Comparison of clinical and magnetic resonance imaging findings of triple-negative breast cancer with non-triple-negative tumours

Purpose: Triple-negative breast cancer (TNBC) has some distinctive features. The aim of the study was to compare clinical and breast magnetic resonance imaging (MRI) findings of TNBC with non-triple-negative breast cancer (nTNBC) in molecular subtypes such as ADC (apparent diffusion coefficient) values, T2-weighted (T2W) image intensity, shape, margin, lymph node involvement, grade, multifocality, multicentricity, bilaterality, and enhancement pattern differences between tumour subtypes. Material and methods: A total of 141 patients who underwent breast biopsy at our institution between January 2010 and June 2018 were included in this study. Patients were divided into molecular subtypes according to hormone receptor status, and Ki-67 index. Tumour grade, enhancement patterns, age, lymph node involvement, ADC values, breast imaging reporting and data system (BI-RADS) category, bilaterality, multifocality, multicentricity, margin, shape, and T2W image intensity were evaluated for these subtypes. Results: ADC values were higher in triple-negative tumours than in luminal A and luminal B tumours (p = 0.010 and p = 0.002, respectively). Circumscribed margin, type 2 enhancement curve, and rim enhancement were significantly higher in triple-negative tumours (p 0.05). Conclusions: ADC values, circumscribed margin, and rim enhancement can provide important information about the tumour's biological behaviour and the course of the disease

A novel technique for the non-surgical management of inadvertent bowel catheterization during percutaneous abscess drainage: a technical note

Percutaneous abscess drainage-related inadvertent bowel catheterization is an undesired complication that requires treatment. In two cases without signs of peritonitis that we examined, it was possible to achieve successful abscess drainage, and to treat abscess-related inadvertent bowel catheterization by using a novel technique without surgery

Meme Kanserli Olgularda İmmunohistokimyasal Belirteçler İle Meme Manyetik Rezonans Görüntülemede Adc (Apparent Dıffusıon Coeffıcıent) Değerlerinin Karşılaştırılması

The aim of this study was to determine the relationship between ADC values in breast MRI with immunohistochemical markers and hormone receptor status in breast cancer patients and also to reveal T2 intensity, shape, margin, size, lymph node involvement, grade, multifocality, multicentricity, bilaterality and enhancement pattern differences between subtypes of tumours. In this study, 141 patients who underwent breast biopsy in the Department of Radiology of Hacettepe University Faculty of Medicine were included between January 2010-June 2018. Patients were divided into receptor subgroups according to hormone receptor status, molecular subtypes according to hormone receptor status, grade and Ki-67 index and pathological main subtypes. Tumor degree, enhancement patterns, age of the patient, side of the mass, lymph node involvement, ADC values, BI -RADS classification, bilaterality, multifocality, multicentricity, margin, shape, T2A intensity were evaluated for these subtypes. ADC values were higher in patients with triple negative tumors than Luminal A and Luminal B tumors. ADC values were higher in triple negative tumors than in ER+, PR + and HER 2 -tumors. Lymph node involvement was found to be lower in ER +, PR +, HER 2-group, which had lower ADC values than triple negative tumors. Rim enhancement was significantly higher in triple negative tumors. Circumscribed margin in both hormone receptor subgroups and molecular subgroup classification was higher in triple negative tumors. In conclusion, ADC values may give information about the course and the type of the tumor.yokİçindekiler TEŞEKKÜR i ÖZET ii ABSTRACT iii TABLOLAR viii RESİMLER x 1. GİRİŞ VE AMAÇ 1 2. GENEL BİLGİLER 3 2.1. Meme Anatomisi ve Embriyolojisi 3 2.2 Benign Meme Lezyonları 7 2.2.1 Nonneoplastik 7 2.2.1.1 Kistler 7 2.2.1.2 Duktal Ektazi 7 2.2.1.3 Yağ Nekrozu 8 2.2.1.4 Radyal Skar 8 2.2.1.5 Galaktosel 9 2.2.1.6 Vasküler Lezyonlar 9 2.2.1.7 Lipom 9 2.2.2 Neoplastik 10 2.2.2.1 Fibroadenom 10 2.2.2.2 İntraduktal Papillom 11 2.2.2.3 Hamartom 12 2.2.2.4 Filloid Tümör 12 2.2.2.5 Diğer Nadir Lezyonlar 13 2.2.2.6 Proliferatif Meme Hastalığı 13 2.3 Malign Meme Lezyonları 13 2.3.1 Noninvazif Meme Karsinomu 13 2.3.1.1 Duktal karsinoma in situ (DKİS) 13 2.3.1.2 Lobüler Karsinoma in Situ (LKİS) 14 2.3.2 İnvaziv Meme Karsinomu 15 2.3.2.1 İnvaziv Duktal Karsinoma 15 2.3.2.1.1 İnvaziv Duktal Karsinoma Spesifiye Edilmemiş Tip (İDK- NOS) 16 2.3.2.1.2 İnvaziv Duktal Karsinoma Spesifiye Edilmiş Tipler 17 2.3.2.1.2.1 Medüller Karsinoma 17 2.3.2.1.2.2 Müsinöz Karsinoma 18 2.3.2.1.2.3 Papiller Karsinoma 19 2.3.2.1.2.4 Tübüler Karsinom 19 2.3.2.1.2.5 Mikropapiller Karsinom 20 2.3.2.2 İnvaziv Lobüler Karsinom 21 2.3.2.3 İnflamatuar karsinom 21 2.3.2.4 Paget Hastalığı 22 2.3.2.5 Malign Filloid Tümör 23 2.3.2.6 Lenfoma, Lösemi 23 2.3.2.7 Metaplastik Karsinom, Sarkomlar, Metastatik Meme Lezyonları 23 2.4 Meme Kanserinde Moleküler Alt Tipler 23 2.5 BI-RADS MRG, ACR Atlası, 2013, 5. Baskı 26 2.6. Meme Manyetik Rezonans Görüntüleme 28 3. GEREÇ VE YÖNTEM 33 3.1. Kapsam ve Yöntem: 33 3.2 Materyal ve Metod: 33 3.3 İstatistiksel Analiz 39 4. BULGULAR 40 6. SONUÇ 61 7. KAYNAKLAR 62Bu çalışmanın amacı meme kanserli hastalarda MRG’de ADC değerleri ile immunohistokimyasal belirteçler arasındaki ilişkinin belirlenmesi, immunohistokimyasal ve reseptör durumuna göre sınıflanan hastalarda tümörün T2 A intensitesi, kenarları, boyutları gibi morfolojik özellikleri, lenf nodu tutulumu, multifokalitesi, multisentrisitesi, derecesi, kontrastlanma paterni gibi parametreler ile alt tipler arasındaki farkların ortaya konmasıdır. Bu çalışmaya Ocak 2010-Haziran 2018 tarihleri arasında Hacettepe Üniversitesi Tıp Fakültesi Radyoloji Anabilim Dalında meme biyopsisi yapılıp, patoloji sonucu invazif meme karsinomu ile uyumlu gelen ve ameliyat öncesi meme MRG'de kitlesel kontrastlanma gösteren 141 hasta dahil edildi. Hastalar reseptör durumuna göre alt gruplara, hormon reseptör durumu, derecesine ve Ki-67 indeksine göre moleküler alt tiplere ve patolojik ana alt tiplere ayrılarak tümörün derecesi, kontrastlanma paternleri, hastanın yaşı, kitlenin tarafı, lenf nodu tutulumu, ADC değerleri, BI-RADS sınıflaması, bilateralite, multifokalite, multisentrisite, kenar, şekil, T2A intensitesi gibi parametreler bu alt tipler için değerlendirildi. Üçlü negatif tümörlerde ADC değerleri Luminal A ve Luminal B tümörlerden yüksek bulundu. Üçlü negatif tümörlerde ADC değeri ER+, PR+, HER 2- tümörlerden yüksek bulundu. ADC değeri üçlü negatif tümörlerden daha düşük bulunan ER +, PR+, HER 2 – grupta lenf nodu tutulumu da daha düşük bulundu. Üçlü negatif tümörlerde halkasal boyanma ve iyi sınır özelliği diğer gruplara göre daha sık görüldü. Sonuç olarak ADC değerleri tümörün seyri ve tipi hakkında bilgi verebilir