Poor Biological Factors and Prognosis of Interval Breast Cancers: Long-Term Results of Bahceehir (Istanbul) Breast Cancer Screening Project in Turkey

PURPOSE The Turkish Bahceehir Breast Cancer Screening Project was a 10-year, organized, population-based screening program carried out in Bahceehir 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. (c) 2020 by American Society of Clinical OncologyRocheRoche Holding; Basaksehir (Basaksehir county in Istanbul) MunicipalitySupported by a grant from Roche (V.O.) and Basaksehir (Bahcesehir is a region in the Basaksehir county in Istanbul) Municipality

The association between non-HDL cholesterol and SYNTAX score in premature heart disease

Aim: This study aimed to estimate the association of coronary artery disease complexity with non-HDL-C levels in premature CAD. Background: Primary prevention has utmost importance in terms of minimizing the number of patients who had premature coronary artery disease (CAD). Non-high density lipoprotein cholesterol (non-HDL-C) contains potentially atherogenic lipoprotein fractions. Material and methods: Coronary angiographic recordings of two hundred acute coronary syndrome patients were evaluated by two cardiologists. Clinical, demographic and lipid parameters of the patients were compared with SYNTAX score. Results: Median age of the study group was 41 (18-45) years. One hundred eighty five (90.5%) of them were male, nineteen (9.5%) of them were female. Median SYNTAX score and ejection fraction of the patients were 17 (4.5-39) and 50 (33-68), respectively. SYNTAX score of the male patients was significantly higher compared to females [17 (4.5-39) vs 12 (8-26), p=0.048), similarly, diabetic patients had higher values of syntax score compared to non-diabetic patients [19 (10-39) vs 16 (4.5-37), p=0.005), There were no differences of SYNTAX score with respect to presence of hypertension, smoking status and family history of CAD.  There were very strong positive correlation between SYNTAX score and non-HDL-C, TC and LDL-C levels (r=0.958, r=0.946 and r=0.921, respectively, p<0.001 for all).   HgA1c levels showed positive correlation, whereas HDL-C showed negative correlation with SYNTAX score (r=0.793 and r=-0.620, respectively, p<0.001 for both). Conclusion: non-HDL-C was a valuable tool in assessing the complexity of atherosclerotic cardiovascular disease in young patients

Radiologic findings of screen-detected cancers in an organized population-based screening mammography program in Turkey

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

Meme kitlelerinin ayırıcı tanısında difüzyon MR görüntülemenin etkinliği ve histopatolojik korelasyonu

ÖZETÇalışmamızın amacı, solid meme kitlelerinin malign-benign ayrıcı tanısında, difüzyon MRincelemesinin ve ADC ölçümünün tanıya katkısının araştırılmasıdır.Çalışmaya, yaşları 18-79 arasında ( ort. 48.5 ) değişen 51 hasta ve histopatolojik tanıalmış 51 kitle alındı. Ellibir hastanın 49 ‘u ( %96.1 ) kadın, 2’ si ( %3.9 ) erkek idi. Hastalar1.5 Tesla manyetik alan gücünde MR cihazı ile bilateral meme koili kullanılarak incelendi.Difüzyon ağırlıklı görüntüler spin eko “echo planar” görüntüleme sekansı ile elde edildi, “b”değeri 50, 400, 800 sn/mm2 olarak belirlendi. Elde olunan görüntüler üzerinden, görünürdifüzyon katsayısı (apparent diffusion coefficients, ADC) normal meme parankimine aitfibroglandüler dokuda ve meme lezyonlarında hesaplandı. Çalışmamızın istatistikselanalizinde SPSS (15.0) programı uygulandı. ADC değerleri min. ± standart sapma olarakverildi. Bağımsız gruplar arasındaki ort. ADC değerleri Student t testi kullanılarakkarşılaştırıldı. Farklı lezyonları ayırt etmek için kullanılan eşik ADC değerlerini elde etmekiçin ROC (Reciever - operating characteristics) analizi yapıldı.Yapılan ölçümlerde min. ADC değerleri ortalaması, normal fibroglandüler dokuda1,42±0,17 x10-3 mm2/sn, benign meme lezyonlarında 1,9±0,45x10-3 mm2/sn ve malign memelezyonlarında 0,86±0,26 mm2/s olarak saptandı. Malign ve benign lezyonların 1,03 × 10-3mm2/sn ADC eşik değeri ile % 88.5 duyarlılık ve %100 özgüllük ilABSTRACTThe purpose of our study was to determine apparent diffusion coefficients (ADCs) of focalbreast lesions on the basis of diffusion-weighted MR imaging sequence and to evaluatewhether ADC measurements can be used to characterize lesions as benign and malign.A total of 51 patient between the age of 18-79 years (mean,48.5 years) with 51histopathologically verifed breast lesions were investigated in this study. 49 ( %96.1 ) of thispatients were female and 2 (%3.9) of them were male. The patients were examined by a 1,5 Tsystem using bilateral phased array breast coil. Spin echo ‘’echo planar’’ diffusion imagingwas used to scan patients. Images were obtained by ‘’b’’ values 50, 400 and 800seconds/mm2. The min. apparent diffusion coefficients (ADC) was calculated on normalfibroglandular tissue and breast lesions. We used SPSS (15.0) program for statistical analysisin our study. ADC values given as min.±SD. ADC values of independent groups compered by‘Student t’ test. ROC (Reciever - operating characteristics) analysis made to find tresholdADC value to differantiate lesions.The ADC values were as follows (mean): Normal fibroglandular tissue 1,42 ±0,17x10-3 mm2/sn, benign breast lesions 1,9±0,45x10-3 mm2/sn and malignant breast lesions0,86±0,26 mm2/sn. The treshold ADC value found 1,03 × 10-3 mm2/sn (with %88.5 specificityand %100 sensitivity) to differantiate beningn lesions from maligns. If we use ADC range(lesion/normal fibroglanduler tissue) to differatiate lessions, the treshold was 0,8 (with % 91.4specificity and %100 sensitivity). The mean min. ADC obtained from malignant breastlesions was statistically different from that observed in benign solid lesions (p <0,01).Diffusion imaging can be used in differentiation of malign and benign breast lesions

Meme kitlelerinin ayırıcı tanısında difüzyon MR görüntülemenin etkinliği ve histopatolojik korelasyonu

Çalışmamızın amacı, solid meme kitlelerinin malign-benign ayrıcı tanısında, difüzyon MR incelemesinin ve ADC ölçümünün tanıya katkısının araştırılmasıdır. Çalışmaya, yaşları 18-79 arasında ( ort. 48.5 ) değişen 51 hasta ve histopatolojik tanı almış 51 kitle alındı. Ellibir hastanın 49 ‘u ( %96.1 ) kadın, 2’ si ( %3.9 ) erkek idi. Hastalar 1.5 Tesla manyetik alan gücünde MR cihazı ile bilateral meme koili kullanılarak incelendi. Difüzyon ağırlıklı görüntüler spin eko “echo planar” görüntüleme sekansı ile elde edildi, “b” değeri 50, 400, 800 sn/mm2 olarak belirlendi. Elde olunan görüntüler üzerinden, görünür difüzyon katsayısı (apparent diffusion coefficients, ADC) normal meme parankimine ait fibroglandüler dokuda ve meme lezyonlarında hesaplandı. Çalışmamızın istatistiksel analizinde SPSS (15.0) programı uygulandı. ADC değerleri min. ± standart sapma olarak verildi. Bağımsız gruplar arasındaki ort. ADC değerleri Student t testi kullanılarak karşılaştırıldı. Farklı lezyonları ayırt etmek için kullanılan eşik ADC değerlerini elde etmek için ROC (Reciever - operating characteristics) analizi yapıldı. Yapılan ölçümlerde min. ADC değerleri ortalaması, normal fibroglandüler dokuda 1,42±0,17 x10-3 mm2/sn, benign meme lezyonlarında 1,9±0,45x10-3 mm2/sn ve malign meme lezyonlarında 0,86±0,26 mm2/s olarak saptandı. Malign ve benign lezyonların 1,03 × 10-3 mm2/sn ADC eşik değeri ile % 88.5 duyarlılık ve %100 özgüllük il ABSTRACT The purpose of our study was to determine apparent diffusion coefficients (ADCs) of focal breast lesions on the basis of diffusion-weighted MR imaging sequence and to evaluate whether ADC measurements can be used to characterize lesions as benign and malign. A total of 51 patient between the age of 18-79 years (mean,48.5 years) with 51 histopathologically verifed breast lesions were investigated in this study. 49 ( %96.1 ) of this patients were female and 2 (%3.9) of them were male. The patients were examined by a 1,5 T system using bilateral phased array breast coil. Spin echo ‘’echo planar’’ diffusion imaging was used to scan patients. Images were obtained by ‘’b’’ values 50, 400 and 800 seconds/mm2. The min. apparent diffusion coefficients (ADC) was calculated on normal fibroglandular tissue and breast lesions. We used SPSS (15.0) program for statistical analysis in our study. ADC values given as min.±SD. ADC values of independent groups compered by ‘Student t’ test. ROC (Reciever - operating characteristics) analysis made to find treshold ADC value to differantiate lesions. The ADC values were as follows (mean): Normal fibroglandular tissue 1,42 ±0,17 x10-3 mm2/sn, benign breast lesions 1,9±0,45x10-3 mm2/sn and malignant breast lesions 0,86±0,26 mm2/sn. The treshold ADC value found 1,03 × 10-3 mm2/sn (with %88.5 specificity and %100 sensitivity) to differantiate beningn lesions from maligns. If we use ADC range (lesion/normal fibroglanduler tissue) to differatiate lessions, the treshold was 0,8 (with % 91.4 specificity and %100 sensitivity). The mean min. ADC obtained from malignant breast lesions was statistically different from that observed in benign solid lesions (p <0,01). Diffusion imaging can be used in differentiation of malign and benign breast lesions

Güneş Civarındaki Metalce Fakir Yıldızların SED Yöntemiyle Temel Astrofizik Parametrelerinin Tayini

Bu çalışmada, Güneş civarından seçilmiş metalce fakir yıldızların tayfsal enerji dağılımları (SED) analiz edilmiş ve teorik olarak hesaplanan model atmosfer fitleriyle, yıldızların tayfsal analizlerinde kullanılabilecek öncül temel astrofizik parametreler tayin edilmiştir. Bu amaç doğrultusunda Polarbase veri tabanı ve ELODIE tayf kütüphanesinden metalce fakir 10 yıldız seçilmiş ve bu yıldızların mor-ötesinden orta kızılötesi bölgesine kadarki parlaklıkları yardımıyla SED’leri oluşturulmuştur. İncelenen yıldızların temel astrofizik parametrelerinin yanı sıra uzaklık ve sönükleşme değerleri de tayin edilmiştir. Elde edilen bulgular, yüksek çözünürlüklü ve yüksek sinyal/gürültü değerli tayflardan hesaplanan model atmosfer parametreleriyle karşılaştırılmıştır. Sonuçlar, Vines ve Jenkins (2022) tarafından sağlanan ve bu çalışma kapsamında uygulanan yöntem ile SED’lerden hesaplanan temel astrofizik parametreleri içerisindeki model atmosfer parametrelerinin yıldızlar için gerçekleştirilecek detaylı bolluk analiz çalışmalarında öncül girdi değerler olarak kullanılabileceğini göstermiştir