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

Cost-Effectiveness of Breast Cancer Screening in Turkey, a Developing Country: Results from Bahçeşehir Mammography Screening Project

Objective: We used the results from the first three screening rounds of Bahcesehir Mammography Screening Project (BMSP), a 10-year (20092019) and the first organized population-based screening program implemented in a county of Istanbul, Turkey, to assess the potential cost-effectiveness of a population-based mammography screening program in Turkey. Materials and Methods: Two screening strategies were compared: BMSP (includes three biennial screens for women between 40-69) and Turkish National Breast Cancer Registry Program (TNBCRP) which includes no organized population-based screening. Costs were estimated using direct data from the BMSP project and the reimbursement rates of Turkish Social Security Administration. The life-years saved by BMSP were estimated using the stage distribution observed with BMSP and TNBCRP. Results: A total of 67 women (out of 7234 screened women) were diagnosed with breast cancer in BMSP. The stage distribution for AJCC stages O, I, II, III, IV was 19.4%, 50.8%, 20.9%, 7.5%, 1.5% and 4.9%, 26.6%, 44.9%, 20.8%, 2.8% with BMSP and TNBCRP, respectively. The BMSP program is expected to save 279.46 life years over TNBCRP with an additional cost of $677.171, which implies an incremental cost-effectiveness ratio (ICER) of$ 2.423 per saved life year. Since the ICER is smaller than the Gross Demostic Product (GDP) per capita in Turkey ($ 10.515 in 2014), BMSP program is highly cost-effective and remains cost-effective in the sensitivity analysis. Conclusion: Mammography screening may change the stage distribution of breast cancer in Turkey. Furthermore, an organized population-based screening program may be cost-effective in Turkey and in other developing countries. More research is needed to better estimate life-years saved with screening and further validate the findings of our study.Roche Turkey; Breast Health Society of Turkey (MEMEDER); Clinical and Translational Science Award (CTSA) program, through the NIH National Center for Advancing Translational Sciences (NCATS)United States Department of Health & Human ServicesNational Institutes of Health (NIH) - USANIH National Center for Advancing Translational Sciences (NCATS) [UL1TR000427]; NATIONAL CENTER FOR ADVANCING TRANSLATIONAL SCIENCESUnited States Department of Health & Human ServicesNational Institutes of Health (NIH) - USANIH National Center for Advancing Translational Sciences (NCATS) [UL1TR000427] Funding Source: NIH RePORTERThe study was funded by Roche Turkey and in part by the Breast Health Society of Turkey (MEMEDER). Also, it was partially supported by the Clinical and Translational Science Award (CTSA) program, through the NIH National Center for Advancing Translational Sciences (NCATS), grant UL1TR000427. The content is solely the responsibility of the authors and does not necessarily represent the official views of the NIH

Ozone therapy as a novel complementary therapeutic approach in refractory idiopathic granulomatous mastitis

Background: Autoimmunity may play a major role in the pathogenesis of idiopathic granulomatous mastitis (IGM). The therapeutic potential of ozone therapy has recently been shown in rheumatological diseases, and this study aimed to assess the clinical efficacy of ozone therapy (OT) in refractory IGM. Methods: Patients with biopsy-verified IGM and incomplete response after steroid therapy (n = 47) between 2018 and 2021 were enrolled. Of these, 23 cases in cohort A had standard treatment with further steroid therapy (ST), and 24 were treated with systemic OT via autohemotherapy (AHT) in addition to steroid therapy (cohort B). Results: The median age was 33 years (range, 24–45). Patients in cohort B had a higher complete response rate after completion of a four-month ozone therapy than those in the ST-group (OT-group, 37.5% vs. ST-group, 0%; p = 0.002). At a median follow-up of 12 months (range, 12–35), the patients treated with OT had a lower one-year recurrence in the affected breast than cases in cohort A treated with ST (OT-group, 21% vs. ST-group, 70%; p = 0.001). No significant side effects were observed in patients in cohort B related to AHT. Furthermore, OT significantly decreased the total steroid treatment duration (median week of steroid use; 26 weeks in cohort A vs. 12 weeks in cohort B; p = 0.001). Conclusion: Systemic OT increases the complete response rate and decreases the duration of steroid treatment in patients with refractory IGM. Therefore, ozone therapy is an effective, well-tolerated, and safe novel complementary therapeutic modality.Istanbul Breast Societ

Perforated double appendicitis: Horseshoe type

Appendix vermiformis duplex is an infrequent malformation. However if it is missed out, there might be some complications and medicolegal troubles. A surgeon must be aware of any other appendix during appendectomy. Therefore, the possible locations and shapes described in the Cave-Wallbridge classification should be considered by the surgeon. In this case report, we present a patient with a horseshoe-type dupplication of appendix in a perforated appendicitis diagnosed during an emergency laparotomy

Molecular profiles of screen-detected breast cancers from a Turkish breast cancer screening program

49th Annual Meeting of the American-Society-of-Clinical-Oncology (ASCO) -- MAY 31-JUN 04, 2013 -- Chicago, IL[No Abstract Available]Amer Soc Clin Onco

KAS ÖNÜ İMPLANT İLE YAPILAN REKONSTRÜKSYON MEME KANSERİ CERRAHİSİNDE YATIŞ SÜRELERİNİ KISALTAN ETKİN BİR YÖNTEMDİR

Giriş-Amaç:Meme kanseri cerrahi tedavisinde implant ile birlikte cilt koruyucu teknikler giderek artan oranlarda kullanılmaktadır.Çalışmamızın amacı kas önü (KÖİ) ve kas altı implant (KAİ) konulan hastaların klinik sonuçlarının değerlendirilmesidir.Gereç-Yöntem:Mayıs 2017 – Mayıs 2019 yılları arasında operabl meme kanseri tanısı ile mastektomi yapılıp KÖİ veya KAİ konulan hastalardemografik veriler, cerrahi teknik ve komplikasyonlar açısından kıyaslandı. Komplikasyon gelişimini etkileyen faktörler analizedildi.Bulgular:Çalışmaya uygun bulunan 79 hastanın ortanca yaş 46 (27-71) olarak bulundu. Hastaların patolojik evreleri: duktal karsinomain situ (DKİS) %17, evre I %25.5, evre IIA %31.2, evre IIB/IIIA %23.3 olduğu saptandı. On iki (%15.6) hastaya neo-adjuvankemoterapi verildi. 79 hastaya 88 mastektomi (9 bilateral) yapıldı. Cerrahi olarak 72 (%81.9) meme başı/areola koruyucu (27’siTUTOPATCH® ile), 16 (%18.1) deri koruyucu mastektomi yapılırken, 38 memeye (%43.2) KÖİ, 50 memeye ise (%56.8) KAİyerleştirildi. KÖİ konulanlarda ortalama implant koyma süresi daha kısa (KÖİ:20 dakika, KAİ:40 dakika; p<0,001) vepostoperatif analjezik ihtiyacı (KÖİ:2 gün, KAİ:7 gün; p<0,001) daha azdı. Cilt iskemisi 11 hastada (%12.5), implant kaybı ise 8hastada (%9) gözlendi. KÖİ ve KAİ’lı hastalarda cilt iskemisi ve implant kaybı açısından anlamlı fark yokken, KÖİ’lı hastalarınortalama yatış süresi daha kısaydı (KÖİ:1,65gün; KAİ:2,74gün p=0,001). Her iki grupta da implant kaybına anlamlı derecedeetki eden faktör cilt iskemisi olarak tespit edildi.Tartışma-Sonuç:KÖİ konulan hastalar ile KAİ konulan hastalar arasında komplikasyonlar açısından anlamlı fark yoktu. KÖİ konulan hastalarınimplant konma süreleri, yatış süreleri daha kısa ve postoperatif analjezik ihtiyaçları daha azdı. Erken sonuçlar KÖİ’ların ciltiskemisi beklenmeyen hastalarda daha iyi bir seçenek olduğunu göstermektedir

Molecular profiles of screen-detected breast cancers from a Turkish breast cancer screening program

49th Annual Meeting of the American-Society-of-Clinical-Oncology (ASCO) -- MAY 31-JUN 04, 2013 -- Chicago, IL[No Abstract Available]Amer Soc Clin Onco