FACTORS AFFECTING DISEASE FREE AND OVERALL SURVIVAL IN PATIENTS WITH LOCALLY ADVANCED BREAST CANCER AFTER NEOADJUVANT CHEMOTHERAPHY (LABC) (THE 10-YEAR RESULTS)

Introduction: The rate of locally advanced breast cancer (LABC) is low in countries with organized population based mammographic screening (5-10%), but it is more than 50% in low-middle income countries. Aim of this study is to find factors affecting disease free and overall survival in patients with LABC after Neoadjuvant Chemotherapy (NAC)

Prognostic value of receptor status change following neoadjuvant chemotherapy in locally advanced breast cancer

© 2015 The Authors.IntroductionThe effect of neoadjuvant chemotherapy (NAC) on the expression of receptor status in locally advanced breast cancer (LABC) is still under investigation. Aims of this study are to evaluate changes in hormone receptor (HR) and HER-2 status post-NAC and correlation with survival. Materials and methodsLABC patients who received NAC between 2001 and 2008 at Istanbul University were analyzed retrospectively. Patients with pathologic complete response (pCR) were excluded in analysis. Immunohistochemical (IHC) analyses was performed on both initial biopsies and surgical specimens. ResultsThe median age of 128 patients was 48 years and 55% of them were premenopausal. Most of the patients had invasive ductal (81%) and histologic grade (HG) III (81%) breast cancer. Partial pathologic response (pPR) rate was 86.7%. HR status changed in 36 patients (28%). The rates of ER, PR and HER-2 receptor positivity at diagnosis and after NAC were 44-32.8%, 43-29.7%, and 24-21%, respectively. Negative-to-positive change in HR status was observed in five patients. The 5-year overall survival (OS) was 76% in patients whose HR status converted to negative, compared with 91% in patients who remained HR-positive (p<0.05). Multivariate Cox regression analysis showed that receptor status change was independently related to disease-free survival (DFS) (Hazard Ratio 6.88; p=0.002), whereas as it did not have any impact on OS (p=0.148). ConclusionNAC induced changes in HR and HER-2 expression, predominantly from positive to negative. These changes were associated with shorter DFS. Postoperative re-evaluation of receptor status may have clinical significance

Clinical and histopathological factors associated with Ki-67 expression in breast cancer patients

WOS: 000350918100005The aim of the present study was to identify the optimal Ki-67 cut-off value in breast cancer (BC) patients, and investigate the association of Ki-67 expression levels with other prognostic factors. Firstly, a retrospective search was performed to identify patients with stage I-III BC (n=462). A range of Ki-67 index values were then assigned to five groups (= 25%). The correlation between the Ki-67 index and other prognostic factors [age, tumor type, histological and nuclear grade, tumor size, multifocality, an in situ component, lymphovascular invasion (LVI), estrogen and progesterone receptor (ER/PR) expression, human epidermal growth factor receptor (HER-2) status, axillary involvement and tumor stage] were investigated in each group. The median Ki-67 value was revealed to be 20% (range, 1-95%). A young age (= 15% was associated with the largest number of poor prognostic factors (P=0.036). In addition, a Ki-67 value of >= 15% was identified to be statistically significant in association with certain luminal subtypes. The rate of disease-free survival was higher in patients with luminal A subtype BC (P=0.036). Following the correlation analysis for the Ki-67 index and the other prognostic factors, a Ki-67 value of >= 15% was revealed to be the optimal cut-off level for BC patients

THE FACTORS EFFECTING MORTALITY IN STAGE 1 BREAST CANCER

Introduction: The incidence of stage 1 breast cancer has been increasing with screening mammography and awareness of breast cancer. However, some patients with early stage breast cancer have been died due to the recurrence of disease. The aim of this study was to examine the factors effecting the mortality in patients with stage 1 breast cancer

Stereotactic Vacuum-Assisted Core Biopsy Results for Non-Palpable Breast Lesions

WOS: 000343722900012PubMed ID: 25040970Background: The increase in breast cancer awareness and widespread use of mammographic screening has led to an increased detection of (non-palpable) breast cancers that cannot be discovered through physical examination. One of the methods used in the diagnosis of these cancers is vacuum-assisted core biopsy, which prevents a considerable number of patients from undergoing surgical procedures. The aim of this study was to present the results of stereotactic vacuum-assisted core biopsy for suspicious breast lesions. Materials and Methods: Files were retrospectively scanned and data on demographic, radiological and pathological findings were recorded for patients who underwent stereotactic vacuum-assisted core biopsy due to suspicious mammographic findings at the Interventional Radiology Centre of the Florence Nightingale Hospital between January 2010, and April 2013. Statistical analysis was carried out using Pearson's Chi-square, continuity correction, and Fisher's exact tests. Results: The mean age of the patients was 47 years (range: 36-70). Biopsies were performed due to BIRADS 3 lesions in 8 patients, BIRADS 4 lesions in 77 patients, and BIRADS 5 lesions in 3 patients. Mammography elucidated clusters of microcalcifications in 73 patients (83%) and focal lesions (asymmetrical density, distortion) in 15 patients (17%). In terms of complications, 1 patient had a hematoma, and 2 patients had ecchymoses (3/88; 3.3%). The histopathologic results revealed benign lesions in 63 patients (71.6%) and malignant lesions in 25 patients (28.4%). The mean duration of the procedure was 37 minutes (range: 18-55). Although all of the BIRADS 3 lesions were benign, 22 (28.6%) of the BIRADS 4 lesions and all of the BIRADS 5 lesions were malignant. Among the malignant cases, 80% were in situ, and 20% were invasive carcinomas. These patients underwent surgery. Conclusions: In cases where non-palpable breast lesions are considered to be suspicious in mammography scans, the vacuum-assisted core biopsy method provides an accurate histopathologic diagnosis thus preventing a significant number of patients undergoing unnecessary surgical procedures

A Risk Assessment Comparison of Breast Cancer and Factors Affected to Risk Perception of Women in Turkey: A Cross-sectional Study

Background: The increase in breast cancer incidence has enhanced attention towards breast cancer risk. The aim of this study was to determine the risk of breast cancer and risk perception of women, factors that affect risk perception, and to determine differences between absolute risk and the perception of risk

Clinical and histopathological factors associated with Ki-67 expression in breast cancer patients

The aim of the present study was to identify the optimal Ki-67 cut-off value in breast cancer (BC) patients, and investigate the association of Ki-67 expression levels with other prognostic factors. Firstly, a retrospective search was performed to identify patients with stage I-III BC (n=462). A range of Ki-67 index values were then assigned to five groups (= 25%). The correlation between the Ki-67 index and other prognostic factors [age, tumor type, histological and nuclear grade, tumor size, multifocality, an in situ component, lymphovascular invasion (LVI), estrogen and progesterone receptor (ER/PR) expression, human epidermal growth factor receptor (HER-2) status, axillary involvement and tumor stage] were investigated in each group. The median Ki-67 value was revealed to be 20% (range, 1-95%). A young age (= 15% was associated with the largest number of poor prognostic factors (P=0.036). In addition, a Ki-67 value of >= 15% was identified to be statistically significant in association with certain luminal subtypes. The rate of disease-free survival was higher in patients with luminal A subtype BC (P=0.036). Following the correlation analysis for the Ki-67 index and the other prognostic factors, a Ki-67 value of >= 15% was revealed to be the optimal cut-off level for BC patients

Effect of Cold Therapy on Managing Postoperative Pain Following Breast Conserving Surgery

Background: Cold therapy is an important non-pharmacologic method used for pain relief. Aim: In the present study, we aimed to evaluate the therapeutic effect of cold therapy on managing postoperative pain following breast-conserving surgery (BCS) and assess its effect on recovering quality. Method: The study was planned and implemented as a randomized controlled clinical study. Sixty patients with breast cancer were included in this study. All patients underwent BCS at Istanbul Faculty of Medicine. There were 30 patients in both the cold therapy and control groups. In the cold therapy group, a cold pack was placed around the incision line for 15 minutes every hour from the first hour after the operation until the 24th hour. To all the patients in both groups, pain levels were measured by visual analog scale (VAS) at the postoperative 1st, 6th, 12th, and 24th hours, respectively, and the quality of recovery was evaluated by a Quality of Recovery-40 questionnaire at the postoperative 24th hour. Results: The patients' median age was 53 (range: 24-71). All patients were T1-2 clinically and had no lymph node metastasis. Interestingly, the mean of pain level in the cold therapy group was statistically significantly lower in the first 24 hours (1st, 6th, 12th, and 24th hours) of the postoperative period (p = .001). Notably, the cold therapy group had higher recovering quality than the control group. In the first 24 hours, only 4 (12.5%) patients in the cold therapy group received additional analgesics, whereas all patients (100%) in the control group received additional analgesics (p = .001). Conclusions: Cold therapy is an easy and effective non-pharmacologic method for pain relief after BCS in patients with breast cancer. Cold therapy reduces the acute pain of the breast and contributes to the quality of recovery of those patients