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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, 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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Ünal Ç, Özmen T, Ordu Ç, Pilanci KN, İlgün AS, Gökmen E, Almuradova E, Özdoğan M, Güler N, Uras C, Kara H, Demircan O, Işık S, Alço G, Saip P, Aydın E, Duymaz T, Çelebi F, Yararbaş K, Soybir G, Ozmen V. Survival results according to Oncotype Dx recurrence score in patients with hormone receptor positive HER-2 negative early-stage breast cancer: first multicenter Oncotype Dx recurrence score survival data of Turkey. Front Oncol 2023; 13:1151733. [PMID: 37448522 PMCID: PMC10338087 DOI: 10.3389/fonc.2023.1151733] [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] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/26/2023] [Accepted: 06/09/2023] [Indexed: 07/15/2023] Open
Abstract
Background The Oncotype Dx recurrence score (ODx-RS) guides the adjuvant chemotherapy decision-making process for patients with early-stage hormone receptor-positive, HER-2 receptor-negative breast cancer. This study aimed to evaluate survival and its correlation with ODx-RS in pT1-2, N0-N1mic patients treated with adjuvant therapy based on tumor board decisions. Patients and methods Estrogen-positive HER-2 negative early-stage breast cancer patients (pT1-2 N0, N1mic) with known ODx-RS, operated on between 2010 and 2014, were included in this study. The primary aim was to evaluate 5-year disease-free survival (DFS) rates according to ODX-RS. Results A total of 203 eligible patients were included in the study, with a median age of 48 (range 26-75) and median follow-up of 84 (range 23-138) months. ROC curve analysis for all patients revealed a recurrence cut-off age of 45 years, prompting evaluation by grouping patients as ≤45 years vs. >45 years. No significant difference in five-year DFS rates was observed between the endocrine-only (ET) and chemo-endocrine (CE) groups. However, among the ET group, DFS was higher in patients over 45 years compared to those aged ≤45 years. When stratifying by ODx-RS as 0-17 and ≥18, DFS was significantly higher in the former group within the ET group. However, such differences were not seen in the CE group. In the ET group, an ODx-RS ≥18 and menopausal status were identified as independent factors affecting survival, with only an ODx-RS ≥18 impacting DFS in patients aged ≤45 years. The ROC curve analysis for this subgroup found the ODx-RS cut-off to be 18. Conclusion This first multicenter Oncotype Dx survival analysis in Turkey demonstrates the importance of Oncotype Dx recurrence score and age in determining treatment strategies for early-stage breast cancer patients. As a different aproach to the literature, our findings suggest that the addition of chemotherapy to endocrine therapy in young patients (≤45 years) with Oncotype Dx recurrence scores of ≥18 improves DFS.
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Affiliation(s)
- Çağlar Ünal
- Division of Medical Oncology, Department of Internal Medicine, Kartal Dr. Lütfi Kırdar City Hospital, İstanbul, Türkiye
| | - Tolga Özmen
- Division of Gastrointestinal and Oncologic Surgery, Harvard Medical School, Boston, MA, United States
- Division of Gastrointestinal and Oncologic Surgery, Massachusetts General Hospital, Boston, MA, United States
| | - Çetin Ordu
- Division of Medical Oncology, Department of Internal Medicine, Gayrettepe Florence Nightingale Hospital, İstanbul, Türkiye
| | - Kezban Nur Pilanci
- Division of Medical Oncology, Department of Internal Medicine, Memorial Bahçelievler Hospital, İstanbul, Türkiye
| | | | - Erhan Gökmen
- Division of Medical Oncology, Department of Internal Medicine, Ege University School of Medicine, Izmir, Türkiye
| | - Elvina Almuradova
- Division of Medical Oncology, Department of Internal Medicine, Tınaztepe Galen Bayraklı Hospital, Izmir, Türkiye
| | - Mustafa Özdoğan
- Division of Medical Oncology, Department of Internal Medicine, Akdeniz University, Antalya, Türkiye
| | - Nilüfer Güler
- Division of Medical Oncology, Department of Internal Medicine, Hacettepe University Institute of Oncology, Ankara, Türkiye
| | - Cihan Uras
- Department of General Surgery, Acıbadem University, İstanbul, Türkiye
| | - Halil Kara
- Department of General Surgery, Acıbadem University, İstanbul, Türkiye
| | - Orhan Demircan
- Department of General Surgery, Çukurova University School of Medicine, Adana, Türkiye
| | - Selver Işık
- Division of Medical Oncology, Department of Internal Medicine, Marmara University Hospital, İstanbul, Türkiye
| | - Gül Alço
- Department of Radiation Oncology, Gayrettepe Florence Nightingale Hospital, İstanbul, Türkiye
| | - Pınar Saip
- Division of Medical Oncology, Department of Internal Medicine, İstanbul University Institute of Oncology, İstanbul, Türkiye
| | - Esra Aydın
- Division of Medical Oncology, Department of Internal Medicine, İstanbul University Institute of Oncology, İstanbul, Türkiye
| | - Tomris Duymaz
- Department of Physiotherapy and Rehabilitation, Faculty of Health Sciences, İstanbul Bilgi University, İstanbul, Türkiye
| | - Filiz Çelebi
- Department of Radiology, Yeditepe University Hospital, İstanbul, Türkiye
| | - Kanay Yararbaş
- Department of Medical Genetics, Demiroglu Bilim University, İstanbul, Türkiye
| | - Gursel Soybir
- Department of General Surgery, Memorial Şişli Hospital, Istanbul, Türkiye
| | - Vahit Ozmen
- Department of General Surgery, İstanbul University İstanbul School of Medicine, İstanbul, Türkiye
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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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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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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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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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Gündoğar Ö, Kımıloğlu E, Komut N, Cin M, Bektaş S, Gönüllü D, İlgün AS, Erdoğan N. Evaluation of appendiceal mucinous neoplasms with a new classification system and literature review. Turk J Gastroenterol 2019; 29:533-542. [PMID: 30260774 DOI: 10.5152/tjg.2018.17605] [Citation(s) in RCA: 20] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 12/16/2022]
Abstract
Appendiceal mucinous neoplasms constitute a diagnostic spectrum ranging from adenoma to mucinous adenocarcinoma. To date, many classification systems have been proposed to reflect the histomorphological diversity of neoplasms in this range and their clinical correspondence, and also to form a common terminology between the pathologist and clinicians. The aim of this review is to provide an updated perspective on the pathological features of appendiceal mucinous neoplasms. Using the 2016 Modified Delphi Consensus Protocol (Delphi) and the Eighth Edition of the American Joint Committee on Cancer (AJCC) Cancer Staging Manual, 19 cases presented from June 2011 to December 2016 were evaluated and diagnosed with appendiceal mucinous neoplasia. According to the Delphi, non-carcinoid epithelial tumours of the appendix were categorized in eight histomorphological architectural groups. These groups are adenoma, serrated polyp, low-grade appendiceal mucinous neoplasm, high-grade appendiceal mucinous neoplasm, mucinous adenocarcinoma, poorly-differentiated adenocarcinoma with signet-ring, signet-ring cell carcinoma and adenocarcinoma. The most common symptom was right lower quadrant pain. The median age of these cases was 60±15 years. There was a preponderance of females (F/M: 15/4). In our re-evaluation, six cases were diagnosed as serrated polyp. There were 11 cases in the LAMN group and two cases in the mucinous adenocarcinoma group. Using the Delphi and the AJCC manual, there were many changes in the classification, evaluation and treatment of appendiceal mucinous neoplasms. These classification systems have facilitated the compatibility and communication of clinicians and pathologists and have guided clinicians on treatment methods.
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Affiliation(s)
- Özgecan Gündoğar
- Department of Pathology, University of Health Sciences Gaziosmanpaşa Taksim Training and Research Hospital, İstanbul, Turkey
| | - Elife Kımıloğlu
- Department of Pathology, University of Health Sciences Gaziosmanpaşa Taksim Training and Research Hospital, İstanbul, Turkey
| | - Neslihan Komut
- Department of Pathology, University of Health Sciences Gaziosmanpaşa Taksim Training and Research Hospital, İstanbul, Turkey
| | - Merve Cin
- Department of Pathology, University of Health Sciences Gaziosmanpaşa Taksim Training and Research Hospital, İstanbul, Turkey
| | - Sibel Bektaş
- Department of Pathology, University of Health Sciences Gaziosmanpaşa Taksim Training and Research Hospital, İstanbul, Turkey
| | - Doğan Gönüllü
- Department of General Surgery, University of Health Sciences Gaziosmanpaşa Taksim Training and Research Hospital, İstanbul, Turkey
| | - Ahmet Serkan İlgün
- Department of General Surgery, University of Health Sciences Gaziosmanpaşa Taksim Training and Research Hospital, İstanbul, Turkey
| | - Nusret Erdoğan
- Department of Pathology, University of Health Sciences Gaziosmanpaşa Taksim Training and Research Hospital, İstanbul, Turkey
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9
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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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10
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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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11
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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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12
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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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