Araştırma Çıktıları
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Item Primary surgery in patients with de novo stage IV BC(2021-01-01) Soran, Atilla; Ozmen, Vahit; Ozbas, Serdar; Karanlik, Hasan; Muslumanoglu, Mahmut; Igci, Abdullah; Canturk, Zafer; Utkan, Zafer; Ozaslan, Cihangir; Evrensel, Turkkan; Uras, Cihan; Aksaz, Erol; Soyder, Aykut; Ugurlu, Umit; Col, Cavit; Cabioglu, Neslihan; Erdem, Ergun; Gurleyik, Gunay; Sezgin, EfeItem Correlations Between Oncotype DX Recurrence Score and Classic Risk Factors in Early Breast Cancer: Results of A Prospective Multicenter Study in Turkey(AVES, 2016-01-01) Ozmen, Vahit; Atasoy, Ajlan; Gokmen, Erhan; Ozdogan, Mustafa; Guler, Nilufer; Uras, Cihan; Ok, Engin; Demircan, Orhan; Isikkdogan, Abdurrahman; Cabioglu, Neslihan; Sen, Fatma; Saip, PinarObjective: Breast cancer is the most common malignancy among Turkish women and the rate of early stage disease is increasing. The Oncotype DX 21-gene assay is predictive of distant recurrence in ER-positive, HER2-negative early breast cancer. We aimed to evaluate the correlations between Recurrence Score (RS) and routine risk factors. Materials and Methods: Ten academic centers across Turkey participated in this prospective trial. Consecutive patients with breast cancer who had pT1-3, pN0-N1mic, ER-positive, and HER2-negative tumors were identified at tumor conferences. Both pre- and post-RS treatment decisions and physician perceptions were recorded on questionnaire forms. Correlations between RS and classic risk factors were evaluated using univariate and multivariate analyses. Results: Ten centers enrolled a total of 165 patients. The median tumor size was 2 cm. Of the 165 patients, 57\% had low RS, 35\% had intermediate RS, and 8\% had high RS, respectively. Multivariate analysis indicated that progesterone receptor (PR) and Ki67 scores were significantly related to RS. Conclusion: Oncotype DX Recurrence Score does not seem to have a significant correlation with the majority of classic risk factors, but it may have a correlation with PR score and Ki67 score.Item Poor Biological Factors and Prognosis of Interval Breast Cancers: Long-Term Results of Bahceehir (Istanbul) Breast Cancer Screening Project in Turkey(AMER SOC CLINICAL ONCOLOGY, 2020-01-01) Cabioglu, Neslihan; Guerdal, Sibel OEzkan; Kayhan, Arda; OEzaydin, Niluefer; Sahin, Cennet; Can, OEmuer; OEzcinar, Beyza; Aykuter, Goenuel; Vatandas, Guelcin; Aribal, Erkin; OEzmen, VahitPURPOSE 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 = 15Item Bahcesehir long-term population-based screening compared to National Breast Cancer Registry Data: effectiveness of screening in an emerging country(TURKISH SOC RADIOLOGY, 2021-01-01) Gurdal, Sibel Ozkan; Ozaydin, Ayse Nilufer; Aribal, Erkin; Ozcinar, Beyza; Cabioglu, Neslihan; Sahin, Cennet; Ozmen, VahitPURPOSE We aimed to show the effects of long-term screening on clinical, pathologic, and survival outcomes in patients with screen-detected breast cancer and compare these findings with breast cancer patients registered in the National Breast Cancer Registry Data (NBCRD). METHODS Women aged 40-69 years, living in Bahcesehir county, Istanbul, Turkey, were screened every 2 years using bilateral mammography. The Bahcesehir National Breast Cancer Registry Data (BMSP) data were collected during a 10-year screening period (five rounds of screening). BMSP data were compared with the NBCRD regarding age, cancer stage, types of surgery, tumor size, lymph node status, molecular subtypes, and survival rates. RESULTS During the 10-year screening period, 8758 women were screened with 22621 mammograms. Breast cancer was detected in 130 patientsItem Comparison of Qualitative and Volumetric Assessments of Breast Density and Analyses of Breast Compression Parameters and Breast Volume of Women in Bahcesehir Mammography Screening Project(GALENOS YAYINCILIK, 2020-01-01) Gemici, Aysegul Akdogan; Aribal, Erkin; Ozaydin, Ayse Nilufer; Gurdal, Sibel Ozkan; Ozcinar, Beyza; Cabioglu, Neslihan; Ozmen, VahitObjective: We aimed to compare visual and quantitative measurements of breast density and to reveal the density profile with compression characteristics. Materials and Methods: Screening mammograms of 1399 women between May 2014 and May 2015 were evaluated by using Volpara 4th and 5th version. First 379 mammograms were assessed according to ACR BI-RODS 4th- edition and compared to Volpara. We categorized the breast density in two subgroups as dens or non-dens. Two radiologists reviewed the images in consensus. Agreement level between visual and volumetric methods and volumetric methods between themselves assessed using weighted kappa statistics. Volpara data such as fibroglandular volume (FGV), breast volume (BV), compression thickness (CT), compression force (CF), compression pressure (CP) were also analyzed with relation to the age. Results: 1399 mammograms were distributed as follows: 12.7\% VDG1, 39.3\% VDG2, 34.1\% VDG3, 13.9\% VDG4 according to the 4th edition of VolparaItem Diagnostic Performance of AI for Cancers Registered in A Mammography Screening Program: A Retrospective Analysis(SAGE PUBLICATIONS INC, 2022-01-01) Kizildag Yirgin, Inci; Koyluoglu, Yilmaz Onat; Seker, Mustafa Ege; Ozkan Gurdal, Sibel; Ozaydin, Ayse Nilufer; Ozcinar, Beyza; Cabioglu, Neslihan; Ozmen, Vahit; Aribal, ErkinPurpose: To evaluate the performance of an artificial intelligence (AI) algorithm in a simulated screening setting and its effectiveness in detecting missed and interval cancers. Methods: Digital mammograms were collected from Bahcesehir Mammographic Screening Program which is the first organized, population-based, 10-year (2009-2019) screening program in Turkey. In total, 211 mammograms were extracted from the archive of the screening program in this retrospective study. One hundred ten of them were diagnosed as breast cancer (74 screen-detected, 27 interval, 9 missed), 101 of them were negative mammograms with a follow-up for at least 24 months. Cancer detection rates of radiologists in the screening program were compared with an AI system. Three different mammography assessment methods were used: (1) 2 radiologists' assessment at screening center, (2) AI assessment based on the established risk score threshold, (3) a hypothetical radiologist and AI team-up in which AI was considered to be the third reader. Results: Area under curve was 0.853 (95\% CI = 0.801-0.905) and the cut-off value for risk score was 34.5\% with a sensitivity of 72.8\% and a specificity of 88.3\% for AI cancer detection in ROC analysis. Cancer detection rates were 67.3\% for radiologists, 72.7\% for AI, and 83.6\% for radiologist and AI team-up. AI detected 72.7\% of all cancers on its own, of which 77.5\% were screen-detected, 15\% were interval cancers, and 7.5\% were missed cancers. Conclusion: AI may potentially enhance the capacity of breast cancer screening programs by increasing cancer detection rates and decreasing false-negative evaluations.Item 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, UmitBackground 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