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Purpose: Concurrence of medullary and papillary thyroid carcinoma (MTC and PTC) represents less than 1% of all thyroid malignancies. We aimed to reveal the demographic and clinical characteristics of this rare pathology and to evaluate the effect of the same or contralateral lobular localization of these two malignancies in clinical and laboratory features. Evaluation of progression-free survival (PFS) in current pathology is one of the important features of our study. Methods: All patients diagnosed with simultaneous MTC and PTC after thyroidectomy were evaluated retrospectively. Data on the following variables were recorded: age, gender, tumor localization (ipsilateral lobe located MTC and PTC-Group I, contralateral lobe located MTC and PTC-Group II), tumor size, cervical lymph node metastasis, distant metastasis, tumor stage, postoperative basal calcitonin, carcinoembryonic antigen, thyroglobulin (Tg), and anti-Tg values. In all our cases, since MTC progressed before PTC, progression was accepted as serum calcitonin values exceeded 150 pg/mL. Results: Groups were formed as follows: Group I, four cases where MTC and PTC were localized in different foci in the same lobe; Group II, nine cases where they were localized in different lobes. There was only one case in which two tumors were located in the same focus. The case with dual differentiation was included in Group I (35. 7%). When the PFS of the two groups were compared, no statistically significant difference was found (P = 0.87). Conclusions: As a result of this analysis, the location of the simultaneously detected PTC in the same or different lobes with the MTC does not make a significant difference in clinical and laboratory features. [ABSTRACT FROM AUTHOR]

Objectives: The aim of this study was to investigate the role of superb microvascular imaging (SMI) and shear wave elastography (SWE) in the prediction of malignancy and invasiveness of isolated microcalcifications (MC) that can be visualized by ultrasonography (US). Material and Methods: Sixty‐seven women with MC, who were considered suspicious on mammography were evaluated. Only those lesions that could be visualized by US and presented as non‐mass lesion were included. They were evaluated by B‐mode US, SMI, and SWE before US‐guided core‐needle biopsy. B‐mode US, SMI (vascular index (SMIvi)), and SWE (E‐mean, E‐ratio) findings were compared with histopathologic features. Results: Pathology confirmed 45 malignant (21 invasive and 24 in situ carcinomas) and 22 benign lesions. There was a statistically significant difference between malignant and benign groups in terms of size (P =.015), distortion (P =.028), cystic component (P <.001), E‐mean (P <.001), E‐ratio (P <.001), and SMIvi (P =.006). For differentiation of invasiveness E‐mean (P =.002), E‐ratio (P =.002), and SMIvi (P =.030) were statistically significant. According to ROC analysis E‐mean (cut‐off point at 38 kPa) was the most sensitive (78%) and the most specific (95%) value among four numeric parameters (size, SMI, E‐mean, and E‐ratio) with AUC = 0.895, PPV = 97%, and NPV = 68% in detecting malignancy. In the evaluation of invasiveness, the most sensitive (71.4%) method was SMI (cut‐off point at 3.4) and the most specific (72%) method was E‐mean (cut‐off point at 91.5 kPa). Conclusion: Our study shows that adding SWE and SMI to the sonographic evaluation of MC would be an advantage for US‐guided biopsy. Including suspicious areas according to SMI and SWE in the sampling area can help target the invasive part of the lesion and avoid underestimation of core biopsy. [ABSTRACT FROM AUTHOR]

The study is an investigation of aggressive tumor features, prognosis, and disease-specific mortality rates of differentiated thyroid cancer (DTC) in the presence of concomitant Hashimoto's Thyroiditis (HT). The data of patients with DTC followed in our tertiary care center between 2000–2022 were analyzed. Variables such as patient age, gender, preoperative serum autoantibody levels, tumor characteristics, and treatment modalities were obtained from medical records. The diagnosis of HT was based either on the presence of a positive result in the pathological examination and/or on antibody positivity. A total of 637 patients [mean±SD age, 44.9±13.5 years; 485 women [76.1%)] were included in the analysis. The overall prevalence of coexistent HT was 22.9% (n=146). The disease-specific mortality associated with DTC was 2.9%. DTC patients with HT compared to those without; have more positive lymphovascular invasion (p<0.001), and lymph node metastases (p<0.001). According to the Kaplan–Meier curves, disease-specific survival rates among DTC patients without HT were significantly higher than patients with HT (log-rank p=0.002). The disease-specific mortality rate was 4.79% in DTC patients with HT, it was 1.43% in those without HT. Hashimoto thyroiditis was not associated with a 10-year recurrence-free survival (p=0.059). Differentiated thyroid cancers with concomitant HT are associated with some aggressive tumor features (such as lymphovascular invasion and nodal metastasis) and lower survival. In staging systems based on tumor risk factors, it may be useful to evaluate the presence of concomitant HT as a prognostic factor. [ABSTRACT FROM AUTHOR]

Introduction. This study aimed to examine the incidence of incidental papillary microcarcinoma (PMC) and papillary thyroid carcinoma (PTC) in patients with benign multinodular goiter (MNG) and to compare their relationship with some prognostic factors from a new perspective. Methods. Bilateral total thyroidectomy (BTT) was used to evaluate the data of 716 patients who underwent a surgery for MNG. The prognostic data for these tumors and the relationship between patients with bilateral and multifocal tumors were evaluated using statistical tests. Results. Papillary carcinomas were detected in 201 patients, PMC in 134 of them, and PTCs in 67. Bilaterality was more common in patients with PTCs than in those with PMC. The incidence of bilaterality in male patients with PTC was statistically more common. The presence of intra-tumoral lymphocytes was higher in multifocal PTC cases than in unifocal PTC cases. Conclusion. The results revealed that the number of PMC s was high in incidental tumors, and patients with PTC with male sex, bilaterality, multifocality, and tumor capsule invasion were associated with poor prognosis. [ABSTRACT FROM AUTHOR]

Objective: To investigate the effectiveness of the different imaging modalities in detecting recurrence in breast cancer follow-up. Materials and Methods: Sixty-four women with recurrent breast cancer were examined between January 2020 and July 2022. Recurrency was divided into four categories: local; regional; second primary; and distant metastasis. The detectability of recurrent lesions with mammography (MG), ultrasound (US) and magnetic resonance imaging (MRI), was evaluated. In addition, recurrences that firstly appeared by positron emission tomography (PET) scan were recorded. Results: Twenty-seven (42.2%) recurrences were local, 10 (15.6%) were regional and 27 (42.2%) were second primary. Forty-six (71.9%) of them were determined to have invasive carcinoma, 8 (12.5%) were ductal carcinoma in situ, and 10 (15.6%) were axillary metastases. Eight (12.5%) of them were first diagnosed by PET-computed tomography/MRI. Among the available images performed, 78.7% could be detected pathologically by MG, 95.2% by US, and 100% by MRI. Distant metastasis associated with other types of recurrence was detected in 6 (9.4%) cases. Conclusion: MRI is the most powerful imaging modality in detecting recurrent breast cancer. With the addition of US to routine MG follow-up, a higher rate and early detection of recurrent cancers can be achieved. [ABSTRACT FROM AUTHOR]

Purpose: To investigate the strength of quantitative imaging and metabolic parameters in differentiating invasive breast carcinomas with elevated Ki‐67 levels. Materials and Methods: A total of 123 patients with 129 breast lesions confirmed as invasive breast carcinoma underwent shear wave elastography (SWE), superb microvascular imaging (SMI) and positron emission tomography (PET)/CT or MRI. Adler's grade (classifying the microvascularity into four types) and Vascular Index (VI) was obtained by SMI as microvascular parameters. In addition, the stiffness value (Emean) was evaluated in kilopascal by SWE. The average of consecutive measurements was recorded as mean VI and mean Emean. PET scan parameters were obtained as SUVmax and SULpeak. Lesions were divided into two groups according to the Ki‐67 expression, low as ≤14 and high as >14. Results: Adler's grading was the most correlated imaging parameter with high Ki‐67 expression (p < 0.05), while VI and Emean had poor correlation (p > 0.05). SUVmax and SULpeak indicated a significant linear correlation with Ki‐67 but a moderate correlation with the high levels of Ki‐67 (p < 0,001). The sensitivity of VI, Emean, SUVmax and SULpeak was 64.6%, 66.7%, 65.7%, and 66.7% when the cut‐off point was set to 5.25, 102.5, 6.59, and 2.63, respectively. SUVmax had the highest AUC value of 0.740, according to the ROC curve analysis. Conclusions: Our results suggest that the quantitative parameters obtained by advanced imaging methods may be useful in predicting the high proliferation in invasive breast carcinomas. But none of them is eligible to be used as an independent biomarker in distinguishing aggressive behavior. Nevertheless, as a noninvasive method, visual assessment of microvascular morphology using SMI increases the prognostic efficiency in invasive breast carcinomas. [ABSTRACT FROM AUTHOR]

Objectives: We aimed to investigate the contribution of mass CT density values to the diagnosis in the evaluation of the response of the local disease to the treatment during the treatment of breast cancer. Methods: 40 female patients histopathologically proven to have breast cancer, had routine Thorax CT at diagnosis and the treatment stage, and whose metabolic activity was known by PET CT were included.The mean mass densities were measured from malignant breast lesions at the time of diagnosis and after treatment through the Thorax CT examinations. Results: In our study, we found the mean mass density measurement values of breast cancer before treatment as 38.21 HU, and the average density measurement values after treatment as 20.54 HU. We showed that malignant mass densities were significantly reduced in the non-metabolic period after treatment. We found that thorax CT density values can be a guide in evaluating the response of malignant breast lesions to local treatment. Conclusion: In conclusion, adding a quantitative CT attenuation value to breast lesions examinations increases the diagnostic accuracy of malignant lesions. We have shown that malignant lesions show significantly higher attenuation on Thorax CT and attenuation values decrease in response to treatment. [ABSTRACT FROM AUTHOR]

Objectives: The aim of this study was to investigate the role of quantitative values obtained by superb microvascular imaging (SMI) and shearwave elastography (SWE) in the prediction of malignancy in intraductal papilloma‐like lesions (IDPL). Methods: In the study, 61 patients between the ages of 14 to 73 years (mean age 44) diagnosed with IDPL on ultrasound (US) examination between the years 2020 and 2021 were included. The B‐Mode US findings (shape, margins, size, echo pattern, and accompanying ductal dilatation), SMI vascular index (SMIvi), E‐mean, and SWE‐ratio values were recorded. Results: There was a statistically significant difference between malignant (n = 14) and benign (n = 47) groups in terms of symptoms (P =.005), size (P =.042), shape (P =.002), margins (P =.001), echogenicity (P =.023), microcalcifications (P =.009), SMIvi (P =.031), E‐mean (P <.005), and SWE‐ratio (P =.007). According to receiver operating characteristic (ROC) curve analysis, sensitivity, specificity, accuracy, area under the curve (AUC), positive predictive values (PPV), and negative predictive values (NPV) were 57.1%, 87.2%, 80%, 0.722, 57.1%, 87.2% for US; 71.4%, 49%, 55.7%, 0.692, 30.3%, 85.7% for SMIvi; 85.7%, 71%, 74%, 0.864, 46%, 94.3% for E‐mean, and 50%, 75.4%, 83%, 0.707, 91.5%, and 50% for SWE‐ratio, respectively. Best results were obtained when SMI and SWE values were used together, achieving a sensitivity, specificity, accuracy, AUC, PPD, NPD of 78.6%, 93.6%, 93.4%, 0.872, 91.7%, and 93.9%, respectively. Conclusions: The SMI and SWE examinations are successful in the differentiation of benign and malignant intraductal lesions. They complement each other and contribute to B‐mode US in managing IDPLs especially when used together. Our study is the first to compare the quantitative data of SWE and SMI in the differentiation of IDPLs. [ABSTRACT FROM AUTHOR]

Background: Expression of kallikrein-11 (KLK11) has been found to be related to the prognosis of various human cancer types but its physiological functions in the steps of breast cancer (BC) progression are still unknown. Materials and Methods: BC and adjacent normal breast tissue samples were collected from 28 patients. KLK11 expression levels were determined by real-time polymerase chain reaction for each sample and associations with known prognostic features were statistically analyzed. Results: Although there was slight up-regulation in tumor tissues overall, significant down-regulation of KLK11 expression in tumor tissue was observed in the elderly and in patients with perineural invasion. Furthermore, tumor size, grade, mitotic score, necrosis, calcification, lymphatic invasion, hormone receptor status and Ki67 expression were associated with altered KLK11 level. Conclusion: Changes in expression levels of KLK11, associated with patient characteristics, might be used as complementary data in order to predict clinical outcome and prognosis in BC. [ABSTRACT FROM AUTHOR]

Leukocyte diapedesis is an important process in breast cancer etiopathogenesis. Therefore, Junctional adhesion molecule-A (JAMA) and lymphocyte function-associated antigen-1 (LFA-1) genes are among potential candidate genes involved in breast cancer development. In the present study, JAM-A rs790056 (T>C), LFA-1 rs8058823 (A>G) and LFA-1 rs2230433 (C>G) gene variations and their associations with breast cancer risk were investigated in breast cancer patients and healthy subjects. The JAM-A and LFA-1 genotypes were determined in 108 breast cancer patients and 63 healthy controls with Polymerase Chain Reaction-Restriction Fragment Length Polymorphism (PCR-RFLP) assay. LFA-1 rs8058823 common AA genotype (χ2= 6.062, p= 0.014) and A allele frequency (p= 0.001) and LFA-1 rs2230433 rare GG genotype frequency (p= 0.048) was higher in the patient group compared with controls. The TA haplotype (JAM-A rs790056-T, LFA-1 rs8058823-A alleles) frequency was significantly increased in the patient group compared with controls (p= 0.0173), while the TG haplotype (JAM-A rs790056-T, LFA-1 rs8058823-G alleles) and CG haplotype (LFA-1 rs2230433-C, LFA-1 rs8058823-G alleles) frequencies were significantly lower in the patient group compared with controls (p= 0.0051 and p= 0.002, respectively). In addition, the TCG haplotype (JAM-A rs790056-T, LFA-1 rs2230433-C, LFA-1 rs8058823-G alleles) frequency was significantly lower in the patient group compared with controls (p= 0.0096). Haplotype analysis confirmed that the LFA-1 rs8058823 is more effective in breast cancer risk than LFA-1 rs2230433 and JAM-A rs790056. LFA-1 rs8058823 A allele may be related to breast cancer risk, influencing leukocyte diapedesis. Our findings indicate that functional gene variations associated with leukocyte diapedesis may affect breast cancer risk. [ABSTRACT FROM AUTHOR]

Introduction: Renal involvement in leprosy has previously been described in the literature and can include amyloidosis, glomerulonephritis, nephrosclerosis, tubulointerstitial nephritis, and granulomas. Aim: To evaluate renal involvement in Turkish patients with leprosy. Material and methods: In total, 32 patients with lepromatous leprosy but without any co-morbidities and 35 healthy control subjects were evaluated for renal involvement at the Elazig Training and Research Hospital in Turkey. The laboratory tests and radiological results concerning renal function were taken from both the patients' medical records and from current examinations. Results: The levels of creatinine, urea, and leukocyturia in the lepromatous leprosy patients were significantly higher than in the controls (p < 0.001, p < 0.001; p = 0.001, p < 0.01; p = 0.036, p < 0.05, respectively). No significant differences in the proteinuria, hematuria, sodium, or potassium levels were found between the leprosy and control groups (p > 0.05). On ultrasonographic examination, the prevalence of renal cortical cysts and renal cortical echogenicity in the leprosy patients was significantly higher than in the controls (p = 0.020, p < 0.05, respectively). There were no significant differences in terms of nephrolithiasis, parapelvic cysts, or hydronephrosis between the leprosy and control groups (p > 0.05). Conclusions: Evaluating the renal function in all leprosy patients is important to detect abnormalities and to prevent renal failure, which remains a potential cause of death in this disease. [ABSTRACT FROM AUTHOR]

The use of high-frequency ultrasound imaging in assessment of the neck abnormalities has led to the detection of various conditions in the general population. Inferior thyroid artery thrombosis is a very uncommon clinical condition, which might be misdiagnosed as a thyroid nodule. In this article, we present a case of a female patient who suffered from a sore throat presumably as a result of inferior thyroid artery thrombosis, which was imitating thyroid nodule. The diagnosis was made by gray-scale and color Doppler ultrasound. We aim to draw attention of physicians to this exceptionally uncommon diagnosis in onder to prevent probable biopsy. Our literature search via PubMed showed only one reported case about inferior thyroid artery thrombosis imitating a thyroid nodule. [ABSTRACT FROM AUTHOR]

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Natural products have been focused by researchers due to their important anticarcinogenic characteristics in the treatment of cancer with the slightest side effects possible. Propolis is one of the most prominent candidates among these natural products in terms of its anticancer features. In this study we aim to research the effects of Anatolian propolis on ER/PR-, HER-2/neu+ human breast cancer cell line SK-BR-3 with intent to clarify the molecular mechanism propolis in HER+ breast cancers in overview of whole genomic expression for the first time via a microarray experiment. Afterwards, microarray data was validated via real time PCR with the selected genes. After performing bioinformatic analysis via GeneSpring Software and String analysis, a 50 ^g/mL dose of propolis affected several pathways of HER-2 positive breast cancer cells including cell cycle, DNA repair and apoptosis especially at 48th hour exposure. In contrast, after exposure to 50 ^g/mL dose of propolis, up-regulated genes were detected at diverse pathways such as immune response, cell migration regulation, organization of cell-cell adhesion, etc. For this reason, we proposed that polyphenol-rich propolis can be used in the treatment of HER-2 positive breast cancer with characteristics of less toxic than the current treatment methods. [ABSTRACT FROM AUTHOR]

Purpose: The aim of this study wasto investigate whole-breast imaging findings (mammography, ultrasonography (US), magnetic resonance imaging (MRI),clinical, and histopathological findings of primary neuroendocrine carcinomas of the breast (NEC) and neuroendocrine differentiated breast cancers (NEBC).Methods: Patients withadiagnosis of breast cancer with histopathological neuroendocrine features between the years 2010 and 2021 were retrospectively screened.The lesions were divided into two main groups depending on staining with neuroendocrine markers (synaptophysin and chromogranin A). Those showing focal staining were categorized as NEBC while those with diffuse staining as NEC.The mammography, US, and MRI of the lesionswere reviewed in consensus by two breast radiologists in order to assess imaging featuresretrospectively according to the Breast Imaging Reporting and Data System (BI-RADS) 5th lexicon.The findings were compared with breast cancers without neuroendocrine features (BC-WNE) which were randomly selected from the same database.Results: A total of 105 lesions [NEBC (n = 44), NEC(n = 11), BC-WNE (n = 50)] were evaluated.Patients with neuroendocrine tumors were older (p < 0.001) than those with BC-WNE. Compared with BC-WNE tumors, radiological findings typical of malignancy such as irregular shape [NEBC (7/20); NEC(3/7) vs BC-WNE (35/43); p < 0.001], spiculation [NEBC (2/20); NEC(0/7) vs BC-WNE (21/43); p < 0.001], architectural distortion [(NEBC (3/24); NEC(0/9) vs BC-WNE (31/50); p < 0.001)], calcification [(NEBC (6/24), NEC(0/9) vs BC-WNE (n = 27/50); p = 0.001)] on mamography, non-parallel orientation to skin [(NEBC (n = 17/29), NEC(n = 4/9), BC-WNE (n = 35/42); p = 0.008)], acoustic shadowing [(NEBC (n = 12/29), NEC(1/9), BC-WNE (n = 29/42); p = 0.009)], axillary lymphadenopathy [(NEBC(n = 3/30), NEC(n = 1/9), BC-WNE (21/50); p < 0.001)]on US were less common features of the neuroendocrine carcinomas of breast. Aside from shape features, there was no significant difference in contrast pattern (p = 0.866), kinetic curve (p = 0.454) and diffusion restriction (p = 0.242) on MRI.Conclusion: Characteristic malignant imaging features, including irregular shape, spiculated margins, suspicious calcifications, and posterior acoustic shadowing, are uncommon in neuroendocrine carcinomas of breast. These carcinomas tend to show more benign imaging features when compared with BC-WNE. [ABSTRACT FROM AUTHOR]

Histologically aggressive micropapillary thyroid carcinomas (PTMC) subtypes are thought to be associated with an aggressive clinical course. However, evidence for unfavorable clinical outcomes in patients with aggressive PTMC subtypes is not clear. In this study, we intended to determine the difference in clinical outcomes between patients with aggressive and non-aggressive PTMC subtypes. In this multicenter cohort study, the computer-recorded clinical and histopathological data of patients who underwent thyroid surgery between January 2000 - January 2021 in 9 referral centers and were diagnosed as PTMC were analyzed. A total of 1585 patients [female 1340 (84.5%), male 245 (15.5%), mean age 47.9±11.63 years), with a mean follow-up time of 66.55±37.16 months], were included in the study. Ninety-eight cases were diagnosed as aggressive and 1487 as non-aggressive subtypes. Persistent/recurrent disease was observed in 33 (33.7% )and 41 (2.8%) patients with aggressive and non-aggressive subtypes (p<0.001). Diseases-free survival rates were markedly lower in patients with aggressive than in those with non-aggressive PTMC subtypes (66.3 vs. 94.8%, log-rank p<0.001). Moreover, in multivariate analysis, aggressive histology was an independent predictor of persistent/recurrent disease, after controlling for other contributing factors (HR 5.78, 95% CI 3.32-10, p<0.001). Patients with aggressive PTMC subtypes had higher rates of incomplete biochemical and structural response than patients with non-aggressive subtypes as well (p<0.001). Aggressive PTMC subtypes share many characteristics with histologically identical tumors>1 cm in size. Therefore, the histopathological subtype of PTMC should be taken into consideration to tailor a personalized management plan., Competing Interests: The authors declare that they have no conflict of interest., (Thieme. All rights reserved.)

Objective: To investigate the effectiveness of the different imaging modalities in detecting recurrence in breast cancer follow-up., Materials and Methods: Sixty-four women with recurrent breast cancer were examined between January 2020 and July 2022. Recurrency was divided into four categories: local; regional; second primary; and distant metastasis. The detectability of recurrent lesions with mammography (MG), ultrasound (US) and magnetic resonance imaging (MRI), was evaluated. In addition, recurrences that firstly appeared by positron emission tomography (PET) scan were recorded., Results: Twenty-seven (42.2%) recurrences were local, 10 (15.6%) were regional and 27 (42.2%) were second primary. Forty-six (71.9%) of them were determined to have invasive carcinoma, 8 (12.5%) were ductal carcinoma in situ, and 10 (15.6%) were axillary metastases. Eight (12.5%) of them were first diagnosed by PET-computed tomography/MRI. Among the available images performed, 78.7% could be detected pathologically by MG, 95.2% by US, and 100% by MRI. Distant metastasis associated with other types of recurrence was detected in 6 (9.4%) cases., Conclusion: MRI is the most powerful imaging modality in detecting recurrent breast cancer. With the addition of US to routine MG follow-up, a higher rate and early detection of recurrent cancers can be achieved., Competing Interests: Conflict of Interest: No conflict of interest was declared by the authors., (©Copyright 2023 by the the Turkish Federation of Breast Diseases Societies / European Journal of Breast Health published by Galenos Publishing House.)

Purpose: The purpose of this study was to retrospectively investigate the response to trastuzumab in breast cancer patients in terms of the potential roles of several oncogenic pathways (phosphatase and tensin homolog (PTEN) and phosphatidylinositol 3-kinase (PI3K)) in relation to HER2 status., Methods: Paraffin-embedded primary tumor tissues of 100 HER2 positive metastatic breast cancer patients who received trastuzumab were analyzed with immunohistochemistry for p85 (PI3K) and PTEN. The relationship between variables was tested via chi-square, Fischer's exact test and Mann-Whitney U test, where appropriate. Progression-free survival (PFS) and overall survival (OS) were calculated with the Kaplan-Meier method and survival curves of subgroups were compared with the log-rank test.   Results: The level of immunohistochemical expression of PI3K was 42%. Loss of PTEN was observed in 43% of the patients. PTEN-expressing tumors had statistically higher response rates for trastuzumab than tumors not-expressing PTEN (p=0.012). PI3K expression had no significant effect on trastuzumab response. Median PFS for PTEN-expressing and not-expressing tumors were 15.3 months (95% CI, 12.6-34) and 12.1 months (95% CI, 7.9-16.2), respectively (p=0.04). The level of PI3K expression had no effect on PFS and OS in our patient population., Conclusions: Loss of PTEN predicted poorer response to trastuzumab treatment and shorter PFS but not OS. We could not find an effect of PI3K expression on the above-mentioned parameters.

Objectives: Axillary lymph node status is one of the important prognostic factors in early-stage breast cancer. Despite the combined use of sonography, fine-needle aspiration, and sentinel lymph node (SLN) dissection, there is a gap between the potential effectiveness of those techniques and current success to determine the axillary lymph node status. The main aim of this study was to evaluate the baseline accuracy of shear wave elastography for differentiation of benign versus malignant SLNs in an ex vivo artifact-free environment., Methods: Thirty patients with breast cancer scheduled for SLN dissection were enrolled prospectively after informed consent and Institutional Review Board approval were obtained. After dissection, lymph nodes were embedded in ultrasound gel and examined with grayscale sonography and shear wave elastography. Findings were compared to histopathologic results., Results: A total of 64 SLNs obtained from the 30 patients were evaluated. Twelve of them (18.8%) were metastatic, and 52 (81.2%) were benign. The mean cortical thickness (benign versus metastatic, 1.6 versus 4.4 mm), short-axis length (4.63 versus 7.50 mm), cortical stiffness (10.7 versus 25.5 kPa), and hilar stiffness (7.5 versus 11.3 kPa) were statistically higher in metastatic lymph nodes (P ≤ .02). Area under the receiver operator characteristic curve values for these variables were 0.814, 0.768, 0.786, and 0.759, respectively. Cortical thickness was found to have the highest diagnostic performance, followed by cortical stiffness., Conclusions: Shear wave elastography can be used with grayscale sonography for evaluation of cases to decide on needle biopsy sampling. However, it cannot be used as a replacement for fine-needle aspiration or SLN dissection., (© 2016 by the American Institute of Ultrasound in Medicine.)

miRNA involvement has been observed in almost every type of cancer, including breast cancer. The etiology of abnormal expression of miRNAs in cancer is still not clearly understood. In order to obtain insight into miRNA de-regulation in breast cancer, we analyzed expression levels of five breast cancer-related miRNAs, miRNA21, miRNA155, miRNA19a, miRNA17-5p and let7a miRNA, in both malignant and neighboring non-tumoral paraffin-embedded tissues of 47 patients with invasive ductal breast cancer. The targeted miRNAs, and a reference snRNA, U6, were analyzed by real-time polymerase chain reaction. let7a Levels were significantly lower in patients with lymphatic invasion than in those without (p=0.047). miR21 was down-regulated in 93.3% of patients with necrosis [p=0.017 (Fisher's exact test (FE))], while at least one oncogenic miRNA was up-regulated in 87.3% of the patients with invasive ductal carcinoma [p=0.009 (FE)]. In addition, tumor-suppressor miRNA was down-regulated or unaltered in 65.8% of the patients with tumor grade 2 or 3 and in all with grade 1 [p=0.047 (FE)]. Based on this preliminary study, we suggest that these miRNAs, especially let7a and miRNA21, might be useful markers in follow-up of breast cancer and in prognosis., (Copyright© 2015 International Institute of Anticancer Research (Dr. John G. Delinassios), All rights reserved.)

Background: The present study aimed to evaluate the role of functional polymorphisms of apoptosis-associated Fatty acid synthase (FAS) and fatty acid synthase ligand (FASL) genes in bladder cancer susceptibility as first presentation in a Turkish population., Patients and Methods: Genotypes of 91 patients with bladder cancer and 101 healthy controls were evaluated for the polymorphism of FAS-1377 G/A and FASL-844 T/C genes by polymerase chain reaction and restriction fragment length polymorphism analysis., Results: The frequency of the FAS-1377 G allele was significantly higher in patients with bladder cancer compared to controls (p<0.001). A significantly increased risk for developing bladder cancer was found for the group bearing a T allele for FASL-844 compared to the homozygous FASL-844 CC genotype (p=0.027). FAS-1377 GG genotype and FASL-844 T allele were found to be independently associated with an increased risk of bladder cancer. Additionally, gene-gene interaction analysis revealed that the frequency of FAS-1377AA with FASL-844TC was significantly lower in patients with bladder cancer in comparison to those of controls (p<0.001). Extensive studies for gene-gene interaction are still needed., Conclusion: Our study provides new evidence that FAS-1377 G and FASL-844 T alleles may be used as low-penetrant risk factors for bladder cancer development in a Turkish population.

Secondary amyloidosis is a rare but serious complication of inflammatory bowel disease (IBD), generally seen in Crohn's disease. At least 1% of patients with Crohn's disease develop amyloidosis. In the literature, the time lapse between the onset of Crohn's disease and the diagnosis of amyloidosis has been reported to range from one to 21 years. In most patients, proteinuria heralded the onset of renal involvement from amyloid and occurred from three to 15 years after Crohn's disease diagnosis. In this case, we estimate secondary amyloidosis occurred before Crohn's disease or early Crohn's disease complication, based on the fact that hypoalbuminaemia and proteinuria was detected approximately one year after the start of gastrointestinal complaints.