Scopus İndeksli Yayınlar Koleksiyonu
Permanent URI for this collectionhttps://hdl.handle.net/11727/4809
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Item Cardiotoxicity of Trastuzumab Emtansine (T-DM1): A Single-center Experience(2021) Acibuca, Aynur; Sezer, Ahmet; Yilmaz, Mustafa; Sumbul, Ahmet Taner; Demircan, Senol; Muderrisoglu, Ibrahim Haldun; Ozyilkan, Ozgur; 0000-0002-3444-8845; 34898302; ABG-4047-2020Objective New anti-cancer drugs promise to increased survival benefits and reduce adverse events. Trastuzumab emtansine (T-DM1) is a novel anti-human epidermal growth factor receptor 2 agent that has shown minimal cardiotoxicity in clinical trials. However, data on real-life outcomes are required. Methods A retrospective review of our center's medical records was performed, including female patients aged >= 18 years with a diagnosis of metastatic breast cancer who were treated with T-DM1. Descriptive statistics were used to investigate clinical features that could increase the risk of cardiotoxicity. Cardiotoxicity was determined by comparing pre and post-T-DM1 echocardiogram results and was defined as a decrease in the left ventricular ejection fraction (LVEF) >10% to below 55%. Results Data from 41 female patients with a mean age of 52 +/- 11.5 years were evaluated. A significant LVEF decrease (from 59% to 33%) was observed in one patient during T-DM1 treatment. Further investigation showed that this decrease was due to underlying coronary artery disease, and LVEF recovered to the baseline value after coronary revascularization. Conclusion T-DM1 seems to be safe in terms of cardiotoxicity. Real-life data with a larger sample size are still needed to confirm the cardiac safety of T-DM1.Item The effect of the use of the Gail model on breast cancer diagnosis in bi-rads 4A cases(2021) Karakaya, Emre; Erken, Murathan; Turnaoglu, Hale; Sirinoglu, Tugce; Akdur, Aydincan; Kavasoglu, Lara; 0000-0002-0664-5147; 0000-0002-8726-3369; 0000-0002-3592-5092; 0000-0002-3592-5092; 35677495; AAJ-8219-2021; AAA-3068-2021; ABI-7217-2020; CAA-2756-2022Objective: The BI-RADS classification system and the Gail Model are the scoring systems that contribute to the diagnosis of breast cancer. The aim of the study was to determine the contribution of Gail Model to the diagnosis of breast lesions that were radiologically categorized as BI-RADS 4A. Material and Methods: We retrospectively examined the medical records of 320 patients between January 2011 and December 2020 whose lesions had been categorized as BI-RADS 4A. Radiological parameters of breast lesions and clinical parameters according to the Gail Model were collected. The relationship between malignant BI-RADS 4A lesions and radiological and clinical parameters was evaluated. In addition, the effect of the Gail Model on diagnosis in malignant BI-RADS 4A lesions was evaluated. Results: Among radiological features, there were significant differences between lesion size, contour, microcalcification content, echogenicity, and presence of ectasia with respect to the pathological diagnosis (p< 0.05). No significant difference was found between the lesions' pathological diagnosis and the patients' Gail score (p> 0.05). An analysis of the features of the Gail model revealed that there was no significant difference between the age of menarche, age at first live birth, presence of a first-degree relative with breast cancer, and a history of breast biopsy and the pathological diagnosis (p> 0.05). Conclusion: As a conclusion Gail Model does not contribute to the diagnosis of BC, especially in patients with BI-RADS 4A lesions.Item The Comparison of Helical-IMRT, Direct-IMRT and 3D Radiotherapy Modalities in Breast Radiotherapy Planning(2020) Erdis, Eda; Yucel, Birsen; Ozyurek, Betul; Bozca, RecepOBJECTIVE This study aims to compare dosimetric 3D-CRT, Tomo-helical mu and Direct IMRT methods in intact breast irradiation. METHODS Radiotherapy was planned with three different techniques simulated images of 30 breast cancer patients with negative lymph nodes who underwent breast-conserving surgery. RESULTS The maximum and minimum doses, homogeneity and conformity index and cold-zone volumes were found to be different in all three techniques (p<0.001). The PTV boost maximum doses and homogeneity index were found to be different (p<0.001). The maximum non-PTV dose (110% volume) and the hot zone volumes grasped by these doses, the V5 volume of the body and V5 volumes, outer of PTV were found to be statistically significant for all three techniques (p<0.001). A statistically significant difference was found between the three techniques concerning the ipsilateral lung V5 and V20 volumes, the contralateral lung V5 and V10 volumes and the counter breast maximum and mean doses (p<0.001). The mean and V10 volume of the heart was statistically significant (p<0.001), while the left breast irradiation and mean values were not statistically significant between the three techniques (p=0.529). However, there was a statistically significant difference in the V10 volume of the left breast irradiation between the three techniques (p=0.033). CONCLUSION According to 3D-CRT, it is possible to achieve better dose distribution and dose homogeneity with Tomo-helical and direct IMRT. Low dose volumes arc high with tomo-helical IMRT. Torno-helical IMRT planning provides better ipsilateral lung and heart doses but causes an increase in heart dose/contralatcral breast and for right breast irradiation causes an increase in heart doseItem Comparison between body composition parameters and response to neoadjuvant chemotherapy by using pre-treatment PET CT in locally advanced breast cancer(2020) Yirgin, İnci Kizildag; Has, Duygu; Arslan, Gozde; Aydin, Esra Cureoglu; Sari, Murat; Onder, Semen; Yasemin, Sanli; Cabioglu, Neslihan; Karanlik, Hasan; Tukenmez, Mustafa; Dursun, Memduh; Muslumanoglu, Mahmut; Ozmen, Vahit; 33294497Purpose: To compare the adipose and muscle tissue areas in patients who responded differently to neoadjuvant chemotherapy. Methods: One hundred and eighty six patients diagnosed with breast cancer who underwent neoadjuvant chemotherapy between January 2015- October 2019 and were operated after the treatment were retrospectively included in the study. Pathological results were divided into five groups using the Miller-Payne grading systems. Grade 1 indicating no significant reduction in malignant cells; Grade 2: a minor loss of malignant cells (<= 30 %); Grade 3: reduction in malignant cells between 30 % and 90 %; Grade 4: disappearance of malignant cells >90 %; Grade 5: no malignant cells identifiable. Pre-treatment PET CT scans were evaluated, and calculation of body composition parameters were performed on a single axial section passing through the L3 vertebrae. Spearman's correlation test was used to analyze the correlation between SAT, VAT, MT parameters and pathological responses. Results: There was no strong correlation between the 5 groups separated according to neoadjuvant chemotherapy treatment response and tissue distributions. However, that there was a very low correlation found between superficial adipose tissue and pathological response (r=, 156). Conclusion: In conclusion, our results have provided a very low correlation between SAT and more than 30 % response. More research is required to evaluate the role of the body fat and muscle parameters in response to neoadjuvant chemotherapy in larger patient populations.Item The use of 18F-FDG positron emission tomography to detect mediastinal lymph nodes in metastatic breast cancer(2020) Onal, Cem; Findikcioglu, Alper; Guler, Ozan Cem; Reyhan, Mehmet; 0000-0001-6908-3412; 0000-0002-2742-9021; 33125983; AAC-5654-2020; D-5195-2014Background: To assess the predictive value of F-18-fluorodeoxyglucose positron-emission tomography (FDG-PET/CT) in detecting mediastinal lymph node metastasis with histopathologic verification in breast cancer (BC) patients. Materials and methods: Between February 2012 and October 2019, 37 BC patients who underwent histopathological verification for FDG-PET positive mediastinal lymph nodes were retrospectively analyzed. Nine patients (24%) were screened before beginning treatment, while 27 (76%) were screened at the time of disease progression, an average of 39 months after completion of initial treatment. Results: The histopathologic diagnosis revealed lymph node metastasis from BC in 15 patients (40%) and benign disease in 22 patients (60%). The standardized uptake value (SUVmax) of mediastinal lymph nodes was significantly higher in patients with lymph node metastasis compared to those with benign histology (9.0 +/- 3.5 vs. 5.9 +/- 2.4; P = 0.007). The cut-off value of SUVmax after the ROC curve analysis for pathological lymph node metastasis was 6.4. Two of the 15 patients with mediastinal SUVmax <= 6.4 and 13 of the 22 patients with SUVmax > 6.4 had lymph node metastasis. Age and pathological findings were prognostic factors for overall survival in univariate analysis. The treatment decision was changed in 19 patients (51%) after mediastinoscopic evaluation of the entire cohort. Conclusions: This is the first study to support the need for pathologic confirmation of a positive PET/CT result following evaluation of mediastinal lymph nodes for staging BC, either at initial diagnosis or at the time of progression. Treatment decisions were consequently altered for nearly half of the patients. (C) 2020 The Author(s). Published by Elsevier Ltd.Item The Comparision of Breast Cancer in the Young and Elderly Patients(2019) Petek Erpolat, Ozge; Yuce Sari, Sezin; Ergen, Sefika Arzu; Aydin, Barbaros; Akkus, Berna; Gultekin, Melis; Copan Oksuz, Didem; Arican, Zumre; Onal, Cem; Gursel, Bilge; Akmansu, Muge; Ozyigit, Gokhan; Bilkay Gorken, Ilknur; Yildiz, FerahOBJECTIVE To compare the tumor characteristics, treatment approaches, recurrence patterns and survival results rates of young and elderly patients with breast cancer. METHODS In this study, Between between 2000-2013, a total of 779 patients were treated for breast cancer at nine radiation oncology departments were evaluated retrospectively. Three-hundred eight four of these patients were young (<= 35 years), and 395 of those the patients were elderly (>= 70 years). RESULTS Young patients were more likely to present with aggressive tumor features. They were more often received comprehensive lymphatic irradiation, tumor bed boost and intense chemotherapy. No difference was found for 5 and 10-year loco-regional recurrence- free survival rates were (96% and 93% for young, 97% and 97% for elderly). The 5 and 10-year distant recurrence- free survival rates were lower in the young patients (77% and 67% for young, 85% and 85% for elderly, p<0.0001). No difference was found in 5 and 10-year breast cancer- specific survival (91% and 79% for young, 92% and 87% for elderly). The 5 and 10-year overall survival rates were higher in the young patients (92% and 78% for young, 78% and 63% for elderly, p<0.0001). CONCLUSION The reason for the similarity between the age groups in terms ofregarding loco-regional recurrence- free survival can be more comprehensive lymphatic irradiation and tumor bed boost, the young patients received. The distant recurrence- free survival rates rates were significantly lower in the young patients even though they received more intensive chemotherapy. Future studies aimed at more effective systemic regimens to decrease distant recurrence in young patients are warranted.Item Dosimetric Comparison of Sequential Versus Simultaneous-integrated Boost in Early-stage Breast Cancer Patients Treated With Breast-conserving Surgery(2019) Onal, Cem; Efe, Esma; Guler, Ozan C.; Yildirim, Berna A.; 0000-0001-6908-3412; 31662554; AAC-5654-2020Background/Aim: To compare simultaneous-integrated boost (SIB) versus sequential-boost (SB) delivered in the context of whole-breast irradiation (WBI) via volumetric-modulated arc therapy (VMAT) and helical-tomotherapy (HT). Materials and Methods: Planning target-volume (PTV) dosimetric parameters and organs at risk (OAR) were analyzed for SB plan (50 Gy plus 16 Gy boost) and SIB plan (50.4 Gy WBI and 64.4 Gy tumor bed boost) in VMAT and HT techniques. Results: Conformity and homogeneity for target-volume doses were better in HT plans compared to VMAT plans. There were no significant differences in ipsilateral lung doses between VMAT and HT plans for SB/SIB techniques, except for a significantly higher lung V5 value with VMAT-SB, and lung V13 value with HT-SIB technique. HT provided a statistically significant decrease in contralateral lung mean V5. Conclusion: The SIB technique showed better target-volume dose distribution in both HT and VMAT plans, and better sparing heart in HT compared to the SB technique.Item Effects of Setup Errors on Dose Distribution for Tangential Wedge Field and Field-in-Field Techniques During Breast Irradiation(2014) Sonmez, Aydan; Onal, Cem; Sonmez, Serhat; Arslan, Gungor; Parlak, Cem; Topkan, Erkan; Yavuz, MelekThis study is aimed to evaluate the effects of setup errors on dose distribution for target volume and healthy tissue within the irradiated volume and also critical surrounding organs for breast radiotherapy (RT) using both the tangential field and the field-in-field (FIF) technique. Ten patients with breast cancer were enrolled. For each patients two plans were generated; tangential field plan and FIF-plan. The setup errors were simulated for a series of displacements of +/- 5 mm and +/- 10 mm in superior-inferior (x-axis), medial-lateral (y-axis), and anterior-posterior (z-axis) directions and dose volume comparisons were made both between and within groups. The most prominent changes were observed in setup errors at z-axis. In wedge plan, 10-mm setup error at the +z axis caused a significant decrease in tumor coverage compared with the plan with no setup error (96.5% vs. 99.2%; p= 0.01). The 5 and 10 mm setup errors at the +z-axis resulted in significantly higher healthy tissue doses in wedge plans compared with FIF plans. The setup errors along z-axis had a significant effect on the dose distribution for target volume and also to the lungs. The setup error in the isocenter should be kept strictly below 5 mm.Item Sarcoidosis mimicking metastatic breast cancer in a patient with early-stage breast cancer(2016) Altinkaya, Metin; Altinkaya, Naime; Hazar, Burhan; 26985162Sarcoidosis is a systemic granulomatous disorder of unknown origin that affects the lungs and mediastinal lymph nodes in most patients. The coexistence of sarcoidosis and breast cancer has been reported. An unfortunate consequence of the presence of both entities in the same patient is the risk of misdiagnosis. We report the case of a 70-year-old female with T1N0 cancer of the right breast that was initially diagnosed as stage IV because of mediastinal positron-emission tomography - positive lymphadenopathy. Biopsy of a mediastinal lymph node allowed us to diagnose sarcoidosis and correctly stage her disease as stage I breast cancer.Item Centralization of mammography reporting with mobile trucks: Turkish experience(2018) Gultekin, M.; Ozturk, C.; Karaca, S.; Boztaş, G.; Turan, S.H.; Dundar, S.; Hacikamiloglu, E.; Araz, L.; Murtuza, K.; Keskinkilic, B.Screening via mammography is a complex process to be implemented. Objective: To report the initial results and the effectiveness of newly implemented Turkey's population based breast cancer screening program performed for 40–69 years old women; and effectiveness of the newly implemented out-sourcing mobile trucks and national central report center. The study is conducted prospectively in one year (March 2016–March 2017) in all 81 provinces of Turkey. Mammography images were transferred via on-line web based system to the central reporting center. BI-RADS Scores and KETEM models (Mobile vs. Stationary) were the parameters were compared. In total mammography images of 414.802 patients were transferred from 155 KETEMs to the central reporting center. From these patients; 95.872 (23,1%) were aged between 40 and 44. Among all images, 21.999 (5,3%) were BI-RADS 0-4-5, 391.123 (94,3%) were BI-RADS 1–2. Totally recall rate of the national reporting center was 5.3%. Number of patients screened per day were significantly higher in out-sourcing mobile trucks compared to stationary KETEMs (31.8 vs. 8.9; p < 0.05). This is the first and the largest breast cancer screening study which results of a population based mammography screening for 40–69 years old women are evaluated at the same time with the evaluation of the efficacy of newly implemented centralized reporting center and the mobile screening trucks in comparison with stationary cancer screening centers. According to the initial results; Turkey's newly implemented population based breast cancer screening system seems to be feasible and effective. © 2018 The Authors