Ankara Oncology Training and Education Hospital

Ankara, Turkey

Ankara Oncology Training and Education Hospital

Ankara, Turkey
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Dogan L.,Ankara Oncology Training and Education Hospital | Kalaylioglu Z.,Middle East Technical University | Karaman N.,Ankara Oncology Training and Education Hospital | Ozaslan C.,Ankara Oncology Training and Education Hospital | And 2 more authors.
Asian Pacific Journal of Cancer Prevention | Year: 2011

Objectives. Breast cancer is a histological, morphological and molecular heterogenous disease. Like clinical outcomes and prognoses of different subtypes, etiologies might also be different. Therefore, epidemiologic risk factors like sociologic, demographic, antropometric, reproductive, and menstrual factors can be considered as an entity reflected in tumor features. This study was planned to explore the relation between well known risk factors of breast cancer and histological and molecular features of the tumor. Materials and Methods. Epidemiologic data for 250 breast cancer patients followed-up by our clinic and 250 healthy individuals without any diagnosis of malignancy were obtained. The data displaying a relation to breast cancer are age, height, weight, body mass index (BMI), place of birth and province, educational level, menstrual status, age of menarche and menopause, number of births, age at first childbirth, family history of breast cancer, history of smoking and hormone treatment, mammographic screening, and presence of benign lesions. The tumor characteristics of patients in the breast cancer group were recorded. Results. Advanced age, nulliparity, low educational level, irregular mammographic screening, early menarche and late menopause, and high BMI in postmenopausal period were found to be related to increased breast cancer risk. Striking results in terms of the relation between epidemiological factors and tumor features were the early diagnosis of breast cancer in patients with regular mammographic screening. Tumor size was decreased with increased age and increased with increased BMI. Advanced age, prolonged lactation, increased number of births, and high education level were found to decrease axillary involvement. Conclusions. Multiparity still continues to be the strongest protective factor against breast cancer in our society. The decrease in menarche age may be an early sign of the increased breast cancer incidence. Women should be informed about the relation between postmenopausal obesity and breast cancer and encouraged to attend physical activity and exercise programmes. Regular physical examination and mammographic screening are protective against breast cancer.


Dogan L.,Ankara Oncology Training and Education Hospital | Gulcelik M.A.,Ankara Oncology Training and Education Hospital | Karaman N.,Ankara Oncology Training and Education Hospital | Ozaslan C.,Ankara Oncology Training and Education Hospital | Reis E.,Ankara Oncology Training and Education Hospital
Clinical Breast Cancer | Year: 2013

Introduction: With the results of studies on the timing of adjuvant treatment, it currently appears that adjuvant treatment should be initiated as soon as possible. Breast conserving surgery and oncoplastic surgery is being used with increasing frequency. Therefore, studies about whether or not these applications delay the adjuvant treatment are needed. The aim of this study was to determine the time period needed for adjuvant chemotherapy and radiotherapy of the patients with breast cancer and to reveal associated factors related to the patient, tumor, and surgical technique. Patients and Methods: Two hundred eighty patients with breast cancer who had surgery and were given adjuvant treatments in our clinic were included in the study. Age, body mass index, concomitant diseases, smoking habits, menopausal status, neoadjuvant treatments, tumor characteristics, surgical technique, and surgical complications were recorded. The time period between surgery and initiation of chemotherapy and radiotherapy, the number of chemotherapy cycles, and the duration of chemotherapy and radiotherapy were calculated. Results: The numbers of patients who had modified radical mastectomy, breast conserving surgery, and oncoplastic surgery were 155 (55%), 47 (16.8%), and 78 (27.9%), respectively. The mean (SD) time period needed for chemotherapy administration was 19.5 ± 4.2 days (range, 13-41 days) and 3.9 ± 0.9 months for radiotherapy. Early wound complication of breast surgery was the only factor that delayed the adjuvant chemotherapy (P =.001). Discussion: It has been well known that the time period between surgical treatment of breast cancer and adjuvant treatment affects survival. In our study, it has been shown that the surgical techniques used in breast and axillary surgery do not delay the initiation of adjuvant treatments. The adjuvant treatments of the patients who had oncoplastic surgery and breast conserving surgery were not delayed. The cooperation between the disciplines for the initiation of adjuvant treatments is important. © 2013 Elsevier Inc. All rights reserved.


Dogan L.,Ankara Oncology Training and Education Hospital | Karaman N.,Ankara Oncology Training and Education Hospital | Irkkan C.,Ankara Oncology Training and Education Hospital | Kucuk A.,Ankara Oncology Training and Education Hospital | Atalay C.,Ankara Oncology Training and Education Hospital
Journal of Clinical and Analytical Medicine | Year: 2014

Thyroid angiosarcomas are typically infiltrative and large tumors with very similar clinical findings of anaplastic carcinoma of thyroid. Early hematogenous metastasis is very frequent, but regional lymph node metastasis is quite rare. We present a case of angiosarcoma of the thyroid gland in a 68 years old man with regional lymph node metastasis. Total thyroidectomy with right modified radical neck dissection was applied. Four out of 19 lymph nodes dissected were seen to contain metastasis. Metastatic tumor was composed of sarcomatous areas containing large numbers of blood filled clefts. There after the surgery PET-CT was performed and multiple metastatic involvements were reported. Thyroid angiosarcomas are completely different tumors from angiomatoid anaplastic carcinomas. Longer survival with these tumors is only possible with agressive surgery and in case of regional LN metastasis, neck dissection should be done.


Gulcelik M.A.,Ankara Oncology Training and Education Hospital | Dogan L.,Ankara Oncology Training and Education Hospital | Yuksel M.,Ankara Oncology Training and Education Hospital | Camlibel M.,Ankara Oncology Training and Education Hospital | And 2 more authors.
Journal of Breast Cancer | Year: 2013

Purpose: The aim of this study is to determine and to compare the oncological outcomes of bilateral reduction mammoplasty to standard breast-conserving surgery for breast cancer. Methods: One hundred sixty-two patients who received a quadrantectomy because of breast cancer (group 1) and 106 breast cancer patients with macromastia who underwent breast-conserving surgery via bilateral reduction mammoplasty (group 2) between 2003 and 2010 were enrolled in this study. Results: The mean follow-up time was 37 months for group 1 and 33 months for group 2. Surgical margins were wider than 2 mm in 82.7% and 10 mm in 76.5% of the patients in group 1. Eleven percent of patients had positive surgical margins in this group. When compared to group 2, the rates were 89%, 84%, and 8.4%, respectively. Three patients (1.8%) in group 1 and one patient (0.9%) in group 2 had local recurrence of the disease and received a mastectomy. No statistical significances were noted for either local recurrence or overall survival between the two groups. Conclusion: Bilateral reduction mammoplasty has some advantages as compared to the standard conventional breast-conserving surgery techniques without having any unfavorable effects on surgical margin confidence, local recurrence, and survival rates. © 2013 Korean Breast Cancer Society. All rights reserved.


Dogan L.,Ankara Oncology Training and Education Hospital | Gulcelik A.M.,Ankara Oncology Training and Education Hospital | Yuksel M.,Ankara Oncology Training and Education Hospital | Uyar O.,Ankara Oncology Training and Education Hospital | Reis E.,Ankara Oncology Training and Education Hospital
Asian Pacific Journal of Cancer Prevention | Year: 2012

Purpose: Guide-wire localization (GWL) has been a standard technique for many years. Excision of non-palpable malignant breast lesions with clear surgical margins reduces the risk of undergoing re-excision. The objective of the present study was to evaluate the efficacy of GWL biopsy for assessing surgical margins. Methods: This retrospective study concerned 53 patients who underwent GWL biopsy for non-palpable breast lesions and breast carcinoma diagnosed by histological examination. Age of the patients, tumour size, radiographic findings, breast density specifications, specimen volumes, menopausal status and family history of the patients and surgical margin status were recorded. Results: Median age was 53.3 years, median tumour size was 1.5 cm and median specimen volume was 71.5 cm3. In fifteen patients (28%) DCIS and in 38 patients (72%) invasive ductal carcinoma was diagnosed. There was positive surgical margins in twenty eight (52.8%) patients. The median distance to the nearest surgical margin was 7.2 mm in clear surgical margins. Younger age and denser breast specifications were found as statistically significant factors for surgical margin status. Median age of the patients who had positive margins was 49.4 years where it was 56.9 years in the patients with negative margins (p=0.04). 79% of the patients with positive margins had type 3-4 pattern breast density according to BIRADS classification as compared to 48% in the patients who had negative margins (p=0.03). Some 38 patients who had positive or close surgical margins received re-excision (72%). Conclusion: Positive margin rates may be higher because of inherent biological differences and diffuse growth patterns in younger patients. There are also technical difficulties that are relevant to denser fibroglandular tissue in placing hooked wire. High re-excision rates must be taken into consideration while performing GWL biopsy in non-palpable breast lesions.


PubMed | Ankara Oncology Training and Education Hospital
Type: Journal Article | Journal: Journal of breast cancer | Year: 2013

The aim of this study is to determine and to compare the oncological outcomes of bilateral reduction mammoplasty to standard breast-conserving surgery for breast cancer.One hundred sixty-two patients who received a quadrantectomy because of breast cancer (group 1) and 106 breast cancer patients with macromastia who underwent breast-conserving surgery via bilateral reduction mammoplasty (group 2) between 2003 and 2010 were enrolled in this study.The mean follow-up time was 37 months for group 1 and 33 months for group 2. Surgical margins were wider than 2 mm in 82.7% and 10 mm in 76.5% of the patients in group 1. Eleven percent of patients had positive surgical margins in this group. When compared to group 2, the rates were 89%, 84%, and 8.4%, respectively. Three patients (1.8%) in group 1 and one patient (0.9%) in group 2 had local recurrence of the disease and received a mastectomy. No statistical significances were noted for either local recurrence or overall survival between the two groups.Bilateral reduction mammoplasty has some advantages as compared to the standard conventional breast-conserving surgery techniques without having any unfavorable effects on surgical margin confidence, local recurrence, and survival rates.


PubMed | Ankara Oncology Training and Education Hospital
Type: Journal Article | Journal: Journal of breast cancer | Year: 2013

Surgical equipment used in breast cancer surgery that affects wound healing and minimizes complications seems to be a popular investigation topic. The aim of this study is to evaluate the effect of plasmakinetic cautery on wound healing in patients receiving mastectomy.Forty-six consecutive breast cancer patients receiving modified radical mastectomy were evaluated prospectively. Plasmakinetic cautery was used in 24 operations and electrocautery was used in 22 operations in random order to manage skin flaps and excise breast tissue. In the postoperative period, vacuum drainage amount and duration time as well as the start time of arm exercises were recorded. Complications like seroma, surgical site infection, hematoma, and flap necrosis were determined.Age, body mass index, breast volume and flap area parameters were similar in each group. Mean drainage duration was found to be 5.5 days in the plasmacautery group and 7.9 days in the electrocautery group (p=0.020). In the plasmacautery and electrocautery groups, mean drainage volume was 707 and 1,093 mL, respectively (p=0.025). There was no statistical significance between the groups when operation duration, amount of blood loss, time to start arm exercises, seroma, hematoma, surgical site infection, and flap necrosis were considered.Plasmakinetic cautery is a promising new surgical instrument that provides atraumatic, scalpel-like cutting precision and electrosurgical-like hemostasis, resulting in minimal tissue injury. So, plasmacautery shortens the drainage amount and duration time compared to electrocautery without elongating operation duration or increasing the amount of blood loss.


PubMed | Ankara Oncology Training and Education Hospital
Type: Comparative Study | Journal: Asian Pacific journal of cancer prevention : APJCP | Year: 2012

Breast cancer is a histological, morphological and molecular heterogenous disease. Like clinical outcomes and prognoses of different subtypes, etiologies might also be different. Therefore, epidemiologic risk factors like sociologic, demographic, antropometric, reproductive, and menstrual factors can be considered as an entity reflected in tumor features. This study was planned to explore the relation between well known risk factors of breast cancer and histological and molecular features of the tumor.Epidemiologic data for 250 breast cancer patients followed-up by our clinic and 250 healthy individuals without any diagnosis of malignancy were obtained. The data displaying a relation to breast cancer are age, height, weight, body mass index (BMI), place of birth and province, educational level, menstrual status, age of menarche and menopause, number of births, age at first childbirth, family history of breast cancer, history of smoking and hormone treatment, mammographic screening, and presence of benign lesions. The tumor characteristics of patients in the breast cancer group were recorded.Advanced age, nulliparity, low educational level, irregular mammographic screening, early menarche and late menopause, and high BMI in postmenopausal period were found to be related to increased breast cancer risk. Striking results in terms of the relation between epidemiological factors and tumor features were the early diagnosis of breast cancer in patients with regular mammographic screening. Tumor size was decreased with increased age and increased with increased BMI. Advanced age, prolonged lactation, increased number of births, and high education level were found to decrease axillary involvement.Multiparity still continues to be the strongest protective factor against breast cancer in our society. The decrease in menarche age may be an early sign of the increased breast cancer incidence. Women should be informed about the relation between postmenopausal obesity and breast cancer and encouraged to attend physical activity and exercise programmes. Regular physical examination and mammographic screening are protective against breast cancer.


PubMed | Ankara Oncology Training and Education Hospital
Type: Journal Article | Journal: Clinical breast cancer | Year: 2013

With the results of studies on the timing of adjuvant treatment, it currently appears that adjuvant treatment should be initiated as soon as possible. Breast conserving surgery and oncoplastic surgery is being used with increasing frequency. Therefore, studies about whether or not these applications delay the adjuvant treatment are needed. The aim of this study was to determine the time period needed for adjuvant chemotherapy and radiotherapy of the patients with breast cancer and to reveal associated factors related to the patient, tumor, and surgical technique.Two hundred eighty patients with breast cancer who had surgery and were given adjuvant treatments in our clinic were included in the study. Age, body mass index, concomitant diseases, smoking habits, menopausal status, neoadjuvant treatments, tumor characteristics, surgical technique, and surgical complications were recorded. The time period between surgery and initiation of chemotherapy and radiotherapy, the number of chemotherapy cycles, and the duration of chemotherapy and radiotherapy were calculated.The numbers of patients who had modified radical mastectomy, breast conserving surgery, and oncoplastic surgery were 155 (55%), 47 (16.8%), and 78 (27.9%), respectively. The mean (SD) time period needed for chemotherapy administration was 19.5 4.2 days (range, 13-41 days) and 3.9 0.9 months for radiotherapy. Early wound complication of breast surgery was the only factor that delayed the adjuvant chemotherapy (P = .001).It has been well known that the time period between surgical treatment of breast cancer and adjuvant treatment affects survival. In our study, it has been shown that the surgical techniques used in breast and axillary surgery do not delay the initiation of adjuvant treatments. The adjuvant treatments of the patients who had oncoplastic surgery and breast conserving surgery were not delayed. The cooperation between the disciplines for the initiation of adjuvant treatments is important.


PubMed | Ankara Oncology Training and Education Hospital
Type: Journal Article | Journal: Asian Pacific journal of cancer prevention : APJCP | Year: 2012

Guide-wire localization (GWL) has been a standard technique for many years. Excision of non- palpable malignant breast lesions with clear surgical margins reduces the risk of undergoing re-excision. The objective of the present study was to evaluate the efficacy of GWL biopsy for assessing surgical margins.This retrospective study concerned 53 patients who underwent GWL biopsy for non-palpable breast lesions and breast carcinoma diagnosed by histological examination. Age of the patients, tumour size, radiographic findings, breast density specifications, specimen volumes, menopausal status and family history of the patients and surgical margin status were recorded.Median age was 53.3 years, median tumour size was 1.5 cm and median specimen volume was 71.5 cm3. In fifteen patients (28%) DCIS and in 38 patients (72%) invasive ductal carcinoma was diagnosed. There was positive surgical margins in twenty eight (52.8%) patients. The median distance to the nearest surgical margin was 7.2 mm in clear surgical margins. Younger age and denser breast specifications were found as statistically significant factors for surgical margin status. Median age of the patients who had positive margins was 49.4 years where it was 56.9 years in the patients with negative margins (p=0.04). 79% of the patients with positive margins had type 3-4 pattern breast density according to BIRADS classification as compared to 48% in the patients who had negative margins (p=0.03). Some 38 patients who had positive or close surgical margins received re-excision (72%).Positive margin rates may be higher because of inherent biological differences and diffuse growth patterns in younger patients. There are also technical difficulties that are relevant to denser fibroglandular tissue in placing hooked wire. High re-excision rates must be taken into consideration while performing GWL biopsy in non-palpable breast lesions.

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