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    Diagnostic utility of two-dimensional shear wave elastography to differentiate benign and malignant breast lesions
    (2019) Arslan, Serdar; Altunkeser, Aysegul; Durmaz, Mehmet Sedat; Eryilmaz, Mehmet Ali; Oncu, Fatih; Unlu, Yasar
    Aim: The aim of this study was to evaluate the diagnostic performance of two-dimensional shear wave elastography in the differentiation of malignant and benign breast lesions. Material and Methods: A total of 83 breast lesions in 76 patients were prospectively investigated with B-mode ultrasonography and two-dimensional shear wave elastography techniques. B-mode ultrasonography findings were classified based on BI-RADS lexicon 5th edition. The mean elasticity and the standard deviation of speed mode (m/s) and elasticity mode (kPa) were calculated for all breast lesions. Diagnostic performances of each quantitative parameters were compared. Results: Of 83 breast lesions, 45 (54.2%) were benign and 38 (45.7%) were malignant. Among the all shear wave elastography parameters, the standard deviation (ESD) of the shear wave speed (m/s) had the highest AUROC (0.953) value. When a cut-off value of 0.85 m/s was used for ESD of speed mode, sensitivity, specificity, accuracy, PPV, and NPV were detected as 94.7%, 88.8%, 91.5%, 87.8%, and 95.2%, respectively. Conclusions: Two-dimensional shear wave elastography has excellent diagnostic performance in the differentiation of benign and malignant breast lesions. The standard deviation (ESD) of speed modehad the best diagnostic performance when compared other quantitative parameters.
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    The importance of SUVmax in predicting prognosis of invasive breast carcinoma-no special types
    (2021) Eren Karanis, Meryem Ilkay; Erol, Mustafa; Unlu, Yasar
    Aim: We aimed to investigate the relationship between FDG uptake and clinicopathological characteristics of invasive breast carcinoma-no special type in the present study.Materials and Methods: One hundred seventy invasive breast carcinoma-no special type cases who underwent PET-CT before surgery between 2011-2019 were included in the study. The clinicopathological features and SUVmax of the patients were compared.Results: We observed a strong relationship between the size, grade, pathological stage groups and SUVmax of the tumors and revealed that the SUVmax increased as the size, grade, and pathological stage groups of the tumors increased (p0.001). Carcinomas with high Ki67 proliferation index and ER and PR negative carcinomas exhibited higher SUVmax (p0.001). Triple negative and HER2-enriched molecular subtypes had distinctly higher SUVmax than Luminal A and Luminal B ones (p0.001). HER2-enriched tumors, the cases that were 40 years old and advanced stage designated higher SUVmax (p0.05). Conclusion: It is observed that invasive breast carcinoma-no special type with good prognostic factors have low SUVmax, while carcinomas with poor prognostic features have high SUVmax. It can be suggested that PET/CT can be use to predict the prognosis of invasive breast carcinoma-no special type.
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    Our sentinel lymph node experience in patients diagnosed with DCIS and microinvasive breast carcinoma
    (2021) Bayramoglu, Zeynep; Omeroglu, Ethem; Koksal, Hande; Eryilmaz, Mehmet Ali; Unlu, Yasar
    Aim: Along with the increased availability of radiologic imaging methods, early identification of tumor tissue, and patient surveillance programs; ductal carcinoma in situ (DCIS) and microinvasive DCIS became more commonly identified in the tru-cut biopsy specimens and resected samples of patients. Pathological examinations of the excision materials from these patients reveal invasive tumors, microinvasions or DCIS alone. Recently, it has become debatable whether to perform a sentinel lymph node biopsy (SLNB) in patients diagnosed with DCIS or microinvasive DCIS. In this present study, we evaluated the diagnosis made by examining the excision material, any presence of lymph node metastases, and the relationship of hormone profile to the presence of metastases in the patients diagnosed with DCIS or microinvasive DCIS by the examination of tru-cut biopsy specimens. Based on our study results, we discussed the requirement for SLNB in patients with a tru-cut diagnosis of DCIS or microinvasive DCIS. Materials and Methods: The study included 172 patients, who underwent surgical excision and SLNB after receiving a tru-cut biopsy diagnosis of DCIS and microinvasive DCIS in our hospital from the year 2010 to 2018. Results: Tru-cut biopsy diagnoses were DCIS and microinvasive DCIS in 69.8% (120 patients) and 30.2% (52 patients) respectively. SLNB metastases were identified in 35.8% (n=43) of the DCIS positive patients and 44.2% (n=23) in the microinvasive DCIS positive patients. The diagnosis of invasive ductal carcinoma after mastectomy was made at a rate of 90.0% (n=108) among the DCIS positive patients and 92.3% (n=48) among the microinvasive DCIS positive patients. Conclusion: SLNB metastases were found in 35.8% (n=43) and 44.2% (n=23) of the DCIS positive patients and microinvasive DCIS positive patients, respectively. We conclude that SLNB should be favorably proper to perform in the patients with tru-cut diagnoses of DCIS and microinvasive DCIS because a high rate of SLNB metastases was detected in our DCIS and microinvasive DCIS patients and a high rate of invasive ductal carcinoma diagnosis was made after examining the excision material of these patients.
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    What GATA-3 told us in breast carcinoma? 2 Years of single tertiary center experience
    (2021) Ugur Kilinc, Ayse Nur; Omeroglu, Ethem; Bayramoglu, Zeynep; Unlu, Yasar
    Aim: Our study aims to find the relationship between the degree of GATA-3 expression in breast cancer and other prognostic factors such as ER, PR, HER-2, Ki67, and axillary metastasis. Materials and Methods: The cases in which GATA-3 immunohistochemical staining was applied to breast cancer tissues between 2018 and 2020 were detected. Immunohistochemically stained preparations of ER, PRG, GATA-3, Ki-67, and HER-2 of these cases were obtained from the hospital archive and evaluated by two pathologists. Results: As a result, GATA-3 was directly proportional to PR and ER and inversely proportional to Ki 67. GATA-3 expression was associated with a higher Ki-67 mitotic index compared to the percentage of ER and PR expression. Conclusion: According to the results of our study, indicating GATA-3 positivity and negativity as well as the degree of expression in the pathology reports of breast tumors will help the clinician in terms of differentiation and prognosis of the tumor. Finally, breast tumors with high GATA-3 loss should be evaluated as more primitive tumors and the patients with these tumors should be followed up more closely.