Araştırma Çıktıları
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Item Has the COVID-19 Pandemic Affected Breast Cancer Stage and Surgical Volume?(FRONTIERS MEDIA SA, 2022-01-01) Kara, Halil; Arikan, Akif Enes; Dulgeroglu, Onur; Tutar, Burcin; Tokat, Fatma; Uras, CihanBackgroundThis study investigates the effects of COVID-19 on the breast cancer stage and the volume of breast cancer surgery in a specialized breast institute. MethodsData of 332 patients who were diagnosed and treated for breast cancer between December 2019 and November 2020 were evaluated retrospectively according to periods of pandemic. ResultsA significant decrease in the number of operations, especially upfront surgeries rather than surgeries after neoadjuvant chemotherapy, was detected in the early period of the COVID-19 pandemic. It was found that patients with complaints were mostly admitted during this period (p = 0.024). No statistical significance was found for age, sex, side of the tumor, type of tumor, surgery to breast, and axilla. Following the early period of the pandemic, it was observed that patients with mostly luminal, early-stage, and less axillary nodal involvement (p < 0.05) were admitted, and as a result, it was founded that upfront surgeries increased, although no change in TNM staging was observed. However, it did affect the decision of initial treatment. Thus, the number of upfront surgeries was significantly higher than the NCT group (p = 0.027) following the early period. ConclusionSurgical volume is significantly affected in the early period of the COVID-19 pandemic. To overcome overload due to delayed surgeries related to pandemics, some hospitals should be spared for oncological treatments. Following the early period, mostly luminal type, early-stage patients were admitted, probably because of increased self-awareness and short wave duration, but the breast cancer stage was not affected.Item Breast Surgery can be Performed Safely During the COVID-19 Pandemic: A Retrospective Single-Center Analysis(ISTANBUL TRAINING \& RESEARCH HOSPITAL, 2022-01-01) Arikan, Akif Enes; Kara, Halil; Dulgeroglu, Onur; Uras, CihanIntroduction: The Coronavirus disease-2019 (COVID-19) outbreak has affected the diagnosis and treatment of various diseases including breast cancer. This study aimed to investigate whether breast surgery can be performed safely during the COVID-19 pandemic. Methods: Patients who underwent surgery for breast cancer or suspicious breast lesions in the pre-pandemic, first wave, and second wave periods of the pandemic were evaluated retrospectively. Results: Data of 220 patients who underwent breast surgery were analyzed. No significant difference was found between the pre-pandemic, first wave, and second wave periods of the COVID-19 pandemic in terms of patient characteristics, complications, types of complication, Clavien-Dindo classification of complications, and complications requiring intervention. No COVID-19 related complication was also observed. Conclusion: Breast surgery can be performed safely in the COVID-19 pandemic. For safe surgery, appropriate precautionary measures against COVID-19 and COVID-19 screening should be initiated. COVID-19-free surgical pathway is also important for safe surgery. With the continuation of surgeries, fear of upstaging, subsequent requirement of more aggressive treatment for tumors, and post-pandemic overload can be prevented.Item Do prognosis and clinicopathological features differ in young early-stage breast cancer?(FRONTIERS MEDIA SA, 2022-01-01) Arikan, Akif Enes; Kara, Halil; Dulgeroglu, Onur; Erdogan, Esin Nur; Capkinoglu, Emir; Uras, CihanBackgroundBreast cancer is the most frequently detected cancer and the leading cause of cancer-related death in women. Although it is mostly seen in older patients, breast cancer affects women aged 24 to >70 years, with poorer prognosis in young patients. Young age remains a controversial topic in the literature. This study aimed to identify subtype differences and the effect of age on early-stage breast cancer outcomes. MethodsA total of 300 consecutive patients underwent surgery between 2011 and 2015 for early-stage breast cancer. Of these, 248 were eligible for this study and were divided into three groups: group Y (aged <= 35 years), group M (aged >35 and <= 45 years), and group E (aged >45 years). The clinical and pathological features and data related to recurrence, metastasis, and death were recorded. ResultsNo statistical differences were found between groups regarding histopathological features except for higher histological grade and Ki-67 levels in group M. Additionally, group Y recorded no progression (recurrence or metastasis) or death. Disease-free survival was 117.8 months (95\% CI 111.8-123.8) for group M, which was significantly shorter than that for group E (p < 0.001). Additionally, the hazard ratio (HR) for progression from group M to group E was 10.21 with significant difference (p = 0.003, 95\% CI 2.26-46.08). However, the HR of group Y to group E was 0.04, without significance (p = 0.788, 95\% CI 0.18-345 x 10(6)). The overall 5-year survival was 100\% in group Y, 98.8\% in group M, and 99.3\% in group E, without significance. ConclusionA very young age cannot be considered an independent risk factor for poor prognosis. Rather than age, histological grade and Ki-67 index are more important factors in early-stage breast cancer.