Radiological and clinicopathological findings of breast cancer during the COVID-19 pandemic: a comparative study with the pre-pandemic era

PURPOSEThe diagnosis and surgical treatment delays that occurred during the coronavirus disease-2019- (COVID-19) pandemic may have affected breast cancer presentation. This study aimed to determine whether there was a difference in the clinicopathological characteristics of breast cancers during the pandemic by comparing them with similar cases from the previous year. The study also aimed to determine the radiological findings of breast cancers during the pandemic.METHODSA retrospective review was made of patients who underwent surgery for breast cancer between March 11, 2020, and December 11, 2020 (the pandemic group). These patients were compared with similar patients from the previous year (the pre-pandemic group). The postoperative histopathology results of both groups were compared, and the preoperative radiological findings of the pandemic group were defined.RESULTSThere were 71 patients in the pandemic group and 219 patients in the pre-pandemic group. The tumor size was significantly greater, lymph node involvement was more frequent, and waiting time for surgery was longer in the pandemic group (P 0.15). The radiologic findings of breast cancer during the pandemic typically showed characteristics of malignancy.CONCLUSIONPatients diagnosed with breast cancer during the COVID-19 pandemic had larger tumor sizes, more frequent lymph node involvement and longer waiting time for surgical treatment. Screening programs should be continued as soon as possible by taking necessary precautions

Prediction of malignancy upgrade rate in high-risk breast lesions using an artificial intelligence model: a retrospective study

PURPOSEHigh-risk breast lesions (HRLs) are associated with future risk of breast cancer. Considering the pathological subtypes, malignancy upgrade rate differs according to each subtype and depends on various factors such as clinical and radiological features and biopsy method. Using artificial intelligence and machine learning models in breast imaging, evaluations can be made in terms of risk estimation in different research areas. This study aimed to develop a machine learning model to distinguish HRL cases requiring surgical excision from lesions with a low risk of accompanying malignancy.METHODSA total of 94 patients who were diagnosed with HRL by image-guided biopsy between January 2008 and March 2020 were included in the study. A structured database was created with clinical and radiological characteristics and histopathological results. A machine learning prediction model was created to make binary classifications of lesions as malignant or benign. Random forest, decision tree, K-nearest neighbors, logistic regression, support vector machine (SVM), and multilayer perceptron machine learning algorithms were used. Among these algorithms, SVM was the most successful. The estimations of malignancy for each case detected by artificial intelligence were combined and statistical analyses were performed.RESULTSConsidering all cases, the malignancy upgrade rate was 24.5%. A significant association was observed between malignancy upgrade rate and lesion size (P = 0.004), presence of mammography findings (P = 0.022), and breast imaging-reporting and data system category (P = 0.001). A statistically significant association was also found between the artificial intelligence prediction model and malignancy upgrade rate (P < 0.001). With the SVM model, an 84% accuracy and 0.786 area-underthe- curve score were obtained in classifying the data as benign or malignant.CONCLUSIONOur artificial intelligence model (SVM) can predict HRLs that can be followed up with a lower risk of accompanying malignancy. Unnecessary surgeries can be reduced, or second line vacuum excisions can be performed in HRLs, which are mostly benign, by evaluating on a case-by-case basis, in line with radiology–pathology compatibility and by using an artificial intelligence model

Yüzyirmiyedi adenomyozis olgusunun değerlendirilmesi

Objective: The aim of this study is to determine the prevalence of adenomyosis uteri and also investigate both its relation with previous uterine surgery and the other uterine pathological conditions which may be found within the same uterus. Material and Method: One hundred and twenty seven patients with the diagnosis of histopathologically proven adenomyosis uteri of all the treated patients by hysterectomy in our clinic between the dates of January 2002 and 2003 were included in the present study. Results: Eighty seven of the patients (68.5%) were between 40-50 years-old and 29 patients were between 51-60 years-old. Six patients (4.7%) were nulliparous, whereas the rest (95.3%) was multiparous. Myoma uteri were the most frequent indication for the surgery with 73 patients (%57.5). When compared with other pathologies, myoma uteri was significantly more frequent that the other etiologies (p;lt;0.01). History of previous cesarean section and dilatation and curettage were found 14 (11%) and 79 (62.2%) respectively. Conclusion: Adenomyosis was more commonly encountered in multiparous women and it usually coexists with myoma uteri. Transcervical or transabdominal uterine surgical procedures may contribute to the pathogenesis of disease.Amaç: Bu çalışma, kliniğimizde opere edilmiş adenomyozisli olguların prevalansını belirlemek ayrıca geçirilmiş uterin cerrahi travma öyküsünün hastalık patogenezindeki rolünü sorgulamak ve de hastalığa eşlik eden diğer uterin patolojilerin belirlenmesi amacıyla planlanmıştır. Gereç ve Yöntem: Kliniğimizde Ocak 2002 ile Ocak 2003 tarihleri arasında histerektomi uygulanmış ve patolojik inceleme sonucunda adenomyozis saptanmış 127 olgu retrospektif olarak kendi aralarında değerlendirilmiştir. Bulgular: Hastaların 87'si (%68.5) 40-50 yaşları arasında, 29'u ise (%22.8) 51-60 yaşları arasındaydı. Altı hasta (%4.7) nullipar, 121 hasta (%95.3) ise multipardı. Operasyon endikasyonları içerisinde birinci sırada 73 olgu ile (%57.5) myoma uteri saptandı. Myoma uteri aynı zamanda adenomyozise eşlik eden en sık patoloji olarak belirlendi ve diğer uterin patolojilerle kıyaslandığında bu sıklık istatistiksel olarak anlamlı bulundu (p0.01). Geçirilmiş sezaryen ve küretaj öyküleri sırasıyla 14 (%11) ve 79 (%62.2) hastada mevcuttu. Sonuç: Adenomyozis özellikle multipar kadınlarda sık karşılaşılan bir uterin patoloji olup, en sık olarak myoma uteri ile birlikte izlenir. Uterusa yapılan transservikal ya da transabdominal cerrahi işlemler hastalığın patogenezinde önemli olabilir

Overin primer rabdomyosarkomu: Olgu sunumu

Rhabdomyosarcomas are soft tissue tumors mostly seen in childhood on head and neck region and limbs. Primary ovarian rhabdomyosarcomas are extremely rare, and are presented as a component of malignant mixed mullerian tumors. 26-year-old female presented with abdominal mass and pain. The abdominal ultrasonography and computed tomography showed bilateral ovarian tumors. Microscopic examination revealed small tumor cells with oval nucleus and eosinophilic cytoplasm composing an alveolar pattern. Tumor cells were stained positively with smooth muscle actin and desmin. The case was evaluated as stage III and died five months after the surgery. By the association of the histopathologic and immunohistochemical findings this case was diagnosed as primary rhabdomyosarcoma of ovary. This case is presented because it is unusual and rare tumor of the ovary.Rabdomyosarkomlar genetikle çocukluk döneminde, baş boyun bölgesi ve ekstremitelerde görülen yumuşak doku tümörleridir. Primer over yerleşimli rabdomyosarkomlar ise çok nadir olup malign mikst müllerian tümörlerin bir komponenti şeklinde izlenmektedirler. Karında kitle ve ağrı yakınmaları ile başvuran 26 yaşındaki olguya yapılan abdominal ultrasonografi ve bilgisayarlı tomografi sonrası her iki overde tümöral oluşumlar saptanmıştır. Cerrahi olarak çıkarılan tümörün mikroskobik incelemesinde, alveolar boşlukları döşeyen oval çekirdekli eozinofilik sitoplazmalı küçük hücreler izlenmiştir. Immünohistokimyasal olarak tümör hücreleri desmin ve düz kas aktini ile boyanmıştır. Evre III olarak değerlendirilen olgu, operasyondan 5 ay sonra yaşamını yitirmiştir. Histopatolojik ve immünohistokimyasal bulgular eşliğinde överin primer rabdomyosarkomu olarak değerlendirilen olgu nadir görülmesi nedeniyle sunulmuştur

Abdominal wall endometrioma arising in a cesarean scar: A case report

The term endometrioma usually refers to a well circumscribed mass of endometriosis and besides the ovaries, it has been also described in pelvic structures, intraperitoneally and superficially within the abdominal wall scars developed secondary to the utero-ovarian procedures such as cesarean section, amniocentesis and rarely with laparoscopic operations. Here we report a 29-year-old woman presenting with an abdominal mass, which proved to be endometrioma. Preoperative diagnose was made based on the history, physical examination, color Doppler sonography and computed tomography (CT) scan. The mass was resected surgically with wide excision.The term endometrioma usually refers to a well circumscribed mass of endometriosis and besides the ovaries, it has been also described in pelvic structures, intraperitoneally and superficially within the abdominal wall scars developed secondary to the utero-ovarian procedures such as cesarean section, amniocentesis and rarely with laparoscopic operations. Here we report a 29-year-old woman presenting with an abdominal mass, which proved to be endometrioma. Preoperative diagnose was made based on the history, physical examination, color Doppler sonography and computed tomography (CT) scan. The mass was resected surgically with wide excision