The effects of clinicopathological and imaging findings on recurrence and survival in mammary Paget's disease.

OBJECTIVE: Mammary Paget's disease (MPD) is a rare presentation type of breast cancer. The aim of this study was to evaluate the clinicopathological and imaging features affecting the invasive component, loco-regional recurrence, prognosis, and survival of MPD. METHODS: Patients who had undergone surgery due to MPD in a 10-year period were included. Parameters including mammography and magnetic resonance imaging (MRI) findings, tumor stage, molecular subtype, axillary involvement, presence of invasive carcinoma, loco-regional recurrence, overall survival (OS), and disease-free survival (DFS) were recorded and statistically analyzed. P<0.05 was determined as statistically significant. RESULTS: The study group consisted of 49 women with a mean age of 67.05±14.43 (range: 23-90) years. There was a significant association between the presence of invasive carcinoma and a mass lesion in the MRI (p=0.002). The frequency of sentinel lymph node (SLN) metastasis was significantly higher in patients with multicentric tumors (p=0.029; p<0.05). Locoregional recurrence and distant metastasis were significantly more frequent in patients with axillary involvement (p=0.0336; p<0.05). The mean DFS was 115.02±7.28 months, while the mean OS was 119.29±6.57 months. CONCLUSION: The presence of a mass lesion on MRI was determined to be significant in recognizing invasive carcinoma in MPD. The rate of SLN metastasis was higher in patients with multicentric tumors than in patients with unifocal tumors. Axillary involvement was associated with impaired DFS.

Comparison of Magnetic Resonance Imaging With Positron Emission Tomography/Computed Tomography in the Evaluation of Response to Neoadjuvant Therapy of Breast Cancer.

INTRODUCTION: The present study aims to determine the diagnostic accuracy of magnetic resonance imaging (MRI) and positron emission tomography-computed tomography (PET-CT) in predicting a pathological response of molecular subtypes of breast cancer to neoadjuvant chemotherapy (NAC). MATERIALS AND METHODS: We retrospectively analyzed patients with breast cancer who were operated after NAC between January 2018 and May 2020. Radiological responses were evaluated as per the Response Evaluation Criteria in Solid Tumors (RECIST) and changes in contrast enhancement patterns on MRI and the classification of PET Response Criteria in Solid Tumors (PERCIST) on PET-CT. The presence of a pathological response was evaluated based on the Sataloff classification. The agreement between the radiological response determined through imaging modalities before and after the NAC and the postoperative pathological complete response (pCR) was evaluated and compared statistically. Among the patients diagnosed with breast cancer between the ages of 18 and 80 y, those with N (+) at the time of diagnosis, those with T2 and advanced tumors, and those who were planned for breast conserving surgery were included in our study. Male patients, patients with distant metastases at the time of diagnosis, and patients with other system malignancies were excluded. RESULTS: The study included 88 patients who had undergone surgery for breast cancer after NAC between January 2018 and May 2020. The study was conducted retrospectively in a single center. The tumor diameters and standard uptake values significantly decreased after NAC (P < 0.001). Estrogen receptor (ER) and progesterone receptor (PR) positivity were negatively associated with pCR (P = 0.03 and P = 0.03, respectively), whereas there was a significant positive association between HER-2 positivity and pCR (P = 0.004). There was a moderate agreement between the RECIST criteria used with MRI and pCR (k: 0.46). Moreover, a good agreement between PET-CT-PERCIST and pCR was detected (k: 0.61). In predicting pCR after NAC, MRI showed a selectivity of 80.7%, a sensitivity of 65.2%, a positive predictive value (PPV) of 75%, and a negative predictive value (NPV) of 72.4%. The corresponding rates for PET-CT were 75.7%, 100%, 57.9%, and 100%. CONCLUSIONS: When evaluating pCR after NAC, MRI was found to be more sensitive in patients with ER-positive cancer cell nuclei with weak to medium staining intensity and a loss of E-cadherin expression, whereas PET-CT was found to be more sensitive in patients with HER-2 overexpression, Luminal B, or Ki-67 proliferation >14% (P = 0.01).

Gastric hepatoid carcinoma: Report of a case.

Gastric hepatoid carcinoma (GHC) is a rare type of gastric cancer with a tendency to have poor prognosis and metastasize to the liver. GHCs generally show histopathologically hepatocellular differentiation and secrete alpha fetoprotein (AFP). AFP production can occur in cancers originating from the embryologically similar liver, gastrointestinal tract, and yolk sac and often metastasizes to the liver. Although GHC is aggressive, it may not always cause liver metastasis and may invade into the other abdominal organs by direct contact. In this article, we present a case of locally advanced GHC with high AFP levels.

Cancer surgery during the Covid-19 pandemic in Turkey.

The coronavirus disease (Covid-19), which has spread rapidly all over the world after its appearance in December 2019, soon became a pandemic. In many places struck by the epidemic, clinical branches have prepared new guidelines for approaching the management of the disease in their area during the pandemic. Surgeons have also delayed elective surgeries. The first case of Covid-19 in Turkey was detected on March 10, 2020. After this date, 39 patients with a diagnosis of cancer were operated on in our clinic. In this study, we wanted to reveal the results of the cancer surgeries that we have performed during this period.