Outcomes of high-risk breast lesions diagnosed using image-guided core needle biopsy: results from a multicenter retrospective study

PURPOSEThe clinical management of high-risk lesions using image-guided biopsy is challenging. This study aimed to evaluate the rates at which such lesions were upgraded to malignancy and identify possible predictive factors for upgrading high-risk lesions.METHODSThis retrospective multicenter analysis included 1.343 patients diagnosed with high-risk lesions using an image-guided core needle or vacuum-assisted biopsy (VAB). Only patients managed using an excisional biopsy or with at least one year of documented radiological follow-up were included. For each, the Breast Imaging Reporting and Data System (BI-RADS) category, number of samples, needle thickness, and lesion size were correlated with malignancy upgrade rates in different histologic subtypes. Pearson’s chi-squared test, the Fisher–Freeman–Halton test, and Fisher’s exact test were used for the statistical analyses.RESULTSThe overall upgrade rate was 20.6%, with the highest rates in the subtypes of intraductal papilloma (IP) with atypia (44.7%; 55/123), followed by atypical ductal hyperplasia (ADH) (38.4%; 144/375), lobular neoplasia (LN) (12.7%; 7/55), papilloma without atypia (9.4%; 58/611), flat epithelial atypia (FEA) (8.7%; 10/114), and radial scars (RSs) (4.6%; 3/65). There was a significant relationship between the upgrade rate and BI-RADS category, number of samples, and lesion size Lesion size was the most predictive factor for an upgrade in all subtypes.CONCLUSIONADH and atypical IP showed considerable upgrade rates to malignancy, requiring surgical excision. The LN, IP without atypia, pure FEA, and RS subtypes showed lower malignancy rates when the BI-RADS category was lower and in smaller lesions that had been adequately sampled using VAB. After being discussed in a multidisciplinary meeting, these cases could be managed with follow-up instead of excision

Decreasing risk of Staphylococcus aureus infections

Karabay, Oguz/0000-0003-0502-432XWOS: 000248570800023PubMed: 17660040

Combined Use of Vancomycin and Meropenem in Patient with Acute Intermittent Porphyria: A Case Report

Acute intermittent porphyria (AIP) is an autosomal dominant disorder that leads to abdominal pain with unknown etiology, nausea, acute peripheric and/or central nervous system disfunctions, hiponatremia and with existence of phorphobilinogen in urine during acute attacks. Young females are more often symptomatic than males. Porphyria attacks arise from outer induction of heme synthesis in liver such as drugs that induces mithocondrial cytochrom P-450. A few antibiotics are considered as safe in patients with porphyria. A quite less previous case were reported in literature about uses of vancomycin and meropenem seperately. However vancomycin plus meropenem combination therapy was not reported in any case with porphyria. In this paper we reported a patient with AIP treated with combined vancomycin plus meropenem therapy because of lifethreatening nosocomial sepsis and had not any side effect

Salmonella arizonae bacteraemia in a Turkish patient with AIDS but no history of contact with reptiles

WOS: 000235553800021PubMed: 16500793

Decreasing risk of Staphylococcus aureus infections

Karabay, Oguz/0000-0003-0502-432XWOS: 000248570800023PubMed: 17660040

The use of teicoplanin in a patient with acute intermittent porphyria

WOS: 000233414700021PubMed: 16323453