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Objective: In this retrospective study, chemotherapy induced amenorrhea in patients with early stage breast cancer and its effects on survival were investigated. Materials and Methods: Two hundred fifty-two patients received adjuvant chemotherapy without ovarian suppression treatment (OST) from 600 premenopausal patients were included in the study. Patients were divided into two groups; with amenorrhea and without, and compared with clinicopathologic features and survival. SPSS version 17 was used. Results: Chemotherapy-induced amenorrhea (CIA) was observed in 145 (57.5%) of 252 patients who received no OST during follow-up. The 5-year OS rate of patients with CIA was significantly higher than patients without CIA (p= 0.042, 95.9% vs. 89.7% vs. 158.88 vs. 135.33 months, respectively). In the subgroup analysis, the OS in patients with hormone receptor (+) was significantly higher than in those receptor (-) in patients with CIA (p=0.011, 97.5% vs. 90.9% vs. 162.13 vs. 126.16 months, respectively). The OS was significantly longer in the luminal A molecular subtype than in those with luminal B molecular subtype, in patients with CIA, but the difference was not significant in patients without CIA (p=0.027 vs. p=0.074, respectively). Conclusion: As a conclusion; survival advantage of the chemotherapy induced amenorrhea more pronounced with hormone receptor positivity, lymph node involvement, and advanced disease over patients who do not develop amenorrhea. This advantage of amenorrhea development further prolongs survival compared with luminal B in the luminal A molecular subtype. [ABSTRACT FROM AUTHOR]

Abstract: Objectives: In this study, they investigated whether mean thrombocyte volume (MPV) and MPV/platelet count ratio have a prognostic significance in advanced NSCLC or not. Methods: A total of 496 NSCLC patients at stage IIIB/IV and did not meet exclusion criteria were included in the study. The demographic features (age, gender, smoking habit), clinical characteristics (performance status, weight loss, disease stage, first‐line treatment regimen), laboratory tests (levels of hemoglobin, lactate dehydrogenase and calcium as well as MPV, MPV/platelet count ratio and counts of white blood cell, platelet), and histological features (histologic type, tumor grade) were recorded. Results: The MPV levels of all patients were determined as 10.2 {plus minus} 3.4 (range, 6.4‐14.1 fL). With ROC curve analysis, the MPV/PC ratio was associated with a sensitivity of 67.8% and a specificity of 84.8% at a cutoff value of 0.47424 for presence of brain metastasis at the time of diagnosis. Univariate analysis showed that OS was significantly shorter in the group with an increased MPV level than in the other group (median OS time 6.8 months vs. 11.5 months, log‐rank, P = .032). Multivariate analysis confirmed that an increased MPV level was an independent poor prognostic factor for OS (HR: 1.704, 95% CI: 1.274‐3.415, P = .014). Conclusions: Unlike results of previous studies, the study showed that increased MPV was an important prognostic factor in patients with NSCLC. Hence, an increased MPV level may be used as a prognostic biomarker to estimate for poor overall survival in patients with NSCLC. [ABSTRACT FROM AUTHOR]

Objective: The aim of this study was to determine the roles of biopsychosocial risk factors in the development of breast cancer. Materials and methods: This hospital-based case-control study included 491 women with breast cancer (study group) and 512 women who did not have cancer or other serious diseases (control group). Biological, psychological, and social risk factors were compared between the two groups. Data were collected using the semi-structured interview, the Stress Assessment Form, and the Coping Strategy Indicator to assess these factors. Results: When the significantly different biopsychosocial variables between the study and the control groups were evaluated together, independent breast cancer risk factors were found as follows: a stressor experienced in the last 5 years, age 40 years and older, inadequate social support perception, use of avoidance coping strategy, being a housewife, having a family history of cancer, and having a body mass index ≥25. Conclusion: This study showed a relationship between breast cancer risk and manageable variables (obesity, stressor and coping strategy, social support, and employment status), age and family history of cancer, which are biopsychosocial factors. Biopsychosocial aspects are becoming a greater part of many different healthcare systems. [ABSTRACT FROM AUTHOR]

Purpose: The correlation between imaging findings and pathologic characteristics of tumors may provide information for diagnosis and treatment of cancer. The aim of this study is to determine whether ultrasound features of breast cancer are associated with molecular subtype, histologic grade, and hormone receptor status, as well as assess the predictive value of these features. Methods: A total of 201 consecutive invasive breast cancer patients were reviewed from the database according to the Breast Imaging and Reporting Data System (BI-RADS). Tumor margins were classified as circumscribed and noncircumscribed. Noncircumscribed group was divided into indistinct, spiculated, angular, and microlobulated. The posterior acoustic features were divided into four categories: shadowing, enhancement, no change, and mixed pattern. Results: Tumors with posterior shadowing were more likely to be of nontriple negative subtype (odds ratio [OR], 7.42; 95% CI, 2.10-24.99; P = 0.002), low histologic grade (grade 1 or 2 vs. grade 3: OR, 2.42; 95% CI, 1.34-4.35; P = 0.003) and having at least one positive receptor (OR, 3.36; 95% CI, 1.55-7.26; P = 0.002). Tumors with circumscribed margins were more often triple-negative subtype (OR, 6.72; 95% CI, 2.56-17.65; P < 0.001), high grade (grade 3 vs. grade 1 or 2: OR, 5.42; 95% CI, 2.66-11.00; P < 0.001) and hormone receptor negative (OR, 4.87; 95% CI, 2.37-9.99; P < 0.001). Conclusion: Sonographic features are strongly associated with molecular subtype, histologic grade, and hormone receptor status of the tumor. These findings may separate triple-negative breast cancer from other molecular subtypes. [ABSTRACT FROM AUTHOR]

Integrated positron-emission tomography-magnetic resonance imaging (PET-MRI) is a new hybrid simultaneous imaging modality with higher soft tissue contrast and lower radiation doses compared with PET-CT. Two patients who were referred to our hospital with left breast masses that were pathologically diagnosed as invasive ductal carcinoma. The women were then scanned using the first PET-MRI system in Turkey, which was established in our department. In this case report, we aimed to determine the advantages of PET-MRI in staging, follow-up, neoadjuvant chemotherapy response, and to compare the usefulness of this modality with PET-CT and dynamic contrast-enhanced breast MRI. [ABSTRACT FROM AUTHOR]

Objective: The study aims to determine the relationship between dietary characteristics of breast cancer patients and tumor. Materials and Methods: Cases with breast cancer treatment in remission were included in the study group and randomly selected healthy women were included in the control group. Demographic (gender, age, marital status, educational status) and anthropometric characteristics (height, weight, body mass index (BMI) were recorded face to face with all women included in the study. The frequency of nutrient consumption was questioned in order to determine the daily average amounts of energy and nutrients taken in the diet and exercise status was questioned to determine the frequency of physical activity. Results: In the study group (n=98), the mean follow-up period was 45 months (±31.7 months) with a median age similar to those in the control group (n=85) [47.5 (24-79) vs. 47 (23-79) years]. There was no significant difference in the body mass indexes of the two groups (p>0.05). In patients with breast cancer, mean carbohydrate percentage from daily energy intake was lower (p=0.00), while fat amount (p=0.00), fat percentage (p=0.003), monosaccharide (p=0.00), glucose (p=0.007), fructose (p=0.002), omega3 (n3) (p=0.013), saturated fat (p=0.57), monounsaturated fat (p=0.00), vitamin A (p=0.50), vitamin C (p=0.42), vitamin E (p=0.49), vitamin B6 (p=0.34), biotin (p=0.10) and copper (p=0.02) values were higher and the results were statistically significant (p<0.05). It was found that 59.8% of the breast cancer patients had more exercise, but the effect of exercise on BMI was not significant (p>0.05). No significant correlation was found between the receptor positivity, histological subtype, Ki 67 positivity rate and the amount of nutrient consumption (P> 0.05). Recurrence was observed in 7 patients (7.1%) during the follow-up period and hormone receptor levels (ER) and vitamin B2 intake in the multivariate reduced model (accuracy 93.9%) were inversely related to the recurrence of the disease (p=0.02). Conlusion: No relationship was found between the dietary habits of breast cancer patients and the characteristics of the tumor. While the percentage of carbohydrate taken with daily diet was lower in breast cancer patients, total fat amounts taken with diet, n3, saturated fatty acid, monounsaturated fatty acid, monosaccharide, glucose, fructose, water-soluble fiber, vitamin B6, biotin and copper values were found to be higher. Further studies are needed for vitamin B2 deficiency in patients with recurrence. [ABSTRACT FROM AUTHOR]

Objective: The aim of our study is to detect factors related with local recurrence in patients treated for in situ breast cancer. Materials and Methods: The patients treated with the diagnosis of DCIS between 1998 and 2018 in our breast center included the study. Kaplan-Meier method and Cox regression was used for statistical analyses. Statistical analyses was performed with SPSS 22.0 Results: Median age was 49 (28-82). Median floow-up 83 (12-244). Thirtyfive patients underwent mastectomy whilst 233 breast conserving surgery. One hundered seventy six patients underwent sentinel lymph node biopsy, 9 patients axillary dissection. No axillary surgery for 53 patients. One hundered ninety three patients underwent radiation theraphy following surgery and 169 patients got hormonal theraphy. Median surgical margin width was 10 (0-25) mm. During our follow up 11 patients developed local recurrence. Three of them was DCIS, 8 were invasive cancer. Contralateral breast cancer occurred in 4 patients. Two patients were lost duo to reasons not related with breast cancer. Five years disease free survival was 97%, 10 years disease free survival was 91%. Five years local recurrence free survival was 99%, 10 years local recurrence free survival was 93%. In multivariate analyses age at diagnosis (=40 vs>40)(p=0.004, HR: 7.1; 95% CI:1.85-27.2), surgical margin width (both =2mm vs >2mm and =3mm vs >3mm)(p=0.01, HR:5.4;95% CI: 1.5-19.5, p=0.03, HR:4.1;95% CI: 1.14-15.1 respectivly) and tumor size (p=0.005, HR;1.033; 95% CI: 1.01-1.05)were significantly related with local recurrence. In multivariate analyses tumor size (p=0.029, HR: 1.033; 95% CI:1.003-1.006) and margin width (both =2mm vs >2mm and =3mm vs >3mm) (p=0.003, HR:10.24; 95% CI: 2.1-48.3, p=0.01, HR:7.6;95% CI: 1.61-35.7 respectivly) detected as significantly related with local recurrence. Conclusion: In our study tumor size and surgical margin width were detected as independent factors significantly related with local recurrence. =3mm surgical margin width was found to have an independent effect on local recurrence together with =2 mm surgical margin accepted in the current literature. [ABSTRACT FROM AUTHOR]

Objective: The aim of this study is to investigate the effect of systemic chemotherapy on Anti-Müllerian Hormone levels, antral follicle counts and ovarian volumes in patients with breast cancer. Materials and Methods: The effects of different chemotherapy regimens on anti-müllerian hormone levels, antral follicle counts and mean ovarian volumes in terms menstrual cycles resumption and chemotherapy induced amenorrhea were investigated in 3-month periods. Results: Seventy-one patients were eligible for the study. Median age was 38 years (ranging from 23 to 51 years) and median follow-up was 37 months (ranging from 20 to 51 months). Anti-müllerian hormone levels before chemotherapy (median: 1.520 vs. 0.755, p=0.001), at the end of first year (median: 0.073 vs. 0.010. p=0.030) and pre-treatment antral follicle counts (median 12 vs. 4.50. p=0.026) was lower in patients with chemotherapy induced amenorrhea compared to those without. In the multivariate logistic regression analysis, anti-müllerian hormone levels (OR: 0.273, 95% CI 0.102-0.733, p=0.010) and antral follicle counts (OR: 1.180. 95% CI; 1.016-1.369, p=0.030) before systemic chemotherapy were the most valuable and earliest factors to predict chemotherapy induced amenorrhea. There were no significant relationships between age of the patients (=30 vs. >30), BMI (30 vs. >30), systemic chemotherapy regimen and number of cycles (4 vs. >4) and chemotherapy induced amenorrhea (p>0.05). Conclusion: Systemic chemotherapy significantly decreases anti-müllerian hormone levels and antral follicle counts independently of chemotherapeutic agents in patients with breast cancer. The low anti-müllerian hormone levels and fewer antral follicle counts before systemic chemotherapy predict chemotherapy induced amenorrhea. [ABSTRACT FROM AUTHOR]

Objective: Tumour-infiltrating lymphocytes (TILs) have been determined as a new prognostic indicator of immunotherapy response in breast cancer (BC). The aim of this study is to investigate the effectiveness of imaging features in predicting the TIL levels in invasive BC patients. Materials and Methods: A total of 158 patients with invasive BC were included in our study. All lesions were evaluated based on the BIRADS lexicon. US was performed for all the patients and 89 of them underwent MRI. The histologic stromal TIL (sTIL) levels were assessed and associations between the sTIL levels and imaging features were evaluated. Results: Tumours with high sTIL levels had more circumscribed margins, round shape, heterogenous echogenicity and larger size on ultrasonography (p<0.005). There was a statistically significant positive correlation between the sTIL levels and ADC value (p<0.001). Tumours with high sTIL levels had significantly more homogeneous enhancement than the tumours with low sTIL levels (p=0.001). Logistic regression analysis showed that the ADC was the most statistically significant parameter in predicting the sTIL levels (the odds ratio was 90.952; p=0.002). The optimal cut-off value for ADC in predicting low and high sTIL levels was found to be 0.87×10-3 mm2 s-1 (AUC=0.726, 73% specificity and 60% sensitivity). Conclusion: Imaging findings, especially the ADC, may play an important role in predicting the sTIL levels as a non-invasive method and improve the accuracy of biopsy results in uncertain situations, giving an opportunity for optimal therapeutic management and prognosis estimation. [ABSTRACT FROM AUTHOR]

Objectives: In this study, they investigated whether mean thrombocyte volume (MPV) and MPV/platelet count ratio have a prognostic significance in advanced NSCLC or not., Methods: A total of 496 NSCLC patients at stage IIIB/IV and did not meet exclusion criteria were included in the study. The demographic features (age, gender, smoking habit), clinical characteristics (performance status, weight loss, disease stage, first-line treatment regimen), laboratory tests (levels of hemoglobin, lactate dehydrogenase and calcium as well as MPV, MPV/platelet count ratio and counts of white blood cell, platelet), and histological features (histologic type, tumor grade) were recorded., Results: The MPV levels of all patients were determined as 10.2 {plus minus} 3.4 (range, 6.4-14.1 fL). With ROC curve analysis, the MPV/PC ratio was associated with a sensitivity of 67.8% and a specificity of 84.8% at a cutoff value of 0.47424 for presence of brain metastasis at the time of diagnosis. Univariate analysis showed that OS was significantly shorter in the group with an increased MPV level than in the other group (median OS time 6.8 months vs. 11.5 months, log-rank, P = .032). Multivariate analysis confirmed that an increased MPV level was an independent poor prognostic factor for OS (HR: 1.704, 95% CI: 1.274-3.415, P = .014)., Conclusions: Unlike results of previous studies, the study showed that increased MPV was an important prognostic factor in patients with NSCLC. Hence, an increased MPV level may be used as a prognostic biomarker to estimate for poor overall survival in patients with NSCLC., (© 2017 John Wiley & Sons Ltd.)

Objective: The effect of estrogen on bone mineral density (BMD) and breast cancer has been known for a long time. The aim of this study was to compare of the BMD of patients with breast cancer and healthy individuals, and to investigate the degree of correlation of estrogen receptor (ER) with BMD., Materials and Methods: Seventy-one patients with postmenopausal breast cancer and 79 healthy dividuals were included in the study. The patient demographics (age, menopause age, body mass index, number of children, BMD, Z scores, and estrogen status for breast cancer patients) were taken from hospital records., Results: No significant difference was detected between the case and control groups in lumbar region Z scores (p=0.074). At the femur neck, the control group Z scores was higher than patient group (p=0.002). BMI was higher in the patients with breast cancer (p=0.001). There was no statistically significant correlation between ER positivity, BMD, and BMI in ER-positive patients (p=0.495, p=0.8, p=0.846, respectively). There was no difference between the Z scores when the patients were divided into two groups as ER positive and negative (p=0.156, p=0.335, respectively)., Conclusion: This study revealed that there is no difference in lumbar region Z scores between patients with breast cancer and heathy controls; however, the Z scores were higher in the femur neck in the control group, and the BMI was lower in the patient group. Tumor ER positivity does not positively affect BMD., Competing Interests: Conflict of Interest: No conflict of interest was declared by the authors.