whereas slight functional loss was identified in 23.6%, moderate functional loss in 5.7%, severe functional loss 1.1%. In the comparison of Q-DASH scores in surgery groups, while these four groups were being analyzed, a significant difference was determined (p=0.007). When dual analyses were made, it was also established that the difference resulted from the group to which ALND and MLDF were applied together. Conclusion We conclude that MLDF application for reconstruction purposes after breast surgery has a negative impact on shoulder functions of the patients who had both of partial mastectomy and ALND.
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Affiliation(s)
- Tomris Duymaz
- Department of Physiotherapy and Rehabilitation, İstanbul Bilgi University School of Health Sciences, İstanbul, Turkey
| | - Zeynep Erdoğan İyigün
- Department of Physiotherapy and Rehabilitation, İstanbul Bilim University School of Medicine, İstanbul, Turkey
| | - Ahmet Serkan İlgün
- Department of General Surgery, Taksim Training and Research Hospital, İstanbul, Turkey
| | - Çetin Ordu
- Department of Medical Oncology, İstanbul Bilim University School of Medicine, İstanbul, Turkey
| | - Muhammed Üçüncü
- Centre of Breast Health, İstanbul Florence Nightingale Hospital, İstanbul, Turkey
| | - Gül Alço
- Department of Radiation Oncology, Gayrettepe Florence Nightingale Hospital, İstanbul, Turkey
| | - Alper Öztürk
- Department of General Surgery, Biruni University School of Medicine, İstanbul, Turkey
| | - Filiz Elbüken
- Departmment of Radiology, Gayrettepe Florence Nightingale Hospital, İstanbul, Turkey
| | - Fatma Aktepe
- Department of Pathology, Gayrettepe Florence Nightingale Hospital, İstanbul, Turkey
| | - Vahit Özmen
- Department of General Surgery, İstanbul University İstanbul School of Medicine, İstanbul, Turkey
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23
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Özmen V, Çakar B, Gökmen E, Özdoğan M, Güler N, Uras C, Ok E, Demircan O, Işıkdoğan A, Saip P. Cost effectiveness of Gene Expression Profiling in Patients with Early-Stage Breast Cancer in a Middle-Income Country, Turkey: Results of a Prospective Multicenter Study. Eur J Breast Health 2019; 15:183-190. [PMID: 31312795 DOI: 10.5152/ejbh.2019.4761] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.8] [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: 02/14/2019] [Accepted: 04/22/2019] [Indexed: 11/22/2022]
Abstract
Objective Breast cancer is a heterogenous disease, and genetic profiling helps to individualize adjuvant treatment. The Oncotype DX is a validated test to predict benefit of adjuvant systemic treatment. The aims of this study are to determine the costs of chemotherapy in government hospitals in Turkey and evaluate the cost-effectiveness of the Oncotype DX from the national insurance perspective. Materials and Methods A Markov model was developed to make long term projections of distant recurrence, survival, quality adjusted life expectancy, and direct costs for patients with ER+, HER2-, node-negative or up to 3 node-positive early stage breast cancer. Turkish decision impact study patient data were captured for model reference. In that study, ten academic centers across Turkey participated in a prospective trial. Of 165 patients with pT1-3, pN0-N1mic, ER-positive, and HER-2 negative tumors, 57% had low recurrence score (RS), 35% had intermediate RS, and 8% had high RS, respectively. The overall rate of change in chemotherapy treatment decisions following Oncotype DX was 33%. Results The cost of adjuvant chemotherapy in public hospitals was estimated at $3.649, and Oncotype Dx test was $5.141. Based on the cost-effectiveness analysis, Oncotype DX testing was estimated to improve life expectancy (+0.86 years) and quality-adjusted life expectancy (+0.68 QALYs) versus standard care. The incremental cost-effectiveness ratio (ICERs) of Oncotype DX was estimated to be $7207.9 per QALY gained and $5720.6 per LY gained versus current clinical practice. Conclusion As Oncotype DX was found both cost-effective and life-saving from a national perspective, the test should be introduced to standard care in patients with ER+, HER-2 negative early-stage breast cancer in Turkey.
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Affiliation(s)
- Vahit Özmen
- Department of General Surgery, İstanbul University School of Medicine, İstanbul, Turkey
| | - Burcu Çakar
- Division of Medical Oncology, Department of Internal Medicine, Ege University School of Medicine, İzmir, Turkey
| | - Erhan Gökmen
- Division of Medical Oncology, Department of Internal Medicine, Ege University School of Medicine, İzmir, Turkey
| | - Mustafa Özdoğan
- Division of Medical Oncology, Memorial Hopital, Antalya, Turkey
| | - Nilufer Güler
- Division of Medical Oncology, Department of Internal Medicine, Hacettepe University Institute of Oncology, Ankara, Turkey
| | - Cihan Uras
- Department of General Surgery, Acıbadem University, İstanbul, Turkey
| | - Engin Ok
- Department of General Surgery, Erciyes University School of Medicine, Kayseri, Turkey
| | - Orhan Demircan
- Department of General Surgery, Acıbadem University, İstanbul, Turkey
| | - Abdurrahman Işıkdoğan
- Division of Medical Oncology, Department of Internal Medicine, Dicle University School of Medicine, Diyarbakır, Turkey
| | - Pınar Saip
- Division of Medical Oncology, Department of Internal Medicine, İstanbul University School of Medicine, İstanbul, Turkey
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Türkyılmaz Z, Aydın T, Yılmaz R, Önder S, Özkurt E, Tükenmez M, Müslümanoğlu M, Acunaş G, İğci A, Özmen V, Dinçağ A, Cabioğlu N. Our 20-Year Institutional Experience with Surgical Approach for Breast Hamartomas. Eur J Breast Health 2019; 15:171-175. [PMID: 31312793 DOI: 10.5152/ejbh.2019.4624] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.0] [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: 12/14/2018] [Accepted: 03/06/2019] [Indexed: 11/22/2022]
Abstract
Objective Hamartomas are rare, slowly-growing breast tumours. Clinical, radiological and histopathological examination together increase the diagnostic accuracy. To evaluate the clinicopathologic features of hamartomas and outline our clinical approach to hamartomas in our 20-year experience at our Breast Clinic. Materials and Methods Between 1995 and 2015, 24 cases were retrospectively analyzed with a diagnosis of breast hamartoma at our Breast Clinic followed by excisional biopsy. Data was obtained on patient demographics, clinical examination, radiological findings and histopathological subtypes. Results Of 1338 benign breast tumours excised from January 1995 to January 2015, 24 (1.8%) were identified as breast hamartoma. Median age of patients was 42 (range, 13-70), whereas the median tumour size was 5 cm (1-10 cm). On preoperative imaging, hamartoma was most commonly misdiagnosed as fibroadenoma. Pathological examination of the 24 biopsy specimens revealed 3 cases with pseudoangiomatous stromal hyperplasia, and another hamartoma associated with a radial scar within the centre of the lesion. Of those, one patient was diagnosed with malignant phylloides tumour in the same breast. At a median follow-up 58.4 months, none of the patients recurred or developed malignancy. Conclusion Hamartomas can often be missed by clinicians, due to its benign nature which is poorly understood. Despite their slow growth, hamartomas can reach large sizes and can cause breast asymmetry. Although it is rare, hamartoma can be seen along with malignancy, as it is formed from similar components of breast tissue. Therefore, careful diagnosis and appropriate management including surgery are required.
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Affiliation(s)
- Zeliha Türkyılmaz
- Department of General Surgery, Trakya University School of Medicine, Edirne, Turkey
| | - Tahacan Aydın
- İstanbul University, İstanbul School of Medicine, İstanbul, Turkey
| | - Ravza Yılmaz
- Department of Radiology, İstanbul University, İstanbul School of Medicine, İstanbul, Turkey
| | - Semen Önder
- Department of Pathology, İstanbul University, İstanbul School of Medicine, İstanbul, Turkey
| | - Enver Özkurt
- Department of General Surgery, İstanbul University, İstanbul School of Medicine, İstanbul, Turkey
| | - Mustafa Tükenmez
- Department of General Surgery, İstanbul University, İstanbul School of Medicine, İstanbul, Turkey
| | - Mahmut Müslümanoğlu
- Department of General Surgery, İstanbul University, İstanbul School of Medicine, İstanbul, Turkey
| | - Gülden Acunaş
- Department of General Surgery, İstanbul University, İstanbul School of Medicine, İstanbul, Turkey
| | - Abdullah İğci
- Department of General Surgery, İstanbul University, İstanbul School of Medicine, İstanbul, Turkey
| | - Vahit Özmen
- Department of General Surgery, İstanbul University, İstanbul School of Medicine, İstanbul, Turkey
| | - Ahmet Dinçağ
- Department of General Surgery, İstanbul University, İstanbul School of Medicine, İstanbul, Turkey
| | - Neslihan Cabioğlu
- Department of General Surgery, İstanbul University, İstanbul School of Medicine, İstanbul, Turkey
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25
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Özmen V, Özmen T, Doğru V. Breast Cancer in Turkey; An Analysis of 20.000 Patients with Breast Cancer. Eur J Breast Health 2019; 15:141-146. [PMID: 31312788 DOI: 10.5152/ejbh.2019.4890] [Citation(s) in RCA: 31] [Impact Index Per Article: 6.2] [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: 03/14/2019] [Accepted: 05/08/2019] [Indexed: 01/22/2023]
Abstract
Objective Breast cancer is the most common type of cancer and the leading cause of cancer-related deaths in women in Turkey. This study presents the characteristics of patients registered in National Breast Cancer Registry Program of Turkish Federation of Breast Diseases Societies. Materials and Methods The registry contains 242 variables under 10 categories and 699 questions. Patients were recorded (online and offline) from nationwide breast centers around Turkey. Results Twenty-thousand patients were registered between May 2005 and April 2017 at 36 centers. After data cleaning, 19,503 women were included in the study. The median age at diagnosis was 51 [14-97]; 17.2% were younger than 40 and 37.2% were premenopausal; 13.6% were nulliparous. Breast conserving surgery rate was 39.3%. Histopathology was invasive ductal cancer in 77%. Majority of patients had stage II cancer (48.3%). Estrogen, progesterone and HER-2 receptor positivity rates in invasive breast cancer were 72.5%, 62.5% and 21.8%, respectively. The mean tumor diameter was 2.5±1.7 cm. During the mean 51.6 months of follow-up, the local/regional and systemic recurrence rates were 3.7% and 5.2%, respectively; five and 10-year overall survival rates were 86% and 76%. Conclusion Despite increasing number of screening centers and free-of-charge mammography (ages 40 to 69) and mobile screening systems in recent years, a significant portion of patients were diagnosed at advanced stage due to lack of breast cancer awareness. In contrast with the study published 5 years ago, there was a decrease in the rate of pre-menopausal women and an increase in the breast conserving surgery.
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Affiliation(s)
- Vahit Özmen
- Department of Surgery, İstanbul University İstanbul School of Medicine, İstanbul, Turkey
| | - Tolga Özmen
- Department of Surgery, University of Miami Miller School of Medicine, Jackson Memorial Hospital, Florida, USA
| | - Volkan Doğru
- Department of Surgery, Akdeniz University School of Medicine, Antalya, Turkey
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26
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Ozkurt E, Yardımcı E, Tükenmez M, Ersoy YE, Yilmaz R, Cabioğlu N, Karanlık H, Kulle CB, Malya FU, Önder S, Gucin Z, İğci A, Özmen V, Dinççağ AS, Müslümanoğlu M. Intraoperative palpation of sentinel lymph nodes can accurately predict axilla in early breast cancer. Breast J 2019; 25:96-102. [DOI: 10.1111/tbj.13149] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/02/2017] [Revised: 04/09/2018] [Accepted: 04/19/2018] [Indexed: 01/04/2023]
Affiliation(s)
- Enver Ozkurt
- Department of General Surgery, Breast Unit Istanbul University Istanbul Faculty of Medicine Topkapi, Istanbul Turkey
| | - Erkan Yardımcı
- Faculty of Medicine, Department of General Surgery Bezmialem Vakif University Topkapi, Istanbul Turkey
| | - Mustafa Tükenmez
- Department of General Surgery, Breast Unit Istanbul University Istanbul Faculty of Medicine Topkapi, Istanbul Turkey
| | - Yeliz Emine Ersoy
- Faculty of Medicine, Department of General Surgery Bezmialem Vakif University Topkapi, Istanbul Turkey
| | - Ravza Yilmaz
- Istanbul Faculty of Medicine, Department of Radiology Istanbul University Topkapi, Istanbul Turkey
| | - Neslihan Cabioğlu
- Department of General Surgery, Breast Unit Istanbul University Istanbul Faculty of Medicine Topkapi, Istanbul Turkey
| | - Hasan Karanlık
- Department of General Surgery Istanbul University Istanbul Institute of Oncology Topkapi, Istanbul Turkey
| | - Cemil Burak Kulle
- Department of General Surgery, Breast Unit Istanbul University Istanbul Faculty of Medicine Topkapi, Istanbul Turkey
| | - Fatma Umit Malya
- Faculty of Medicine, Department of General Surgery Bezmialem Vakif University Topkapi, Istanbul Turkey
| | - Semen Önder
- Istanbul Faculty of Medicine, Department of Pathology Istanbul University Topkapi, Istanbul Turkey
| | - Zuhal Gucin
- Faculty of Medicine, Department of Pathology Bezmialem Vakif University Topkapi, Istanbul Turkey
| | - Abdullah İğci
- Department of General Surgery, Breast Unit Istanbul University Istanbul Faculty of Medicine Topkapi, Istanbul Turkey
| | - Vahit Özmen
- Department of General Surgery, Breast Unit Istanbul University Istanbul Faculty of Medicine Topkapi, Istanbul Turkey
| | - Ahmet Sait Dinççağ
- Department of General Surgery, Breast Unit Istanbul University Istanbul Faculty of Medicine Topkapi, Istanbul Turkey
| | - Mahmut Müslümanoğlu
- Department of General Surgery, Breast Unit Istanbul University Istanbul Faculty of Medicine Topkapi, Istanbul Turkey
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27
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Özçınar B, Güler SA, Kocaman N, Özkan M, Güllüoğlu BM, Özmen V. Complications Associated with Loco-Regional Treatment of Breast Cancer and Their Impact on Quality-of-Life. Eur J Breast Health 2018; 15:51-58. [PMID: 30816353 DOI: 10.5152/ejbh.2018.4198] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.7] [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: 05/22/2018] [Accepted: 07/24/2018] [Indexed: 01/12/2023]
Abstract
Objective Aim of this prospective study was to determine the complications of different treatment modalities for breast cancer and assess their impact on patients' quality-of-life and psychological status. Materials and Methods Patients surgically treated for early-stage breast cancer were enrolled in the study. Complications after treatment and quality-of-life parameters were measured and recorded. Results 218 patients, all female with a median age of 48 (19-82) years, were included in the study. In early period, significant limitation of shoulder movements, increased pain and decreased in functional capacity were observed, whereas in mid-term, all shoulder movements, as well as pain and functional capacity returned normal. In both early period and mid-terms, anxiety scores were significantly decreased, whereas depression scores were significantly increased. In early period, there was a significant decrease in physical and mental area scores. Social area scores were significantly increased, whereas environmental, mental and physical area scores were significantly decreased in mid-term and late period. Conclusion Overall, patients' quality-of-life was found to be significantly deteriorated in both early period and mid-term and returned to pre-treatment period at long term follow up.
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Affiliation(s)
- Beyza Özçınar
- Department of General Surgery, Istanbul University Istanbul School of Medicine, İstanbul, Turkey
| | - Sertaç Ata Güler
- Department of General Surgery, Marmara University School of Medicine, İstanbul, Turkey
| | - Nazmiye Kocaman
- Department of Pschiatry, İstanbul University İstanbul School of Medicine, İstanbul, Turkey
| | - Mine Özkan
- Department of Pschiatry, İstanbul University İstanbul School of Medicine, İstanbul, Turkey
| | - Bahadır M Güllüoğlu
- Department of General Surgery, Marmara University School of Medicine, İstanbul, Turkey
| | - Vahit Özmen
- Department of General Surgery, Istanbul University Istanbul School of Medicine, İstanbul, Turkey
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28
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Ordu Ç, Pilancı KN, Alço G, Elbüken F, Köksal Üİ, İlgun S, Sarsenov D, Aydın AE, Öztürk A, Erdoğan Zİ, Ağaçayak F, Çubuk F, Tecimer C, Eralp Y, Duymaz T, Aktepe F, Özmen V. Prognostic Significance of Adjuvant Chemotherapy Induced Amenorrhea in Luminal A and B Subtypes. Eur J Breast Health 2018; 14:173-179. [PMID: 30123884 DOI: 10.5152/ejbh.2018.3808] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [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: 10/02/2017] [Accepted: 02/26/2018] [Indexed: 02/02/2023]
Abstract
Objective In this retrospective study, chemotherapy induced amenorrhea in patients with early stage breast cancer and its effects on survival were investigated. Materials and Methods Two hundred fifty-two patients received adjuvant chemotherapy without ovarian suppression treatment (OST) from 600 premenopausal patients were included in the study. Patients were divided into two groups; with amenorrhea and without, and compared with clinicopathologic features and survival. SPSS version 17 was used. Results Chemotherapy-induced amenorrhea (CIA) was observed in 145 (57.5%) of 252 patients who received no OST during follow-up. The 5-year OS rate of patients with CIA was significantly higher than patients without CIA (p= 0.042, 95.9% vs. 89.7% vs. 158.88 vs. 135.33 months, respectively). In the subgroup analysis, the OS in patients with hormone receptor (+) was significantly higher than in those receptor (-) in patients with CIA (p=0.011, 97.5% vs. 90.9% vs. 162.13 vs. 126.16 months, respectively). The OS was significantly longer in the luminal A molecular subtype than in those with luminal B molecular subtype, in patients with CIA, but the difference was not significant in patients without CIA (p=0.027 vs. p=0.074, respectively). Conclusion As a conclusion; survival advantage of the chemotherapy induced amenorrhea more pronounced with hormone receptor positivity, lymph node involvement, and advanced disease over patients who do not develop amenorrhea. This advantage of amenorrhea development further prolongs survival compared with luminal B in the luminal A molecular subtype.
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Affiliation(s)
- Çetin Ordu
- Department of Medical Oncology, Gayrettepe Florence Nightingale Hospital, İstanbul, Turkey
| | - Kezban Nur Pilancı
- Department of Medical Oncology, Haseki Research and Training Hospital, İstanbul, Turkey
| | - Gül Alço
- Department of Medical Oncology, Gayrettepe Florence Nightingale Hospital, İstanbul, Turkey
| | - Filiz Elbüken
- Department of Medical Oncology, Gayrettepe Florence Nightingale Hospital, İstanbul, Turkey
| | - Ülkühan İner Köksal
- Department of Medical Oncology, Gayrettepe Florence Nightingale Hospital, İstanbul, Turkey
| | - Serkan İlgun
- Department of General Surgery, Gaziosmanpaşa Research and Training Hospital, İstanbul, Turkey
| | - Dauren Sarsenov
- Department of Breast Surgery, Istanbul Florence Nightingale Hospital, İstanbul, Turkey
| | - Ayşe Esra Aydın
- Department of Breast Surgery, Istanbul Florence Nightingale Hospital, İstanbul, Turkey
| | - Alper Öztürk
- Department of General Surgery, Biruni University, İstanbul, Turkey
| | - Zeynep İyigün Erdoğan
- Department of Physical Therapy and Rehabilitation, Şişli Florence Nightingale Hospital, İstanbul, Turkey
| | - Filiz Ağaçayak
- Department of Breast Surgery, Istanbul Florence Nightingale Hospital, İstanbul, Turkey
| | - Fatmagül Çubuk
- Department of General Surgery, Gaziosmanpaşa Research and Training Hospital, İstanbul, Turkey
| | - Coşkun Tecimer
- Department of Medical Oncology, Gayrettepe Florence Nightingale Hospital, İstanbul, Turkey
| | - Yeşim Eralp
- Department of Medical Oncology, Istanbul University School of Medicine, İstanbul, Turkey
| | - Tomris Duymaz
- Department of Physical Therapy and Rehabilitation, İstanbul Bilim University, İstanbul, Turkey
| | - Fatma Aktepe
- Department of Medical Oncology, Gayrettepe Florence Nightingale Hospital, İstanbul, Turkey
| | - Vahit Özmen
- Department of Medical Oncology, Istanbul University School of Medicine, İstanbul, Turkey
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29
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Özkurt E, Tükenmez M, Yılmaz R, Cabioğlu N, Müslümanoğlu M, Dinççağ AS, İğci A, Özmen V. Favorable Long-Term Outcome in Male Breast Cancer. Eur J Breast Health 2018; 14:180-185. [PMID: 30123885 DOI: 10.5152/ejbh.2018.3946] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [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: 12/23/2017] [Accepted: 03/03/2018] [Indexed: 11/22/2022]
Abstract
Objective Male breast cancer (MBC) is a rare type of cancer in the breast cancer series and in the male population. Data is usually extrapolated from female breast cancer (FBC) studies. We aim to study the clinicopathological characteristics and outcome of MBC patients at our institution and we aim to emphasize the differences compared with FBC. Materials and Methods Between January 1993 and April 2016, 56 male patients who were diagnosed as breast cancer and underwent surgical operation were retrospectively analyzed. Patients were evaluated for demographical characteristics, surgery type, clinicopathological characteristics, adjuvant and neoadjuvant treatments, follow-up time, overall survival (OS), disease free survival (DFS), and disease specific survival (DSS). Results The ratio of MBC among all breast cancers at our institution is 1%. The median age was 64 (34-85). Surgical procedures were modified radical mastectomy (MRM) in 41 patients (77%), simple mastectomy in 11 patients (21%), and lumpectomy in 1 patient (2%). Two patients were Stage 0 (4%), 7 were Stage 1 (13%), 12 were Stage 2 (22.6%), and 32 were Stage 3 (60.4%). Molecular subtypes of the invasive tumors were luminal A in 40 (80%), luminal B in 6 (12%), HER-2 type in 1 (2%), and basal-like in 3 (6%). Median follow-up time was 77 (3-287) months. 5-year and 10-year OS, DFS, and DSS rates were 80.7%, 96%, 95.6% and 71.6%, 81.9%, 91.7% respectively. Conclusion MBC presents different clinicopathological and prognostic factors when compared to FBC. Our survival rates are higher than the average presented in available literature. Because of the high rate of hormone receptor positivity, hormonal therapy is the mainstay for the treatment of estrogen receptor (ER)+ male breast cancer.
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Affiliation(s)
- Enver Özkurt
- Department of General Surgery, Istanbul University, Istanbul School of Medicine, İstanbul, Turkey.,Department of Breast Surgical Oncology, Harvard Medical School, Dana-Farber Cancer Institute, Boston, USA
| | - Mustafa Tükenmez
- Department of General Surgery, Istanbul University, Istanbul School of Medicine, İstanbul, Turkey
| | - Ravza Yılmaz
- Department of Radiology, Istanbul University, Istanbul School of Medicine, İstanbul, Turkey
| | - Neslihan Cabioğlu
- Department of General Surgery, Istanbul University, Istanbul School of Medicine, İstanbul, Turkey
| | - Mahmut Müslümanoğlu
- Department of General Surgery, Istanbul University, Istanbul School of Medicine, İstanbul, Turkey
| | - Ahmet Said Dinççağ
- Department of General Surgery, Istanbul University, Istanbul School of Medicine, İstanbul, Turkey
| | - Abdullah İğci
- Department of General Surgery, Istanbul University, Istanbul School of Medicine, İstanbul, Turkey
| | - Vahit Özmen
- Department of General Surgery, Istanbul University, Istanbul School of Medicine, İstanbul, Turkey
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Cabıoğlu N, Karanlık H, Kangal D, Özkurt E, Öner G, Sezen F, Yılmaz R, Tükenmez M, Önder S, İğci A, Özmen V, Dinççağ A, Engin G, Müslümanoğlu M. Improved False-Negative Rates with Intraoperative Identification of Clipped Nodes in Patients Undergoing Sentinel Lymph Node Biopsy After Neoadjuvant Chemotherapy. Ann Surg Oncol 2018; 25:3030-3036. [PMID: 29978371 DOI: 10.1245/s10434-018-6575-6] [Citation(s) in RCA: 29] [Impact Index Per Article: 4.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/23/2018] [Indexed: 01/06/2023]
Abstract
BACKGROUND Identification and resection of a clipped node was shown to decrease the false-negative rate (FNR) of sentinel lymph node biopsy (SLNB) after neoadjuvant chemotherapy (NAC) for patients presenting with initially node-positive breast cancer. METHODS Between March 2014 and March 2016, a prospective trial analyzed 98 patients with axilla-positive locally advanced breast cancer (T1-4, N1-3) to assess the feasibility and efficacy of placing clips into most suspicious biopsy-proven node. The study considered blue, radioisotope active, and suspiciously palpable nodes as sentinel lymph nodes (SLNs). RESULTS The SLN identification rate was 87.8%. The median age of the patients with an SLNB (n = 86) was 44 years (range 28-66 years). Of these patients, 77 (88.4%) had cT1-3 disease, and 10 (11.6%) had cT4 disease. The majority of the patients (n = 66, 76.7%) had cN1, whereas 21 patients (23.3%) had cN2 and cN3. A combined method was used for 37 patients (43%), whereas blue dye alone was used for the remaining patients (57%). The clipped node was the SLN in 70 patients (81.4%). For the patients with cN1 before NAC, the FNR was found to be 4.2% (1/24) when the clipped node was identified as an SLN. However, the FNR was estimated to be as high as 16.7% (1/6) for the patients with cN1 before NAC when the clipped node was found to be a non-SLN. CONCLUSIONS The study results also suggest that axillary dissection could be omitted for patients presenting initially with N1 disease and with a negative clipped node as the SLN after NAC due to the low FNR.
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Affiliation(s)
- Neslihan Cabıoğlu
- Department of Surgery, Istanbul Faculty of Medicine, Istanbul University, Millet cad. Çapa Fatih, Istanbul, 34390, Turkey.
| | - Hasan Karanlık
- Department of Surgical Oncology, Institute of Oncology, University of Istanbul, Istanbul, Turkey
| | - Dilek Kangal
- Department of Radiology, Institute of Oncology, University of Istanbul, Istanbul, Turkey
| | - Enver Özkurt
- Department of Surgery, Istanbul Faculty of Medicine, Istanbul University, Millet cad. Çapa Fatih, Istanbul, 34390, Turkey
| | - Gizem Öner
- Department of Surgery, Istanbul Faculty of Medicine, Istanbul University, Millet cad. Çapa Fatih, Istanbul, 34390, Turkey
| | - Fatma Sezen
- Department of Surgery, Istanbul Faculty of Medicine, Istanbul University, Millet cad. Çapa Fatih, Istanbul, 34390, Turkey
| | - Ravza Yılmaz
- Department of Radiology, Istanbul Faculty of Medicine, University of Istanbul, Istanbul, Turkey
| | - Mustafa Tükenmez
- Department of Surgery, Istanbul Faculty of Medicine, Istanbul University, Millet cad. Çapa Fatih, Istanbul, 34390, Turkey
| | - Semen Önder
- Department of Pathology, Istanbul Faculty of Medicine, University of Istanbul, Istanbul, Turkey
| | - Abdullah İğci
- Department of Surgery, Istanbul Faculty of Medicine, Istanbul University, Millet cad. Çapa Fatih, Istanbul, 34390, Turkey
| | - Vahit Özmen
- Department of Surgery, Istanbul Faculty of Medicine, Istanbul University, Millet cad. Çapa Fatih, Istanbul, 34390, Turkey
| | - Ahmet Dinççağ
- Department of Surgery, Istanbul Faculty of Medicine, Istanbul University, Millet cad. Çapa Fatih, Istanbul, 34390, Turkey
| | - Gülgün Engin
- Department of Radiology, Institute of Oncology, University of Istanbul, Istanbul, Turkey
| | - Mahmut Müslümanoğlu
- Department of Surgery, Istanbul Faculty of Medicine, Istanbul University, Millet cad. Çapa Fatih, Istanbul, 34390, Turkey
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31
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Yıldırım NK, Özkan M, İlgün AS, Sarsenov D, Alço G, Aktepe F, Kalyoncu N, İzci F, Selamoğlu D, Ordu Ç, Pilancı KN, İyigün ZE, Eralp Y, Özmen V. Possible role of stress, coping strategies, and life style in the development of breast cancer. Int J Psychiatry Med 2018; 53:207-220. [PMID: 29292669 DOI: 10.1177/0091217417749789] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/12/2023]
Abstract
Objective The aim of the present study was to investigate the possibility of the effect of life long stressful events, along with coping method used, perception of social support, and life style on the development of breast cancer. Methods In this hospital-based case control study, the study group comprised 250 women with breast cancer who were followed by Florence Nightingale Breast Study Group. Control group included 250 women, who had similar sociodemographic characteristics to the study group. Data were collected with semi-structured interview form, Healthy Life Style Behavior Scale, Coping Strategy Indicator, and Stress Evaluation Form developed by us. Results In multivariate analysis, family history of cancer (OR: 1.55, 95% CI: 2.29-1.05), inadequate social support (OR: 1.83, 95% CI: 1.23-2.73), and loss of father during childhood (OR: 2.68, 95% CI: 5.52-1.30) and serious stressor within the last five years (OR: 4.72, 95% CI: 7.03-3.18) were found to be risk factors increasing the risk of breast cancer. When family history of cancer was excluded from the model, the presence of psychiatric disorder history (OR: 1.95, 95% CI: 3.26-1.17) and major life events (OR: 2.24, 95% CI: 4.07-1.24) were added to the model as risk factors. Conclusion The present study indicates that especially the stressful events experienced within the last five years plays an undeniable role in the risk of breast cancer. Social support may be as important in the period before the diagnosis as in the period after diagnosis.
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Affiliation(s)
- Nazmiye K Yıldırım
- 1 Department of Consultation Liaison Psychiatry, Istanbul Medical Faculty, Istanbul University, Istanbul, Turkey
| | - Mine Özkan
- 1 Department of Consultation Liaison Psychiatry, Istanbul Medical Faculty, Istanbul University, Istanbul, Turkey
| | - Ahmet S İlgün
- 2 Istanbul Florence Nightingale Hospital, Breast Health Center, Istanbul, Turkey
| | - Dauren Sarsenov
- 2 Istanbul Florence Nightingale Hospital, Breast Health Center, Istanbul, Turkey
| | - Gül Alço
- 3 Department of Radiation Oncology, Istanbul Bilim University, Istanbul, Turkey
| | - Fatma Aktepe
- 4 Department of Pathology, Gayrettepe Florence Nightingale Hospital, Istanbul, Turkey
| | - Nesiba Kalyoncu
- 1 Department of Consultation Liaison Psychiatry, Istanbul Medical Faculty, Istanbul University, Istanbul, Turkey
| | - Filiz İzci
- 5 Department of Psychiatry, Medical Faculty, Istanbul Bilim University, Istanbul, Turkey
| | - Derya Selamoğlu
- 6 Department of General Surgery, Istanbul Mehmet Akif Ersoy Thoracic and Cardiovascular Surgery Training and Research Hospital, Istanbul, Turkey
| | - Çetin Ordu
- 7 Radiation Oncology Center, Gayrettepe Florence Nightingale Hospital, Istanbul, Turkey
| | - Kezban N Pilancı
- 8 Department of Medical Oncology, Istanbul Haseki Training and Research Hospital, Istanbul, Turkey
| | - Zeynep E İyigün
- 9 Physical Therapy and Rehabilitation Center, Istanbul Florence Nightingale Hospital, Istanbul, Turkey
| | - Yeşim Eralp
- 10 Medical Oncology Unit, Institute of Oncology, 37516 Istanbul University , Istanbul, Turkey
| | - Vahit Özmen
- 11 Department of General Surgery, Faculty of Medicine, 37516 Istanbul University , Istanbul, Turkey
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İzci F, Sarsanov D, Erdogan Zİ, İlgün AS, Çelebi E, Alço G, Kocaman N, Ordu Ç, Öztürk A, Duymaz T, Pilavcı KN, Elbüken F, Ağaçayak F, Aktepe F, Ünveren G, Özdem G, Eralp Y, Özmen V. Impact of Personality Traits, Anxiety, Depression and Hopelessness Levels on Quality of Life in the Patients with Breast Cancer. Eur J Breast Health 2018; 14:105-111. [PMID: 29774319 DOI: 10.5152/ejbh.2018.3724] [Citation(s) in RCA: 16] [Impact Index Per Article: 2.7] [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: 07/13/2017] [Accepted: 12/19/2017] [Indexed: 11/22/2022]
Abstract
Objective The aim of this study was to investigate the impacts of personality traits, anxiety, depression and hopelessness levels on quality of life in the patients with breast cancer. Materials and methods The study was performed on 90 patients diagnosed with breast cancer and 90 healthy women. Sociodemographic and Clinical Data Collection Form designed by us, Beck Hopelessness Scale (BHS), Beck Anxiety Scale (BAS), Beck Depression Scale (BDS), Eysenck Personality Inventory (EPI) and Quality of Life Scale-Short Form (SF-36) were administered to patients and to control group. Results The patients with breast cancer were found to indicate higher levels of anxiety and depression, lower levels of quality of life, and higher scores of personality inventory subscales as compared to the healthy control group. In the patient group, it was identified that the quality of life subscale scores were found to be negatively correlated with anxiety, depression, hopelessness and neurotic personality scores; there was a positive correlation between neurotic personality scores and depression, anxiety and hopelessness scores. Conclusions It can be concluded that the breast cancer patients with extraversion personality traits have lower levels of anxiety and depression, keeping their quality of life better, whereas the patients with higher neuroticism scores may have more impaired quality of life. Therefore, the psychiatric evaluation of the breast cancer patients during and after the treatment cannot be ruled out.
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Affiliation(s)
- Filiz İzci
- Department of Psychiatry, İstanbul Bilim University School of Medicine, İstanbul, Turkey
| | - Dauren Sarsanov
- Department of General Surgery, İstanbul Florence Nightingale Hospital, İstanbul, Turkey
| | - Zeynep İyigün Erdogan
- Department of Physical Therapy and Rehabilitation, İstanbul Bilim University School of Medicine, İstanbul, Turkey
| | - Ahmet Serkan İlgün
- Department of General Surgery, İstanbul Taksim Training and Research Hospital, İstanbul, Turkey
| | - Esra Çelebi
- Department of General Surgery, İstanbul Florence Nightingale Hospital, İstanbul, Turkey
| | - Gül Alço
- Department of Nucleer Medicine, İstanbul Bilim University School of Medicine, İstanbul, Turkey
| | - Nazmiye Kocaman
- Department of Psyhiatry, İstanbul University School of Medicine, İstanbul, Turkey
| | - Çetin Ordu
- Department of Onchology, İstanbul Bilim University School of Medicine, İstanbul, Turkey
| | - Alper Öztürk
- Department of General Surgery, İstanbul Biruni University School of Medicine, İstanbul, Turkey
| | - Tomris Duymaz
- Department of Physical Therapy and Rehabilitation, İstanbul Biruni University School of Medicine, İstanbul, Turkey
| | - Kezban Nur Pilavcı
- Department of Onchology, İstanbul Haseki Training and Research Hospital, İstanbul, Turkey
| | - Filiz Elbüken
- Department of Radiology, Gayrettepe Florence Nightingale Hospital, İstanbul, Turkey
| | - Filiz Ağaçayak
- Department of Radiology, İstanbul Florence Nightingale Hospital, İstanbul, Turkey
| | - Fatma Aktepe
- Department of Pathology, İstanbul Biruni University School of Medicine, İstanbul, Turkey
| | - Gizem Ünveren
- Department of Psychology, İstanbul Florence Nightingale Hospital, İstanbul, Turkey
| | - Gözdem Özdem
- Department of Psychology, Gayrettepe Florence Nightingale Hospital, İstanbul, Turkey
| | - Yeşim Eralp
- Department of Internal Medicine, İstanbul University School of Medicine, İstanbul, Turkey
| | - Vahit Özmen
- Department of General Surgery, İstanbul University School of Medicine, İstanbul, Turkey
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Yılmaz R, Cömert RG, Aliyev S, Toktaş Y, Önder S, Emirikçi S, Özmen V. Encapsulated Papillary Carcinoma in A Man with Gynecomastia: Ultrasonography, Mammography and Magnetic Resonance Imaging Features with Pathologic Correlation. Eur J Breast Health 2018; 14:127-131. [PMID: 29774323 DOI: 10.5152/ejbh.2018.3761] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [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: 08/17/2017] [Accepted: 11/28/2017] [Indexed: 01/28/2023]
Abstract
Male breast cancer is an uncommon disease that constitutes 1% of all breast cancers and encapsulated papillary carcinoma (EPC) is a rare subtype of malignant male diseases. Gynecomastia is the most common disease of the male breast. We report a 63-year-old male patient with EPC accompanied by gynecomastia that was diagnosed and treated at our breast center. Mammography showed an oval-shaped dense mass with circumscribed margins on the ground of nodular gynecomastia. On ultrasonographic exam, we saw a well-circumscribed complex mass with a solid component which was vascular on Doppler ultrasonography. Magnetic resonance imaging revealed a complex cystic mass containing solid components. Dynamic images showed enhancement of the cystic mass wall and mural components. Tumor stage was evaluated as T2N0. The lesion's histologic examination and immunohistochemical analysis by showing no myoepithelial layer revealed an encapsulated papillary carcinoma. To our knowledge, this is the first case report which describes MR imaging findings of male breast encapsulated papillary cancer.
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Affiliation(s)
- Ravza Yılmaz
- Department of Radiology, İstanbul University, İstanbul School of Medicine, İstanbul, Turkey
| | - Rana Günöz Cömert
- Department of Radiology, İstanbul University, İstanbul School of Medicine, İstanbul, Turkey
| | - Samil Aliyev
- Department of Radiology, İstanbul University, İstanbul School of Medicine, İstanbul, Turkey
| | - Yücel Toktaş
- Department of Radiology, İstanbul University, İstanbul School of Medicine, İstanbul, Turkey
| | - Semen Önder
- Department of Pathology, İstanbul University, İstanbul School culty of Medicine, İstanbul, Turkey
| | - Selman Emirikçi
- Department of Surgery, İstanbul University, İstanbul School of Medicine, İstanbul, Turkey
| | - Vahit Özmen
- Department of Surgery, İstanbul University, İstanbul School of Medicine, İstanbul, Turkey
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Affiliation(s)
- Vahit Özmen
- Department of Surgery, Istanbul University, Istanbul School of Medicine, İstanbul, Turkey
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35
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Yılmaz R, Bayramoğlu Z, Emirikçi S, Önder S, Salmaslıoğlu A, Dursun M, Acunaş G, Özmen V. MR Imaging Features of Tubular Carcinoma: Preliminary Experience in Twelve Masses. Eur J Breast Health 2018; 14:39-45. [PMID: 29322118 DOI: 10.5152/ejbh.2017.3543] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [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: 04/18/2017] [Accepted: 06/26/2017] [Indexed: 11/22/2022]
Abstract
Objective We retrospectively analyzed the magnetic resonance (MR) imaging features and diffusion-weighted imaging findings of the 12 masses of 10 patients with tubular carcinoma (TC), including mammography and sonography findings. Materials and Methods Mammographic, sonographic and magnetic resonance imaging features in 12 histopathologically confirmed masses diagnosed as TC of the breast within 10 patients were evaluated. Morphologic characteristics, enhancement features, apparent diffusion coefficient (ADC) values were reviewed. Results On mammography (n=5), TC appeared as high density masses with indistinct, spiculated or obscured margins. Sonographically, TC appeared as a hypoechoic appearance (n=12) with posterior acoustic shadowing in nine. On MR imaging, the margins of ten of twelve masses were irregular. Internal enhancement patterns were heterogeneous in 10 patients. Dynamic enhancement patterns illustrated plateau kinetics (n=8). On the T2-weighted images 4 masses were hypointense, and 8 were hyperintense; hypointense internal septation was found in seven of these. Tubular carcinoma appeared as hyperintense on diffusion-weighted imaging with ADC values of 0.85±0.16×10-3 mm2/s that was lower than the normal parenchyma of 1.25±0.25×10-3 mm2/s. Conclusion According to our study with a limited number of cases, tubular carcinomas can be described as hyperintense breast carcinomas with or without dark internal septation like appearance on T2-weighted images. Low ADC values from DW imaging can be used to differentiate TC from hyperintense benign breast lesions.
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Affiliation(s)
- Ravza Yılmaz
- Department of Radiology, İstanbul University School of Medicine, İstanbul, Turkey
| | - Zuhal Bayramoğlu
- Department of Radiology, İstanbul University School of Medicine, İstanbul, Turkey
| | - Selman Emirikçi
- Department of General Surgery, İstanbul University School of Medicine, İstanbul, Turkey
| | - Semen Önder
- Department of Pathology, İstanbul University School of Medicine, İstanbul, Turkey
| | - Artur Salmaslıoğlu
- Department of Radiology, İstanbul University School of Medicine, İstanbul, Turkey
| | - Memduh Dursun
- Department of Radiology, İstanbul University School of Medicine, İstanbul, Turkey
| | - Gülden Acunaş
- Department of Radiology, İstanbul University School of Medicine, İstanbul, Turkey
| | - Vahit Özmen
- Department of General Surgery, İstanbul University School of Medicine, İstanbul, Turkey
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Özkan M, Yıldırım N, Dişçi R, İlgün AS, Sarsenov D, Alço G, Aktepe F, Kalyoncu N, İzci F, Selamoğlu D, Ordu Ç, Pilancı KN, Erdoğan Zİ, Eralp Y, Özmen V. Roles of Biopsychosocial Factors in the Development of Breast Cancer. Eur J Breast Health 2017; 13:206-212. [PMID: 29082379 DOI: 10.5152/ejbh.2017.3519] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.7] [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: 03/24/2017] [Accepted: 08/07/2017] [Indexed: 11/22/2022]
Abstract
OBJECTIVE The aim of this study was to determine the roles of biopsychosocial risk factors in the development of breast cancer. MATERIALS AND METHODS This hospital-based case-control study included 491 women with breast cancer (study group) and 512 women who did not have cancer or other serious diseases (control group). Biological, psychological, and social risk factors were compared between the two groups. Data were collected using the semi-structured interview, the Stress Assessment Form, and the Coping Strategy Indicator to assess these factors. RESULTS When the significantly different biopsychosocial variables between the study and the control groups were evaluated together, independent breast cancer risk factors were found as follows: a stressor experienced in the last 5 years, age 40 years and older, inadequate social support perception, use of avoidance coping strategy, being a housewife, having a family history of cancer, and having a body mass index ≥25. CONCLUSION This study showed a relationship between breast cancer risk and manageable variables (obesity, stressor and coping strategy, social support, and employment status), age and family history of cancer, which are biopsychosocial factors. Biopsychosocial aspects are becoming a greater part of many different healthcare systems.
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Affiliation(s)
- Mine Özkan
- Department of Consultation Liaison Psychiatry, İstanbul Faculty of Medicine, İstanbul University, İstanbul, Turkey
| | - Nazmiye Yıldırım
- Department of Consultation Liaison Psychiatry, İstanbul Faculty of Medicine, İstanbul University, İstanbul, Turkey
| | - Rian Dişçi
- Department of Public Health, İstanbul Faculty of Medicine, İstanbul University, İstanbul, Turkey
| | - Ahmet Serkan İlgün
- Breast Health Center, İstanbul Florence Nightingale Hospital, İstanbul, Turkey
| | - Dauren Sarsenov
- Breast Health Center, İstanbul Florence Nightingale Hospital, İstanbul, Turkey
| | - Gül Alço
- Department of Radiation Oncology, İstanbul Bilim University, İstanbul, Turkey
| | - Fatma Aktepe
- Department of Pathology, Gayrettepe Florence Nightingale Hospital, İstanbul, Turkey
| | - Nesiba Kalyoncu
- Department of Consultation Liaison Psychiatry, İstanbul Faculty of Medicine, İstanbul University, İstanbul, Turkey
| | - Filiz İzci
- Department of Psychiatry, İstanbul Bilim University School of Medicine, İstanbul, Turkey
| | - Derya Selamoğlu
- Department of General Surgery, İstanbul Mehmet Akif Ersoy Thoracic and Cardiovascular Surgery Training and Research Hospital, İstanbul, Turkey
| | - Çetin Ordu
- Radiation Oncology Center, Gayrettepe Florence Nightingale Hospital, İstanbul, Turkey
| | - Kezban Nur Pilancı
- Department of Medical Oncology, İstanbul Haseki Training and Research Hospital, İstanbul, Turkey
| | - Zeynep İyigün Erdoğan
- Physical Therapy and Rehabilitation Center, İstanbul Florence Nightingale Hospital, İstanbul, Turkey
| | - Yeşim Eralp
- Department of Medical Oncology, Oncology Institute, İstanbul University, İstanbul, Turkey
| | - Vahit Özmen
- Department of General Surgery, İstanbul Faculty of Medicine, İstanbul University, İstanbul, Turkey
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Özkurt E, Tükenmez M, Güven E, Çelet Özden B, Öner G, Müslümanoğlu M, İğci A, Özmen V, Küçücük S, Cabioğlu N. Favorable Outcome with Close Margins in Patients Undergoing Nipple/Skin Sparing Mastectomy with Immediate Breast Reconstruction: 5-year Follow-up. Balkan Med J 2017; 35:84-92. [PMID: 28958980 PMCID: PMC5820453 DOI: 10.4274/balkanmedj.2017.0029] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/02/2023] Open
Abstract
Background: Implant-based breast reconstruction after mastectomy has recently been reported to be the preferred type of surgery among breast-specific surgeons and plastic surgeons. Aims: To explore the significant clinicopathological factors associated with long-term outcome related to local recurrences of the nipple among patients who underwent immediate breast reconstruction with tissue expander or implant after mastectomy. Study Design: Retrospective cohort. Methods: From January 2007 to January 2013, 51 breast cancer patients who underwent immediate breast reconstruction with tissue expander or implant were retrospectively analysed. Patients’ demographic data, clinicopathological characteristics, and clinical outcome by disease-free survival and disease-specific survival analyses were determined. Results: The median follow-up was 64 (31-114) months. Of the 57 mastectomies, 41 were skin sparing mastectomy (72%) and 16 were nipple-areola sparing mastectomy (28%). Immediate breast reconstruction surgery included tissue expander (n=46, 81%) or implant (n=11, 19%) placement. The molecular subgroups of 47 invasive cancers were as follows: luminal A (n=23, 49%), luminal B (n=16, 34%), non-luminal HER2 (n=5, 10.6), triple negative breast cancer (n=3, 6.4%). The 5-years disease-specific survival, disease-free survival, and locoregional recurrence-free survival rates were 96.8%, 90%, and 97.6% respectively. Patients with luminal A cancer were found to have an improved 5-year disease-free survival time than other (luminal A; 100% vs. non-luminal A; 78%; p=0.028). Of the 14 nipple-areola sparing mastectomy, 13 had a close median tumour distance to nipple-areola complex (<20 mm) with a 5-year locoregional recurrence free survival of 100%. Conclusion: Immediate breast reconstruction with implant or tissue expander can be safely applied in patients undergoing skin sparing mastectomy or nipple-areola sparing mastectomy. Patients with luminal-A type show the most favourable outcome. During the 5-year follow-up period, patients even with close margins (<20 mm) to nipple-areola complex with nipple-areola sparing mastectomy have excellent locoregional and overall survival when treated by contemporary multidisciplinary oncological management.
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Affiliation(s)
- Enver Özkurt
- Department of General Surgery, Breast Unit, İstanbul University İstanbul School of Medicine, İstanbul, Turkey
| | - Mustafa Tükenmez
- Department of General Surgery, Breast Unit, İstanbul University İstanbul School of Medicine, İstanbul, Turkey
| | - Erdem Güven
- Department of Plastic Surgery, İstanbul University İstanbul School of Medicine, İstanbul, Turkey
| | - Burcu Çelet Özden
- Department of Plastic Surgery, İstanbul University İstanbul School of Medicine, İstanbul, Turkey
| | - Gizem Öner
- Department of General Surgery, Breast Unit, İstanbul University İstanbul School of Medicine, İstanbul, Turkey
| | - Mahmut Müslümanoğlu
- Department of General Surgery, Breast Unit, İstanbul University İstanbul School of Medicine, İstanbul, Turkey
| | - Abdullah İğci
- Department of General Surgery, Breast Unit, İstanbul University İstanbul School of Medicine, İstanbul, Turkey
| | - Vahit Özmen
- Department of General Surgery, Breast Unit, İstanbul University İstanbul School of Medicine, İstanbul, Turkey
| | - Seden Küçücük
- Department of Radiation Oncology, İstanbul University İstanbul Institute of Oncology, İstanbul, Turkey
| | - Neslihan Cabioğlu
- Department of General Surgery, Breast Unit, İstanbul University İstanbul School of Medicine, 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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Özmen V, Gürdal SÖ, Cabioğlu N, Özcinar B, Özaydın AN, Kayhan A, Arıbal E, Sahin C, Saip P, Alagöz O. Cost-Effectiveness of Breast Cancer Screening in Turkey, a Developing Country: Results from Bahçeşehir Mammography Screening Project. Eur J Breast Health 2017; 13:117-122. [PMID: 28894850 DOI: 10.5152/ejbh.2017.3528] [Citation(s) in RCA: 16] [Impact Index Per Article: 2.3] [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: 05/16/2017] [Accepted: 05/28/2017] [Indexed: 11/22/2022]
Abstract
OBJECTIVE We used the results from the first three screening rounds of Bahcesehir Mammography Screening Project (BMSP), a 10-year (2009-2019) and the first organized population-based screening program implemented in a county of Istanbul, Turkey, to assess the potential cost-effectiveness of a population-based mammography screening program in Turkey. MATERIALS AND METHODS Two screening strategies were compared: BMSP (includes three biennial screens for women between 40-69) and Turkish National Breast Cancer Registry Program (TNBCRP) which includes no organized population-based screening. Costs were estimated using direct data from the BMSP project and the reimbursement rates of Turkish Social Security Administration. The life-years saved by BMSP were estimated using the stage distribution observed with BMSP and TNBCRP. RESULTS A total of 67 women (out of 7234 screened women) were diagnosed with breast cancer in BMSP. The stage distribution for AJCC stages O, I, II, III, IV was 19.4%, 50.8%, 20.9%, 7.5%, 1.5% and 4.9%, 26.6%, 44.9%, 20.8%, 2.8% with BMSP and TNBCRP, respectively. The BMSP program is expected to save 279.46 life years over TNBCRP with an additional cost of $677.171, which implies an incremental cost-effectiveness ratio (ICER) of $2.423 per saved life year. Since the ICER is smaller than the Gross Demostic Product (GDP) per capita in Turkey ($10.515 in 2014), BMSP program is highly cost-effective and remains cost-effective in the sensitivity analysis. CONCLUSION Mammography screening may change the stage distribution of breast cancer in Turkey. Furthermore, an organized population-based screening program may be cost-effective in Turkey and in other developing countries. More research is needed to better estimate life-years saved with screening and further validate the findings of our study.
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Affiliation(s)
- Vahit Özmen
- Department of Surgery, İstanbul Faculty of Medicine, İstanbul University, İstanbul, Turkey
| | - Sibel Ö Gürdal
- Departments of Surgery, Namık Kemal University School of Medicine, Tekirdağ, Turkey
| | - Neslihan Cabioğlu
- Department of Surgery, İstanbul Faculty of Medicine, İstanbul University, İstanbul, Turkey
| | - Beyza Özcinar
- Department of Surgery, İstanbul Faculty of Medicine, İstanbul University, İstanbul, Turkey
| | - A Nilüfer Özaydın
- Department of Public Health, Marmara University School of Medicine, İstanbul, Turkey
| | - Arda Kayhan
- Departments of Radiology, University Health Sciences, İstanbul Kanuni Sultan Süleyman Training and Research Hospital, İstanbul, Turkey
| | - Erkin Arıbal
- Department of Radiology, Marmara University School of Medicine, İstanbul, Turkey
| | - Cennet Sahin
- Department of Radiology, University Health Sciences, İstanbul Şisli Hamidiye Etfal Training and Research Hospital, İstanbul, Turkey
| | - Pınar Saip
- Department of Medical Oncology, İstanbul University School of Medicine, İstanbul, Turkey
| | - Oğuzhan Alagöz
- Department of Industrial & Systems Engineering and Population Health Sciences, UW Carbone Cancer Center, University of Wisconsin Hospital and Clinics, Madison, WI, USA
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Kayhan A, Arıbal E, Şahin C, Taşçı ÖC, Özkan Gürdal S, Öztürk E, Hatipoğlu HH, Özaydın N, Cabioğlu N, Özçınar B, Özmen V. Radiologic findings of screen-detected cancers in an organized population-based screening mammography program in Turkey. Diagn Interv Radiol 2017; 22:508-513. [PMID: 27705880 DOI: 10.5152/dir.2016.15250] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/22/2022]
Abstract
PURPOSE Bahçeşehir Breast Cancer Screening Program is a population based organized screening program in Turkey, where asymptomatic women aged 40-69 years are screened biannually. In this prospective study, we aimed to determine the mammographic findings of screen-detected cancers and discuss the efficacy of breast cancer screening in a developing country. METHODS A total of 6912 women were screened in three rounds. The radiologic findings were grouped as mass, focal asymmetry, calcification, and architectural distortion. Masses were classified according to shape, border, and density. Calcifications were grouped according to morphology and distribution. Cancers were grouped according to the clinical stage. RESULTS Seventy cancers were detected with an incidence of 4.8/1000. Two cancers were detected in other centers and three were not visualized mammographically. Mammographic presentations of the remaining 65 cancers were mass (47.7%, n=31), calcification (30.8%, n=20), focal asymmetry (16.9%, n=11), architectural distortion (3.1%, n=2), and skin thickening (1.5%, n=1). The numbers of stage 0, 1, 2, 3, and 4 cancers were 13 (20.0%), 34 (52.3%), 14 (21.5%), 3 (4.6%), and 1 (1.5%), respectively. The numbers of interval and missed cancers were 5 (7.4%) and 7 (10.3%), respectively. CONCLUSION A high incidence of early breast cancer has been detected. The incidence of missed and interval cancers did not show major differences from western screening trials. We believe that this study will pioneer implementation of efficient population-based mammographic screenings in developing countries.
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Affiliation(s)
- Arda Kayhan
- Department of Radiology, Kanuni Sultan Süleyman Training and Research Hospital, İstanbul, Turkey.
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Abstract
Breast cancer management changed from radical mastectomy to precision medicine in a period longer than a century. The aims of these changes were to refrain from overdiagnoses and overtreatments as well as their harmful side effects and extra costs. Breast cancer is a heterogeneous disease and characterized by many morphological, clinical and molecular features. We now increasingly realise that a one-size-fits-all strategy does not apply to all breast cancer patients. Personalized medicine may be used for breast cancer screening, diagnosis and treatment. Individualized screening can decrease the number of unnecessary mammograms, additional radiologic studies, breast biopsies and false positivity rates. However, additional 15 to 20 years are necessary to reach the results of prospective randomized trials comparing low-risk and normal-risk women. We also should wait for outcomes of risk-based screening trials. The rates of overtreatment in patients with early-stage breast cancer have reached 40% in many studies. Personalized treatment has succeeded in reducing it substantially by using tumour genetic profiling and tumour receptors in early breast cancer patients. However, it has its limits and it is impossible to generalize it to all patients. New biomarkers and molecular classifications have also led to the development of novel therapies and treatment strategies. And, they can contribute to a more personalized management of breast cancer patients.
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Affiliation(s)
- Vahit Özmen
- Department of General Surgery, İstanbul University İstanbul Faculty of Medicine, İstanbul, Turkey
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Sarsenov D, Aktepe F, Özmen V. Radiation Fibrosis Syndrome Imitating Breast Cancer Recurrence; A Case Report. J Breast Health 2017; 13:40-42. [PMID: 28331767 DOI: 10.5152/tjbh.2016.3351] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 12/19/2016] [Accepted: 12/19/2016] [Indexed: 12/27/2022]
Abstract
Nowadays, surgery, radiotherapy and chemotherapy are the most frequently used modalities in the treatment of breast cancer. It is very well-known that some severe complications may result from after these treatments. Early and late complications of radiotherapy are well known. The complications of radiation therapy may be seen in (early) or after three months (late-delayed) of periods. These complications may be related with direct or indirect effect of radiation. The radiation fibrosis syndrome is a progressive fibrotic tissue sclerosis together with various clinical symptoms in the irradiation field. It is usually a late finding of radiation therapy and may be seen weeks or even years after the treatment. Many systems such as musculo-skeletal, soft tissue, neural tissue and cardiopulmonary system may be affected. In this report, we present a case of a breast cancer treated with breast conserving surgery and radiation therapy twelve years ago. The patient had ipsilateral lymphedema, right axillary mass, and pain during arm and shoulder mobilization. Her physical examination and radiologic findings revealed a big mass invading right thoracic wall, thoracic cavity and the axilla. Histopathological evaluation performed after tru-cut and open biopsy from the mass showed fibrosis resulting from radiation therapy.
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Affiliation(s)
- Dauren Sarsenov
- Department of General Surgery, İstanbul Florence Nigtingale Hospital, İstanbul, Turkey
| | - Fatma Aktepe
- Department of Pathology, İstanbul Florence Nigtingale Hospital, İstanbul, Turkey
| | - Vahit Özmen
- Department of General Surgery, İstanbul University İstanbul School of Medicine, İstanbul, Turkey
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43
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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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Abstract
Secretory carcinoma is a very rare subtype of breast carcinoma. These tumors are generally associated with a favorable prognosis, although having triple-negative phenotype (estrogen receptor (ER), progesterone receptor (PR) negative and c-erbB2 (HER2) negative). In this presentation, a rare secretory carcinoma of the breast in a woman aged 24 years is discussed and the literature is reviewed.
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Affiliation(s)
- Fatma Aktepe
- Florence Nightingale Hospital, The Breast Center, İstanbul, Turkey
| | - Dauren Sarsenov
- Florence Nightingale Hospital, The Breast Center, İstanbul, Turkey
| | - Vahit Özmen
- Florence Nightingale Hospital, The Breast Center, İstanbul, Turkey
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Özmen V, Atasoy A, Gökmen E, Özdoğan M, Güler N, Uras C, Ok E, Demircan O, Işıkkdoğan A, Cabioğlu N, Şen F, Saip P. Correlations Between Oncotype DX Recurrence Score and Classic Risk Factors in Early Breast Cancer: Results of A Prospective Multicenter Study in Turkey. J Breast Health 2016; 12:107-111. [PMID: 28331745 DOI: 10.5152/tjbh.2016.2874] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 11/30/2015] [Accepted: 04/05/2016] [Indexed: 01/25/2023]
Abstract
OBJECTIVE Breast cancer is the most common malignancy among Turkish women and the rate of early stage disease is increasing. The Oncotype DX 21-gene assay is predictive of distant recurrence in ER-positive, HER2-negative early breast cancer. We aimed to evaluate the correlations between Recurrence Score (RS) and routine risk factors. MATERIALS AND METHODS Ten academic centers across Turkey participated in this prospective trial. Consecutive patients with breast cancer who had pT1-3, pN0-N1mic, ER-positive, and HER2-negative tumors were identified at tumor conferences. Both pre- and post-RS treatment decisions and physician perceptions were recorded on questionnaire forms. Correlations between RS and classic risk factors were evaluated using univariate and multivariate analyses. RESULTS Ten centers enrolled a total of 165 patients. The median tumor size was 2 cm. Of the 165 patients, 57% had low RS, 35% had intermediate RS, and 8% had high RS, respectively. Multivariate analysis indicated that progesterone receptor (PR) and Ki67 scores were significantly related to RS. CONCLUSION Oncotype DX Recurrence Score does not seem to have a significant correlation with the majority of classic risk factors, but it may have a correlation with PR score and Ki67 score.
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Affiliation(s)
- Vahit Özmen
- Department of General Surgery, İstanbul University İstanbul School of Medicine, İstanbul, Turkey
| | - Ajlan Atasoy
- Division of Medical Oncology, Department of Internal Medicine, Marmara University School of Medicine, İstanbul, Turkey
| | - Erhan Gökmen
- Division of Medical Oncology, Department of Internal Medicine, Ege University School of Medicine, İzmir, Turkey
| | - Mustafa Özdoğan
- Division of Medical Oncology, Department of Internal Medicine, Akdeniz University School of Medicine, Antalya, Turkey; Department of General Surgery, Acıbadem University, İstanbul, Turkey
| | - Nilufer Güler
- Division of Medical Oncology, Department of Internal Medicine, Hacettepe University Institute of Oncology, Ankara, Turkey
| | - Cihan Uras
- Department of General Surgery, Acıbadem University, İstanbul, Turkey
| | - Engin Ok
- Department of General Surgery, Erciyes University School of Medicine, Kayseri, Turkey
| | - Orhan Demircan
- Department of General Surgery, Çukurova University School of Medicine, Adana, Turkey; Department of General Surgery, Acıbadem University, İstanbul, Turkey
| | - Abdurrahman Işıkkdoğan
- Division of Medical Oncology, Department of Internal Medicine, Dicle University School of Medicine, Diyarbakır, Turkey
| | - Neslihan Cabioğlu
- Department of General Surgery, İstanbul University İstanbul School of Medicine, İstanbul, Turkey
| | - Fatma Şen
- Department of Medicine, Division of Medical Oncology, İstanbul University Institute of Oncology, İstanbul, Turkey
| | - Pınar Saip
- Department of Medicine, Division of Medical Oncology, İstanbul University Institute of Oncology, İstanbul, Turkey
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İzci F, İlgün AS, Fındıklı E, Özmen V. Psychiatric Symptoms and Psychosocial Problems in Patients with Breast Cancer. J Breast Health 2016; 12:94-101. [PMID: 28331743 PMCID: PMC5351486 DOI: 10.5152/tjbh.2016.3041] [Citation(s) in RCA: 33] [Impact Index Per Article: 4.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 03/03/2016] [Accepted: 04/18/2016] [Indexed: 01/01/2023]
Abstract
Cancer is a physical disease and also one of the leading clinical manifestations where psychosocial problems are prevalent. Psychosocial problems that these patients may have in the long run include anxiety, uneasiness, mourning, helplessness, fatigue, impairment of concentration, sleep disorders, mental and cognitive reservation, sexual dysfunction, infertility, psychological distress, and psychiatric disorders. Psychosocial problems have a nature of underpinning the emergence of psychological troubles. The prevalence of psychological disorders in patients with cancer range from 29% to 47%. Psychiatric disorders that are likely to be seen are severe stress disorder, adjustment disorder, depressive disorder, and other neurotic disorders. It is considered by the present author that in the event of breast cancer, potential psychiatric disorders may affect prognosis of the disease, adherance to and success of therapy, social and societal functioning, and survival rate. This paper aims to review the psychiatric symptoms and diseases that may develop in patients with breast cancer, which is one of the most frequent types of a globally common disease; i.e., cancer, as well as the impact of psychiatric symptoms on the treatment of disease.
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Affiliation(s)
- Filiz İzci
- Department of Psychiatry, İstanbul Bilim University School of Medicine, İstanbul, Turkey
| | - Ahmet Serkan İlgün
- Clinic of General Surgery, Gaziosmanpaşa Taksim Training and Research Hospital, İstanbul, Turkey
| | - Ebru Fındıklı
- Department of Psychiatry, Kahramanmaraş Sütçü İmam University School of Medicine, Kahramanmaraş, Turkey
| | - Vahit Özmen
- Clinic of General Surgery, İstanbul University İstanbul School of Medicine, İstanbul, Turkey
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47
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Çabuk FK, Aktepe F, İlgün AS, Sarsenov D, Elbüken F, Özmen V. A Rare Tumor that Mimicked Metastasis in a Patient with Breast Cancer: Epithelioid Hemangioendothelioma. J Breast Health 2016; 12:83-85. [PMID: 28331739 DOI: 10.5152/tjbh.2016.2844] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 11/20/2015] [Accepted: 12/08/2015] [Indexed: 12/12/2022]
Abstract
A woman aged 50 years was diagnosed as having an invasive ductal carcinoma in the right breast and ductal carcinoma in situ in the left breast and underwent bilateral mastectomy eight years ago. A mass was identified during follow-up in positron-emission tomography (PET) image in the left infraclavicular region, indicating metastasis. Histopathologic examination showed a mass of 1.9 × 1 × 0.7 cm in dimensions characterized by spindle or round nuclei cells that formed island or cords in hyaline and myxoid ground and intracytoplasmic vacuoles containing erythrocytes. In the immunohistochemical analysis, tumor cells were widespread with diffuse positivity with CD34 and vimentin. These findings redirected us from a diagnosis of metastatic carcinoma to epithelioid hemangioendothelioma, a rare tumor of intermediate vascular tumor groups. In this respect, confirmation through biopsy from considered cases of metastasis is important in making a definite pathologic differential diagnosis.
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Affiliation(s)
- Fatmagül Kuşku Çabuk
- Department of Pathology, İstanbul Bilim University School of Medicine, İstanbul, Turkey
| | - Fatma Aktepe
- Clinic of Pathology, Gayrettepe Florence Nightingale Hospital, İstanbul, Turkey
| | - Ahmet Serkan İlgün
- Breasth Health Center, İstanbul Florence Nightingale Hospital, İstanbul, Turkey
| | - Dauren Sarsenov
- Breasth Health Center, İstanbul Florence Nightingale Hospital, İstanbul, Turkey
| | - Filiz Elbüken
- Clinic of Radiology, Gayrettepe Florence Nightingale Hospital, İstanbul, Turkey
| | - Vahit Özmen
- Department of General Surgery, İstanbul University İstanbul School of Medicine, İstanbul, Turkey
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Özmen T, Yüce S, Güler T, Ulun C, Özaydın N, Pruthi S, Akkapulu N, Karabulut K, Soran A, Özmen V. Barriers Against Mammographic Screening in a Socioeconomically Underdeveloped Population: A Population-based, Cross-sectional Study. J Breast Health 2016; 12:72-77. [PMID: 28331737 DOI: 10.5152/tjbh.2016.2879] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 12/07/2015] [Accepted: 02/09/2016] [Indexed: 12/30/2022]
Abstract
OBJECTIVE Mammography-screening (MS) rates remain low in underdeveloped populations. We aimed to find the barriers against MS in a low socioeconomic population. MATERIALS AND METHODS Women aged 40-69 years who lived in the least developed city in Turkey (Mus), were targeted. A survey was used to question breast cancer (BC) knowledge and health practices. RESULTS In total, 2054 women were surveyed (participation rate: 85%). The MS rate was 35%. Women aged 50-59 years (42%, p<0.001), having annual Obstetric-Gynecology (OB-GYN) visits (42%, p<0.001), reading daily newspaper (44%, p=0.003), having Social Security (39%, p=0.006) had increased MS rates. The most common source of information about BC was TV/radio (36%). Having doctors as main source of information (42%, p<0.001), knowing BC as the most common cancer in females (36%, p=0.024), knowing that BC is curable if detected early (36%, p=0.016), knowing that MS is free (42%, p<0.001) and agreeing to the phrase "I would get mammography (MG), if my doctor referred me" (36%, p=0.015) increased MS rates. Agreeing that MG exposes women to unnecessary radiation decreased MS rate (32%, p=0.002). CONCLUSION To increase the MS rate in low socioeconomic populations, clear messages about BC being the most common cancer in women, MS after 40 years of age not causing unnecessary radiation but saving lives through enabling early detection, and MS being free of charge should be given frequently on audiovisual media. Uninsured women and women aged 40-49 years should be especially targeted. Physicians from all specialties should inform their patients about BC.
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Affiliation(s)
- Tolga Özmen
- Department of General Surgery, Marmara University School of Medicine, İstanbul, Turkey
| | | | - Tekin Güler
- Association for Fight against Cancer, Muş, Turkey
| | - Canan Ulun
- Department of Nurses, Muş Alparslan University High School of Nursing, Muş, Turkey
| | - Nilufer Özaydın
- Department of Public Health, Marmara University School of Medicine, İstanbul, Turkey
| | | | - Nezih Akkapulu
- Clinic of General Surgery, Ordu Training and Research Hospital, Ordu, Turkey
| | - Koray Karabulut
- Department of General Surgery, Fırat Universty School of Medicine, Elazığ, Turkey
| | | | - Vahit Özmen
- Department of General Surgery, İstanbul University İstanbul School of Medicine, İstanbul, Turkey
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49
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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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50
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Özmen V, Dağoğlu N, Dede İ, Akçakaya A, Kerem M, Göksel F, Özgür E, Başkan E, Yaylacı M, Ceydeli A, Baykara M, Kızıltan HŞ, Kömürcü Ş, Gümüş M, Türk HM, Demirhan R, Akgün A, Kadoglou N, Yatman E, Elbi CC, Güleç S, Soran A, Özet A, Keleştimur F. Turkish Ministry of Health, 2 nd Turkish Medical General Assembly Clinical Oncology Study Group Report. J Breast Health 2016; 12:9-17. [PMID: 28331725 DOI: 10.5152/tjbh.2015.2869] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 11/29/2015] [Accepted: 12/08/2015] [Indexed: 11/22/2022]
Abstract
OBJECTIVE There is an increase in the incidence of cancer, and consequently in mortality rates, both in the world and in Turkey. The increase in the incidence and mortality rate of cancer are more prominent in our country as well as in other developing countries. The aim of this workshop was to determine the current status on prevention, screening, early diagnosis and treatment of cancer in our country, to identify related shortcomings, specify solutions and to share these with health system operators, and to aid in implementation of these systems. Developments on palliative care were also evaluated. MATERIALS AND METHODS The current situation in the practice of clinical oncology, related drawbacks, problems encountered during multidisciplinary approach and their solutions were discussed under several sub-headings during a 3-day meeting organized by the Turkish Ministry of Health (Türkiye Cumhuriyeti Sağlık Bakanlığı-TCSB) with participation of 16 scientists from Turkey and 6 from abroad, and the conclusions were reported. RESULTS It is expected that the newly established Turkish Health Institutes Association (Türkiye Sağlık Enstitüleri Başkanlığı-TÜSEB) and the National Cancer Institute (Ulusal Kanser Enstitüsü) will provide a new framework in the field of oncology. The current positive findings include the increase in the number of scientists who carry out successful trials in oncology both in Turkey and abroad, the implementation of the national cancer registry program by the Cancer Control Department and the breast cancer registry program by the Turkish Federation of Breast Diseases Societies (Türkiye Meme Hastalıkları Dernekleri Federasyonu-TMHDF), and introduction of Cancer Early Diagnosis, Screening, and Training Centers (Kanser Erken Tanı, Tarama ve Eğitim Merkezi-KETEM) for the application of community-based cancer screening programs. In addition to these, obvious shortcomings related to education, implementation, management and research issues were also determined, and policy and project proposals to address these issues were presented. Collaboration with relevant organizations in the implementation of these studies was supported. CONCLUSION Both the incidence and mortality rates of cancer are increasing in Turkey. The widespread deficiencies in population-based screening and in effective treatment lead to an increase in delay in diagnosis and mortality. Despite improvements in data recording, screening and treatment over the last 10 years, extensive, organized, population-based screening programs and fully equipped early diagnosis and treatment centers are required. Enhancement of basic cancer epidemiologic, translational, genetic and molecular research studies is essential in our country. Improvements on pain treatment and palliative care of patients with chronic and terminal cancer are also required.
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Affiliation(s)
- Vahit Özmen
- Department of General Surgery, İstanbul University İstanbul Faculty of Medicine, İstanbul, Turkey
| | - Nergiz Dağoğlu
- Department of Radiation Oncology, İstanbul University İstanbul Faculty of Medicine, İstanbul, Turkey
| | - İsmet Dede
- Cancer Surgeon General Office, İstanbul, Turkey
| | - Adem Akçakaya
- Department of General Surgery, Bezmialem University Faculty of Medicine, İstanbul, Turkey
| | - Mustafa Kerem
- Department of General Surgery, Gazi University Faculty of Medicine, İstanbul, Turkey
| | - Fatih Göksel
- Clinic of General Surgery, Ankara Oncology Training and Research Hospital, Ankara, Turkey
| | - Enver Özgür
- Department of Urology, Köln University Faculty of Medicine, Köln, Germany
| | - Emel Başkan
- Turkey Public Hospitals Institution, Ankara, Turkey
| | - Mustafa Yaylacı
- Clinic of Medical Oncology, İstanbul Bayındır Hospital, İstanbul, Turkey
| | | | - Meltem Baykara
- Clinic of Medical Oncology, Sakarya Training and Research Hospital, Sakarya, Turkey
| | - Huriye Şenay Kızıltan
- Department of Radiation Oncology, Bezmialem University Faculty of Medicine, İstanbul, Turkey
| | - Şeref Kömürcü
- Clinic of Medical Oncology, Memorial Hospital, İstanbul, Turkey
| | - Mahmut Gümüş
- Department of Medical Oncology, Bezmialem University Faculty of Medicine, İstanbul, Turkey
| | - H Mehmet Türk
- Department of Medical Oncology, Bezmialem University Faculty of Medicine, İstanbul, Turkey
| | - Recep Demirhan
- Clinic of Thoracic Surgery, Kartal Dr. Lütfü Kırdar Training and Research Hospital, İstanbul, Turkey
| | | | - Naim Kadoglou
- Department of General Surgery, National Health System-Konsultan, Pittsburgh, USA
| | - Emre Yatman
- Turkey Public Hospitals Institution, Ankara, Turkey
| | | | - Seza Güleç
- Department of General Surgery, Florida International University, Florida, USA
| | - Atilla Soran
- Department of General Surgery, Pittsburgh University Faculty of Medicine, Pittsburgh, USA
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