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Öğe Fine needle aspiration cytology of inflammatory myofibroblastic tumour (inflammatory pseudotumour) of the breast: a case report and review of the literature(Blackwell Publishing, 2007) Akbulut, M.; Gunhan-Bilgen, I.; Zekioglu, O.; Duygulu, G.; Oktay, A.; Ozdemir, N.Öğe High-Grade Ductal Carcinoma in Situ of the Breast with Regressive Changes: Radiological and Clinicopathological Findings(Galenos Publishing House, 2023) Gursoy, M.; Oktay, A.; Aslan, O.; Zekioglu, O.Objective: Tumour regression is defined as continuity of changes leading to the elimination of a neoplastic population and is reflected as periductal fibrosis and intraductal tumour attenuation. The aim of this study was to describe the radiological and clinicopathological characteristics of high-grade breast ductal carcinoma in situ (DCIS) with regressive changes (RC). Materials and Methods: Thirty-two cases of high-grade DCIS with RC on biopsy specimens followed by excision were included. The mammographic, ultrasonographic (US), and magnetic resonance imaging (MRI) findings of cases were retrospectively reviewed according to the breast imaging reporting and data system (BI-RADS) lexicon. Clinical and histopathological findings [comedonecrosis, estrogen receptor (ER), progesterone receptor (PR), human epidermal growth factor receptor 2 (HER2) status and Ki-67 proliferation index] were recorded. The rate of upgrade to invasive cancer after surgical excision and lymph node involvement were evaluated. Results: The most common mammographic finding was microcalcifications alone (68.8%). The most frequently seen findings on US were microcalcifications only (21.9%), followed by microcalcifications and hypoechoic area (18.7%). On MRI, most lesions presented as clumped non-mass enhancement with segmental distribution. ER/PR negativity (53.1%, 65.6%), HER2 positivity (56.3%) and high Ki-67 (62.5%), which are known to be associated with more aggressive behavior, were found to be proportionally higher. The rate of upgrade to invasive cancer was 21.8%. Conclusion: DCIS with RC lesions present most often as microcalcifications alone on both mammography and US. MRI features are not distinguishable from those of other DCIS lesions. DCIS with RC lesions show biomarker status reflecting more aggressive behavior and high upgrade rate to invasive cancer. © Copyright 2023 by the Turkish Federation of Breast Diseases Societies / European Journal of Breast Health published by Galenos Publishing House.Öğe Mammographic features of local recurrence after conservative surgery and radiation therapy: Comparison with that of the primary tumor(Sage Publications Ltd, 2007) Guenhan-Bilgen, I.; Oktay, A.Purpose: To compare the mammographic features of recurrent breast cancer with those of the primary tumor and to determine whether certain mammographic features are associated with a higher risk of local recurrence after breast-conserving therapy. Material and Methods: A retrospective review of mammograms of 421 patients who were treated with conservative surgery and radiotherapy revealed 41 recurrent tumors. Mammographic findings, location, and histopathologic characteristics were retrospectively compared between primary and recurrent tumors. Results: Recurrent tumors were similar in mammographic appearance to primary tumors in 27 (66%) cases. Of 27 primary tumors that occurred as masses without calcifications, 19 (70%) recurred as a mass, and of the six isolated calcifications, five (83%) recurred with calcifications. Ten (53%) of the 19 recurrent masses and five (100%) of the five recurrent calcifications had morphologic features that were similar to those of the primary tumor. Ninety-two percent (11/12) of the recurrences containing microcalcifications ( isolated or associated with a mass) had microcalcifications in their primary tumor. Of 27 masses that recurred, the morphology of the primary tumor was obscured in 13 (48%), ill defined in 10 (37%), and spiculated in four (15%) of the masses. Seventy-six percent (31/41) of recurrences were within the lumpectomy quadrant. In 25 (61%) cases, the histologic findings from the primary tumor and the recurrence were identical. Conclusion: The majority of recurrent tumors appear to be mammographically similar to primary tumors. Therefore, it is important to review preoperative mammograms during follow-up of these patients. Although the study population is small, it was noted that mass with spiculated contour is associated with a lower risk for local recurrence.Öğe Prediction of malignancy upgrade rate in high-risk breast lesions using an artificial intelligence model: a retrospective study(Galenos Publishing House, 2023) Aslan, Ö.; Oktay, A.; Katuk, B.; Erdur, R.C.; Dikenelli, O.; Yeniay, L.; Zekioğlu, O.PURPOSE High-risk breast lesions (HRLs) are associated with future risk of breast cancer. Considering the pathological subtypes, malignancy upgrade rate differs according to each subtype and depends on various factors such as clinical and radiological features and biopsy method. Using artificial intelligence and machine learning models in breast imaging, evaluations can be made in terms of risk estimation in different research areas. This study aimed to develop a machine learning model to distinguish HRL cases requiring surgical excision from lesions with a low risk of accompanying malignancy. METHODS A total of 94 patients who were diagnosed with HRL by image-guided biopsy between January 2008 and March 2020 were included in the study. A structured database was created with clinical and radiological characteristics and histopathological results. A machine learning prediction model was created to make binary classifications of lesions as malignant or benign. Random forest, decision tree, K-nearest neighbors, logistic regression, support vector machine (SVM), and multilayer perceptron machine learning algorithms were used. Among these algorithms, SVM was the most successful. The estimations of malignancy for each case detected by artificial intelligence were combined and statistical analyses were performed. RESULTS Considering all cases, the malignancy upgrade rate was 24.5%. A significant association was ob-served between malignancy upgrade rate and lesion size (P = 0.004), presence of mammography findings (P = 0.022), and breast imaging-reporting and data system category (P = 0.001). A statistically significant association was also found between the artificial intelligence prediction model and malignancy upgrade rate (P < 0.001). With the SVM model, an 84% accuracy and 0.786 area-under-the-curve score were obtained in classifying the data as benign or malignant. CONCLUSION Our artificial intelligence model (SVM) can predict HRLs that can be followed up with a lower risk of accompanying malignancy. Unnecessary surgeries can be reduced, or second line vacuum exci-sions can be performed in HRLs, which are mostly benign, by evaluating on a case-by-case basis, in line with radiology–pathology compatibility and by using an artificial intelligence model. © 2023, Turkish Society of Radiology. All rights reserved.Öğe Screening for metastasis in primary breast cancer patients having four or more axillary lymph node involvement: is it really necessary?(Imprimatur Publications, 2010) Uslu, R.; Kapkac, M.; Karaca, B.; Camyar, H.; Durusoy, R.; Ozdemir, N.; Aras, A. B.; Oktay, A.; Ozkilic, H.; Yilmaz, R.Purpose: To evaluate the necessity and direct cost effectiveness of screening and staging procedures in breast cancer patients having >= 4 positive axillary lymph nodes and to identity further possible biopathological risk factors associated with increased risk of metastasis. Methods: We reviewed the demographic and clinicopathological data from the medical records of 1897 newly diagnosed breast cancer patients. Patients having >= 4 positive axillary lymph nodes after primary surgery for breast cancer and who had staging examinations for metastasis were eligible. The impact of staging procedures (thoracoabdominal CT, bone scan etc.) for detecting metastasis, decision of adjuvant treatment and direct costs were analyzed in 329 patients with operable breast cancer Results: Thirty-five (10.6%) patients were found with metastasis at diagnosis. Seven (20.0%) among them had multiple metastases. Eighteen (51.4%) had lung, 17(48.6%) bone, and 7 (20.0%) liver metastasis. Twenty-one (60.0%) patients needed further radiological investigation for metastasis confirmation. Treatment decision was changed in 27 (77.1%) patients. No statistically significant risk factor was identified among the metastatic patients by means of conventional demographic and biopathological parameters. The cost of screening was lower when compared to the cost of treatment without any screening procedure. Conclusion: Since the conventional clinicopathological data seems not sufficient to define the risk of developing metastasis in breast cancer patients with >= 4 axillary lymph node involvement, all of them should undergo full staging examinations until new parameters based on genomic level are defined. Staging procedures need modification for high risk breast cancer patients.Öğe Treatment algorithms for target joints and chronic synovitis in children with hemophilia: izmir experience(Blackwell Publishing, 2008) Kavakli, K.; Aydogdu, S.; Capaci, K.; Taner, M.; Duman, Y.; Oktay, A.; Balkan, C.; Karapinar, D.
