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    Position paper on screening for breast cancer by the European Society of Breast Imaging (EUSOBI) and 30 national breast radiology bodies from Austria, Belgium, Bosnia and Herzegovina, Bulgaria, Croatia, Czech Republic, Denmark, Estonia, Finland, France, Germany, Greece, Hungary, Iceland, Ireland, Italy, Israel, Lithuania, Moldova, The Netherlands, Norway, Poland, Portugal, Romania, Serbia, Slovakia, Spain, Sweden, Switzerland and Turkey
    (SPRINGER, 2017-01-01) Sardanelli, Francesco; Aase, Hildegunn S.; Alvarez, Marina; Azavedo, Edward; Baarslag, Henk J.; Balleyguier, Corinne; Baltzer, Pascal A.; Beslagic, Vanesa; Bick, Ulrich; Bogdanovic-Stojanovic, Dragana; Briediene, Ruta; Brkljacic, Boris; Herrero, Julia Camps; Colin, Catherine; Cornford, Eleanor; Danes, Jan; de Geer, Gerard; Esen, Gul; Evans, Andrew; Fuchsjaeger, Michael H.; Gilbert, Fiona J.; Graf, Oswald; Hargaden, Gormlaith; Helbich, Thomas H.; Heywang-Koebrunner, Sylvia H.; Ivanov, Valentin; Jonsson, Asbjorn; Kuhl, Christiane K.; Lisencu, Eugenia C.; Luczynska, Elzbieta; Mann, Ritse M.; Marques, Jose C.; Martincich, Laura; Mortier, Margarete; Mueller-Schimpfle, Markus; Ormandi, Katalin; Panizza, Pietro; Pediconi, Federica; Pijnappel, Ruud M.; Pinker, Katja; Rissanen, Tarja; Rotaru, Natalia; Saguatti, Gianni; Sella, Tamar; Slobodnikova, Jana; Talk, Maret; Taourel, Patrice; Trimboli, Rubina M.; Vejborg, Ilse; Vourtsis, Athina; Forrai, Gabor
    EUSOBI and 30 national breast radiology bodies support mammography for population-based screening, demonstrated to reduce breast cancer (BC) mortality and treatment impact. According to the International Agency for Research on Cancer, the reduction in mortality is 40 \% for women aged 50-69 years taking up the invitation while the probability of false-positive needle biopsy is < 1 \% per round and overdiagnosis is only 1-10 \% for a 20-year screening. Mortality reduction was also observed for the age groups 40-49 years and 70-74 years, although with ``limited evidence{''}. Thus, we firstly recommend biennial screening mammography for average-risk women aged 50-69 years
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    Magnetic resonance imaging before breast cancer surgery: results of an observational multicenter international prospective analysis (MIPA)
    (SPRINGER, 2022-01-01) Sardanelli, Francesco; Trimboli, Rubina M.; Houssami, Nehmat; Gilbert, Fiona J.; Helbich, Thomas H.; Alvarez Benito, Marina; Balleyguier, Corinne; Bazzocchi, Massimo; Bult, Peter; Calabrese, Massimo; Camps Herrero, Julia; Cartia, Francesco; Cassano, Enrico; Clauser, Paola; Cozzi, Andrea; de Andrade, Danubia A.; de Lima Docema, Marcos F.; Depretto, Catherine; Dominelli, Valeria; Forrai, Gabor; Girometti, Rossano; Harms, Steven E.; Hilborne, Sarah; Ienzi, Raffaele; Lobbes I, Marc B.; Losio, Claudio; Mann, Ritse M.; Montemezzi, Stefania; Obdeijn, Inge-Marie; Ozcan, Umit A.; Pediconi, Federica; Pinker, Katja; Preibsch, Heike; Raya Povedano, Jose L.; Sacchetto, Daniela; Scaperrotta, Gianfranco P.; Schiaffino, Simone; Schlooz, Margrethe; Szabo, Botond K.; Taylor, Donna B.; Ulus, Ozden S.; Van Goethem, Mireille; Veltman, Jeroen; Weigel, Stefanie; Wenkel, Evelyn; Zuiani, Chiara; Di Leo, Giovanni
    Objectives Preoperative breast magnetic resonance imaging (MRI) can inform surgical planning but might cause overtreatment by increasing the mastectomy rate. The Multicenter International Prospective Analysis (MIPA) study investigated this controversial issue. Methods This observational study enrolled women aged 18-80 years with biopsy-proven breast cancer, who underwent MRI in addition to conventional imaging (mammography and/or breast ultrasonography) or conventional imaging alone before surgery as routine practice at 27 centers. Exclusion criteria included planned neoadjuvant therapy, pregnancy, personal history of any cancer, and distant metastases. Results Of 5896 analyzed patients, 2763 (46.9\%) had conventional imaging only (noMRI group), and 3133 (53.1\%) underwent MRI that was performed for diagnosis, screening, or unknown purposes in 692/3133 women (22.1\%), with preoperative intent in 2441/3133 women (77.9\%, MRI group). Patients in the MRI group were younger, had denser breasts, more cancers >= 20 mm, and a higher rate of invasive lobular histology than patients who underwent conventional imaging alone (p < 0.001 for all comparisons). Mastectomy was planned based on conventional imaging in 22.4\% (MRI group) versus 14.4\% (noMRI group) (p < 0.001). The additional planned mastectomy rate in the MRI group was 11.3\%. The overall performed first- plus second-line mastectomy rate was 36.3\% (MRI group) versus 18.0\% (noMRI group) (p < 0.001). In women receiving conserving surgery, MRI group had a significantly lower reoperation rate (8.5\% versus 11.7\%, p < 0.001). Conclusions Clinicians requested breast MRI for women with a higher a priori probability of receiving mastectomy. MRI was associated with 11.3\% more mastectomies, and with 3.2\% fewer reoperations in the breast conservation subgroup.
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    Efficacy of Palbociclib and Endocrine Treatment in Heavily Pretreated Hormone Receptor-positive/HER2-negative Advanced Breast Cancer: Retrospective Multicenter Trial
    (GALENOS PUBL HOUSE, 2020-01-01) Demir, Atakan; Mandel, Nil Molinas; Paydas, Semra; Demir, Gokhan; Er, Ozlem; Turhal, Nazim Serdal; Bavbek, Sevil; Eralp, Yesim; Saip, Pinar Mualla; Guler, Emine Nilufer; Aydiner, Adnan; Uluc, Basak Oyan; Kilickap, Sadettin; Uskent, Necdet; Karadurmus, Nuri; Kaplan, Mehmet Ali; Yanmaz, Mustafa Teoman; Demir, Hacer; Alan, Ozkan; Korkmaz, Taner; Olgun, Polat; Uysal, Ozlem Sonmez; Altundag, Kadri; Gunduz, Seyda; Gunaldi, Meral; Sari, Murat; Beypinar, Ismail; Basaran, Gul
    Background: The synthesis of CDK4/6 inhibitors with endocrine treatment in two series of treatment has been widely accepted as the standard for patients with estrogen receptor-positive metastatic breast cancer. In spite of this, the activity of CDK4/6 inhibitors in patients with metastatic breast cancer who have progressed despite receiving multiple lines of treatment is not well understood. Aims: To report the activity and safety of a CDK4/6 inhibitor (palbociclib) in patients in whom at least three lines of treatment for ER+ metastatic breast cancer had failed. Study Design: Multicenter retrospective observational cohort study. Methods: In this retrospective observational cohort study, we included 43 patients who received palbociclib after at least three lines of systemic treatment for ER+/HER2- metastatic breast cancer. Results: The median progression-free survival in our population was 7 months (25th-75th percentile, 4-10), and the median overall survival was 11 months (25th-75th percentile, 6-19). Although there were some adverse events, palbociclib was generally well tolerated, so dose reduction was needed for only six patients (14\%). Conclusion: The efficacy of palbociclib among heavily treated hormone receptor-positive/HER2- patients with advanced breast cancer was acceptable in terms of clinical benefit, and it was generally well tolerated among this population.
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    An investigation of the effects of FGFR2 and B7-H4 polymorphisms in breast cancer
    (WOLTERS KLUWER MEDKNOW PUBLICATIONS, 2013-01-01) Ozgoz, Asuman; Samli, Hale; Ozturk, Kuyas Hekimler; Orhan, Bulent; Icduygu, Fadime Mutlu; Aktepe, Fatma; Imirzalioglu, Necat
    Introduction: Polymorphisms in FGFR2 are important markers for breast cancer susceptibility in the general population. CHEK2 and FGFR2 polymorphisms with known susceptibility alleles of BRCA1, BRCA2, PTEN, and TP53, can be investigated as potential modifiers of high penetrant risk alleles. Although the B7-H4 gene is highly expressed in many different tumors, there is one published study showing the association of polymorphisms with breast cancer. We aimed to investigate FGFR2 and B7-H4 polymorphisms in breast cancer in the Turkish community. Materials and Methods: In a group of 31 cases diagnosed with breast cancer and 30 healthy women with matched ages, the single-nucleotide polymorphisms (SNPs) rs1219648, rs2981582 in FGFR2 gene were identified by sequence analysis and the SNPs rs10754339, rs10801935, and rs3738414 in the B7-H4 gene were identified by polymerase chain reaction-restriction fragment length polymorphism (PCR-RFLP) method. Statistical analysis was performed using SPSS. Results: Although statistically not significant, the frequency of FGFR2 heterozygous polymorphisms in the group with breast cancer was detected to be higher. In the B7-H4 SNP rs10801935, polymorphic AA, and AG genotype distributions were found in higher frequencies in the breast cancer patients. In contrast to the results of a published study, the present study shows that B7-H4 rs3738414 polymorphism GG genotype was found in higher frequency in the control group than the breast cancer group and the result was statistically significant (P=0.018). Conclusion: Larger scale studies are necessary to determine the prevalence of these polymorphisms and association with breast cancer in Turkish community, as this study is the first study performed.
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    Investigation of effects of PALB2 genetic variations on breast cancer predisposition
    (CUKUROVA UNIV, FAC MEDICINE, 2020-01-01) Bilen, Muge Yuksel; Berkoz, Mehmet; Yalin, Ali Erdinc; Calikusu, Zuleyha; Eroglu, Pelin; Comelekoglu, Ulku; Yalin, Serap
    Purpose: In this study, the effects of three different single nucleotide polymorphisms (rs249954, rs249935, and rs16940342) of partner and localizer of breast cancer gene 2 (PALB2) on breast cancer predisposition have been investigated. Materials and Methods: For this purpose, 150 patients diagnosed to have breast cancer and 150 healthy individuals have been included. By using real time polymerase chain reaction (PCR) method isolated deoxyribonucleic acid (DNA) from each case has been investigated for the PALB2 genetic variations. Results: The distribution of homozygote wild type (AA) and heterozygote (AG) genotypes at rs16940342 polymorphism has been observed to be 44.7\% and 55.3\% in breast cancer group and 32.7\% and 67.3\% in control group. The homozygote polymorphic (GG) genotype was not observed in both groups. The discrepancy between the groups in terms of genotype distribution regarding rs16940342 polymorphism has been found statistically significant. However, there was no significant difference in the frequencies of rs249954 and rs249935 polymorphisms comparing both groups. Conclusion: These results show that rs16940342 polymorphism may be an important determinant in terms of breast cancer predisposition in the Turkish population.
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    Association between ABCB1, ABCG2 carrier protein and COX-2 enzyme gene polymorphisms and breast cancer risk in a Turkish population
    (ELSEVIER, 2020-01-01) Zeliha, Kara Pala; Dilek, Ozturk; Ezgi, Oztas; Halil, Kara; Cihan, Uras; Gul, Ozhan
    Aim: Breast cancer is the most common cancer and the second leading cause of cancer-related deaths among women. Several genetic and environmental factors are known to be involved in breast cancer pathogenesis, but the exact etiology of this disease is complicated and not completely understood. We aimed to investigate whether the gene polymorphisms of ABCB1 and ABCG2 carrier proteins and COX-2 enzyme affect breast cancer risk. Method: ABCG2 C421A (rs2231142), ABCB1 C3435T (rs1045642), COX-2 T8473C (rs5275) and COX-2 G306C (rs5277) were genotyped 104 breast cancer patients and 90 healthy controls using a real-time PCR for breast cancer susceptibility. Results: Patients carrying ABCG2 C421A, the CC genotype, had a higher risk of disease compared with patients carrying any A allele (OR = 3.06
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    Correlation between 18F-FDG Positron-Emission Tomography 18F-FDG Uptake Levels at Diagnosis and Histopathologic and Immunohistochemical Factors in Patients with Breast Cancer
    (AVES, 2016-01-01) Ugurluer, Gamze; Yavuz, Sinan; Calikusu, Zuleyha; Seyrek, Ertugrul; Kibar, Mustafa; Serin, Meltem; Ersoz, Canan; Demircan, Orhan
    Objective: In this study, we aimed to determine the correlation between pretreatment-staging 18F-FDG total body positron-emission tomography/computed tomography (PET/CT) maximum standardized uptake value (SUVmax) levels and histopathologic and immunohistochemical predictive and prognostic factors in patients with breast cancer. Materials and Methods: One hundred thirty-nine women with breast cancer who were treated between 2009 and 2015 at our hospital and who had pretreatment-staging PET/CT were included in the study. SUVmax levels and histopathologic and immunohistochemical results were compared. Results: The median age was 48 years (range, 29-79 years). The mean tumor diameter was 33.4 mm (range, 7-120 mm). The histology was invasive ductal carcinoma in 80.6\% of the patients. In the univariate analysis, SUVmax levels were significantly higher in patients with invasive ductal carcinoma
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    How Do Breast Cancer Patients Present Following COVID-19 Early Peak in a Breast Cancer Center in Turkey?
    (GALENOS YAYINCILIK, 2021-01-01) Isiklar, Aysun Dauti; Deniz, Cem; Soyder, Aykut; Guldogan, Nilgun; Yilmaz, Ebru; Basaran, Gul
    Objective: Coronavirus disease 2019 (COVID-19) has placed an unprecedented burden on healthcare systems and restricted resources for non-COVID patients worldwide. Treatment approaches and follow-up plans have been modified to prevent the risk of infection for patients and healthcare workers. Patients prefer to delay or cancel their treatments during the peak period of infection. Materials and Methods: We retrospectively reviewed the characteristics of patients with breast cancer who were consulted at our outpatient clinic right after early COVID-19 peak in May and June 2020 and compared them with the same period in 2017 to 2019. Results: The number of patients who consulted at our outpatient medical oncology clinic declined in May and June 2020. This decline was regardless of stage and was larger in May than in June 2020. In general, the distribution of tumor subtypes {[}luminal, human epidermal growth factor receptor 2 (HER-2) positive, and triple negative] was not different from 2017 to 2020. Less than half of the patients received adjuvant chemotherapy following early COVID-19 peak in May and June 2020. Few patients received chemotherapy for metastatic disease, whereas many metastatic patients received endocrine therapy. None of the consulted new patients had a non-invasive disease. More patients received endocrine therapy than chemotherapy. Conclusion: The presentation patterns of patients with breast cancer after early COVID-19 peak differed from those during the same period in the last 3 years. The pandemic affected the number of new patients consulted and the way medical oncologists treat their patients.
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    What Has Changed in Patients Aged 65 and over Diagnosed with Breast Cancer during the COVID-19 Pandemic: A Single-Center Experience
    (KARGER, 2022-01-01) Soyder, Aykut; Guldogan, Nilgun; Isiklar, Aysun; Aribal, Erkin; Basaran, Gul
    Introduction: The COVID-19 pandemic has a worldwide negative impact on healthcare systems. This study aims to determine how the diagnosis, clinicopathological features, and treatment approaches of patients with breast cancer (BC) diagnosed at >= 65 years old were affected during the pandemic. This survey has shown that patients, especially the elderly, had to postpone their BC health problems or delay their routine controls due to the risk of COVID-19 transmission, high mortality rates due to comorbidity, and restrictions. Materials and Methods: The medical records of 153 patients with BC diagnosed at >= 65 years old before (January-December 2019
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    Favorable locoregional control in clinically node-negative hormone-receptor positive breast cancer with low 21-gene recurrence scores: a single-institution study with 10-year follow-up
    (BMC, 2022-01-01) Uras, Cihan; Cabioglu, Neslihan; Tokat, Fatma; Er, Ozlem; Kara, Halil; Korkmaz, Taner; Bese, Nuran; Ince, Umit
    Background Recent studies have shown a lower likelihood of locoregional recurrences in patients with a low 21-gene recurrence score (RS). In this single-institution study, we investigated whether there are any associations between different cutoff values of 21-gene RS, histopathological factors, and outcome in patients with long-term follow-up. Methods The study included 61 patients who had early-stage (I-II) clinically node-negative hormone receptor-positive and HER2-negative breast cancer and were tested with the 21-gene RS assay between February 2010 and February 2013. Demographic, clinicopathological, treatment, and outcome characteristics were analyzed. Results The median age was 48 years (range, 29-72 years). Patients with high histologic grade (HG), Ki-67 >= 25\%, or Ki-67 >= 30\% were more likely to have intermediate/high RS (>= 18). Based on the 21-gene RS assay, only 19 patients (31\%) received adjuvant chemotherapy. At a median follow-up of 112 months, 3 patients developed locoregional recurrences (4.9\%), which were treated with endocrine therapy alone. Among patients treated with endocrine treatment alone (n = 42), the following clinicopathological characteristics were not found to be significantly associated with 10-year locoregional recurrence free survival (LRRFS): age < 40 years, age < 50 years, high histological or nuclear grade, high Ki-67-scores (>= 15\%, >= 20\%, >= 25\%, >= 30\%), presence of lymphovascular invasion, luminal-A type, multifocality, lymph node positivity, tumor size more than 2 cm, RS >= 18, and RS > 11. However, patients with RS >= 16 had significantly poorer 10-year LRRFS compared to those with RS < 16 (75\% vs. 100\%, respectively