Publications by authors named "Varol Celik"

23 Publications

  • Page 1 of 1

The effect of preoperative F-FDG PET on the surgical decision in early breast cancer: 5-Year follow-up.

Hell J Nucl Med 2020 Sep-Dec;23(3):256-263. Epub 2020 Dec 14.

Bakirkoy Dr. Sadi Konuk Egitim ve Arastirma Hastanesi, Genel Cerrahi 4. Kat Zuhuratbaba Mah. Tevfik Sağlam Cd. No:11 Bakirkoy, Istanbul, Turkey.

Objective: The diagnosis, treatment, and management of the breast cancer (BC) require a multidisciplinary approach. In newly diagnosed BC, fluorine-18-fluorodeoxyglucose positron emission tomography (F-FDG PET) can detect extra-axillary regional nodal and distant lesions.

Subjects And Methods: Between 2010 and 2015, this study included 101 patients with early-stage BC who were examined with F-FDG PET before surgery. Patients were divided into two groups: Group 1 consisted of patients with suspected F-FDG uptake and Group 2 with the remaining F-FDG-negative patients. Differences between these groups were tested using the Pearson chi-square test, Fisher's exact test, Mann Whitney-U test, independent t-test and ROC analysis. They could be followed-up after 2015 for 5 years. All patients were then rediscussed either neoadjuvant therapy or surgery in the oncology board in 2020 with changing neoadjuvant criteria and oncoplastic surgery techniques.

Results: Fluorine-18-FDG PET was found to have a sensitivity of 77.8% and a specificity of 90.8% in detecting axillary lymph node metastasis. During the minimum 5-year follow-up, one patient had bone metastasis, 2 patients had a local recurrence, and 3 patients had metastatic lymph nodes in the axilla. In the re-evaluation of the same patients over 5 years, the decrease in mastectomy decision was remarkable (P-value 0.01).

Conclusion: We observed that we could not achieve a significant difference in 5-year metastasis/recurrence between the groups. Moreover, due to F-FDG-PET high false positivity, it significantly extended the time to surgery (P-value 0.01). In early-stage BC, F-FDG PET demonstrated better performance in axillary lymph nodes metastases detection in comparison with other diagnostic imaging methods, even if SLNB remains the gold standard technique.
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http://dx.doi.org/10.1967/s002449912205DOI Listing
December 2020

Combination Technique Is Superior to Dye Alone in Identification of the Sentinel Lymph Node in Male Breast Cancer.

Am Surg 2018 Dec;84(12):1957-1960

Sentinel lymph node (SLN) biopsy is the main method in staging the axilla. There are insufficient data available regarding the accuracy of an SLN biopsy in male breast cancer. The aim of this study is to evaluate whether the combination of dye and radiotracer would improve the detection rate of SLNs dye alone in male breast cancer patients. From February 2009 to January 2012, our SLN biopsy database was retrospectively reviewed to identify male breast cancer cases. Of the 890 SLN procedures contained in the database, 10 male breast cancer patients were identified. Patient age, body mass index, SLN biopsy technique, SLN identification, number of SLN excised, and pathology reports were reviewed. Mean age was 57.2 (34-85) years with a mean tumor size was 2.2 (1.0-4.0) cm. SLN detection ratios were two in four with blue dye and six in six with the combination technique. Overall, SLNs were identified in 8 of the 10 patients. SLN biopsy is applicable in male breast cancer cases. The addition of a radiotracer to the dye in SLN biopsy increases the detection rate of sentinel nodes in male breast cancer patients.
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December 2018

Sentinel lymph node biopsy under fluorescent indocyanin green guidance: Initial experience.

Ulus Cerrahi Derg 2016 18;32(1):50-3. Epub 2015 Aug 18.

Department of General Surgery, Breast Diseases Service, İstanbul University, Cerrahpaşa Medical Faculty İstanbul, Turkey.

Objective: Sentinel lymph node biopsy can be applied by using either blue dye or radionuclide method or both in breast cancer. Fluorescent imaging with indocyanine green is a new defined method. This study evaluates the applicability of sentinel lymph node biopsy via fluorescent indocyanine green.

Material And Methods: IC-VIEW (Pulsion Medical Systems AG, Munich, Germany) infrared visualization system was used for imaging. Two mL of indocyanine green was injected to visualize sentinel lymph nodes. After injection, subcutaneous lymphatics were traced and sentinel lymph nodes were found with simultaneous imaging. Sentinel lymph nodes were excised under fluorescent light guidance, and excised lymph nodes were examined histopathologically. Patients with sentinel lymph node metastases underwent axillary dissection.

Results: Four patients with sentinel lymph node biopsy due to breast cancer were included in the study. Sentinel lymph nodes were visualized with indocyanine green in all patients. The median number of excised sentinel lymph node was 2 (2-3). Two patients with lymph node metastasis underwent axillary dissection. No metastasis was detected in lymph nodes other than the sentinel nodes in patients with axillary dissection. There was no complication during and after the operation related to the method.

Conclusion: According to our limited experience, sentinel lymph node biopsy under fluorescent indocyanine green guidance, which has an advantage of simultaneous visualization, is technically feasible.
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http://dx.doi.org/10.5152/UCD.2015.2832DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC4771427PMC
March 2016

Magnetic Resonance Imaging Guided Vacuum Assisted and Core Needle Biopsies.

J Breast Health 2016 Jan 1;12(1):25-30. Epub 2016 Jan 1.

Department of Radiology, İstanbul University Faculty of Medicine, İstanbul, Turkey.

Objective: The purpose of this study to present the results of Magnetic resonance imaging (MRI) guided cutting needle biopsy procedures of suspicious breast lesions that can be solely detected on Magnetic resonance (MR) examination.

Materials And Methods: The study included 48 patients with 48 lesions which were solely be observed in breast MRI, indistinguishable in ultrasonography and mammography, for MR guided vacuum-assisted cutting needle biopsy and 42 patients with 42 lesions for MR guided cutting needle biopsy for the lesions of the same nature. MR imaging was performed using a 1.5-Tesla MRI device. Acquired MR images were determined and biopsy protocol was performed using computer-aided diagnosis system on the workstation. Vacuum biopsies were performed using 10 G or 12 G automatic biopsy systems, cutting needle biopsy procedures were performed using fully automated 12 G biopsy needle.

Results: All biopsy procedures were finalized successfully without major complications. The lesions were 54 mass (60%), 28 were non-mass contrast enhancement (31%) and 8 were foci (9%) in the MR examination. Histopathological evaluation revealed 18 malignant (invasive, in-situ ductal carcinoma and lobular carcinoma), 66 benign (apocrine metaplasia, fibrosis, fibroadenomatoid lesion, sclerosing adenosis, fibrocystic disease and mild-to-severe epithelial proliferation) and 6 high-risk (atypical ductal hyperplasia, intraductal papilloma, radial scar) lesions.

Conclusion: Magnetic resonance guided vacuum and cutting needle biopsy methods are successful methods fort he evaluation of solely MRI detected suspicious breast lesions. There are several advantages relative to each other in both methods.
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http://dx.doi.org/10.5152/tjbh.2015.2769DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC5351431PMC
January 2016

A low cost training phantom model for radio-guided localization techniques in occult breast lesions.

J Surg Oncol 2015 Sep 6;112(4):449-51. Epub 2015 Aug 6.

Women's Cancer Center, Dana-Farber/Brigham and Women's Hospital, Harvard Medical School, Boston, Massachusetts.

Radio-guided localization (RGL) for identifying occult breast lesions has been widely accepted as an alternative technique to other localization methods, including those using wire guidance. An appropriate phantom model would be an invaluable tool for practitioners interested in learning the technique of RGL prior to clinical application. The aim of this study was to devise an inexpensive and reproducible training phantom model for RGL. We developed a simple RGL phantom model imitating an occult breast lesion from inexpensive supplies including a pimento olive, a green pea and a turkey breast. The phantom was constructed for a total cost of less than $20 and prepared in approximately 10 min. After the first model's construction, we constructed approximately 25 additional models and demonstrated that the model design was easily reproducible. The RGL phantom is a time- and cost-effective model that accurately simulates the RGL technique for non-palpable breast lesions. Future studies are warranted to further validate this model as an effective teaching tool.
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http://dx.doi.org/10.1002/jso.23984DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC4583351PMC
September 2015

Bilateral idiopathic granulomatous mastitis.

Asian J Surg 2016 Jan 2;39(1):12-20. Epub 2015 May 2.

Department of General Surgery, Cerrahpasa Medical Faculty, Istanbul University, Istanbul, Turkey. Electronic address:

Objectives: Idiopathic granulomatous mastitis (IGM) is a benign rare inflammatory pseudotumor. Bilateral involvement of IGM has been reported in a few cases. To our knowledge, this study is the largest series of bilateral cases to date. The goals of this study were to present clinical features of bilateral IGM and to evaluate the results of treatments.

Materials And Methods: We performed a retrospective review of the idiopathic granulomatous mastitis database from 2010 to 2013. Ten female patients who met required histologic and clinical criteria of IGM in both breasts were included in study. Demographic data, clinical findings, medication history, and radiologic findings are presented.

Results: The mean age at onset of the disease was 38.4 ± 8.3 years (range: 29-52 years). Nine patients had no recurrence during a mean follow-up period of 21 months (range: 11-26 months). Additionally, the median time to second breast involvement was 15.6 months.

Conclusion: Bilateral IGMs have a higher rate of more relapse and greater resistance to medical therapies than do unilateral IGMs. Surgical management should be avoided unless all medical treatment options have been exhausted. Nevertheless, expectant management seems a rational option for the treatment of bilateral IGM.
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http://dx.doi.org/10.1016/j.asjsur.2015.02.003DOI Listing
January 2016

Factors affecting breast cancer treatment delay in Turkey: a study from Turkish Federation of Breast Diseases Societies.

Eur J Public Health 2015 Feb 5;25(1):9-14. Epub 2014 Aug 5.

15 Collegium of World Economy, Warsaw School of Economics, Warsaw, Poland.

Background: One of the most important factors in breast cancer (BC) mortality is treatment delay. The primary goal of this survey was to identify factors affecting the total delay time (TDT) in Turkish BC patients.

Methods: A total of 1031 patients with BC were surveyed using a uniform questionnaire. The time between discovering the first symptom and signing up for the first medical visit (patient delay time; PDT) and the time between the first medical visit and the start of therapy (system delay time; SDT) were modelled separately with multilevel regression.

Results: The mean PDT, SDT and TDT were 4.8, 10.5 and 13.8 weeks, respectively. In all, 42% of the patients had a TDT >12 weeks. Longer PDT was significantly correlated with disregarding symptoms and having age of between 30 and 39 years. Shorter PDT was characteristic of patients who: had stronger self-examination habits, received more support from family and friends and had at least secondary education. Predictors of longer SDT included disregard of symptoms, distrust in success of therapy and medical system and having PDT in excess of 4 weeks. Shorter SDT was linked to the age of >60 years. Patients who were diagnosed during a periodic check-up or opportunistic mammography displayed shorter SDT compared with those who had symptomatic BC and their first medical examination was by a surgeon.

Conclusion: TDT in Turkey is long and remains a major problem. Delays can be reduced by increasing BC awareness, implementing organized population-based screening programmes and founding cancer centres.
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http://dx.doi.org/10.1093/eurpub/cku086DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC4304375PMC
February 2015

HER2 Ile655Val and PTEN IVS4 polymorphisms in patients with breast cancer.

Mol Biol Rep 2013 Feb 21;40(2):1813-8. Epub 2012 Oct 21.

Department of Molecular Medicine, Istanbul University, Experimental Medicine and Research Institute (DETAE), Istanbul, 34100, Turkey.

Although HER2/PTEN pathway is commonly disrupted in cancer, association of HER2 and PTEN polymorphisms with breast cancer (BC) remains controversial. We investigated the HER2 Ile655 Val and PTEN IVS4 polymorphisms in patients with BC in Turkish population. HER2 Ile655Val (rs 1136201) and PTEN IVS4 (rs 3830675) polymorphisms were determined using polymerase chain reaction-based restriction fragment length polymorphism (PCR-RFLP) in blood samples of 118 BC patients and 118 age-matched healthy controls. We found that the frequency of the Ile/Val genotype of HER2 Ile655Val gene was significantly higher in BC patients (p < 0.009; OR: 1,983 95 % CI: 1.181-3.328). The presence of ATCTT insertion (+/+) genotype at downstream of exon 4 in intron 4 of PTEN IVS4 gene was also associated with 1.83 fold decreased risk of BC development (p < 0.033; OR: 1.83, 95 % CI: 1.11-3.03). Analysis on clinico-pathological parameters showed neither HER2 Ile655Val nor PTEN IVS4 genotypes were not associated with any of the variables (p > 0.05).In conclusion, our findings suggest that the Ile/Val genotype of HER2 and ATCTT insertion (+/+) genotype of PTEN IVS4 gene may play an important role as genetic markers for breast cancer risk, but both genes genotypes may not be useful for predicting tumor prognosis in Turkish population.
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http://dx.doi.org/10.1007/s11033-012-2235-2DOI Listing
February 2013

Excision of Nonpalpable Breast Cancer with Indocyanine Green Fluorescence-Guided Occult Lesion Localization (IFOLL).

Breast Care (Basel) 2012 Feb 13;7(1):48-51. Epub 2012 Feb 13.

Department of General Surgery, Istanbul University Cerrahpasa Medical School, Istanbul, Turkey.

BACKGROUND: Currently employed techniques for the localization of nonpalpable breast lesions suffer from various limitations. In this paper, we report on 2 patients in order to introduce an alternative technique, indocyanine green fluorescence-guided occult lesion localization (IFOLL), and determine its applicability for the surgical removal of this type of breast lesions. CASE REPORTS: Preoperatively, one of the patients had a needle biopsy-proven diagnosis of breast cancer, and the other one had suspicious findings for malignancy. Lesion localization was performed within 1 h before surgery under ultrasonography control by injecting 2 ml and 0.2 ml of indocyanine green into the lesion and its subcutaneous tissue projection, respectively. During surgery, the site of skin incision and the resection margins were identified by observing the area of indocyanine-derived fluorescence under the guidance of a near-infrared-sensitive camera. In both cases, the breast lesion was correctly localized, and the area of fluorescence corresponded well to the site of the lesions. Subsequent surgical excision was successful with no complications. On histopathologic examination, the surgical margins were found to be clear. CONCLUSION: IFOLL seems to be a technically applicable and clinically acceptable procedure for the removal of nonpalpable breast cancer.
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http://dx.doi.org/10.1159/000336497DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC3335456PMC
February 2012

Simultaneous excision of ipsilateral nonpalpable multiple breast lesions using radioguided occult lesion localization.

Breast 2011 Jun 2;20(3):241-5. Epub 2011 Feb 2.

Department of General Surgery, Istanbul University Cerrahpasa Medical School, Istanbul, Turkey.

The purpose of this study was to determine the feasibility and effectiveness of ROLL technique for the identification and excision of ipsilateral nonpalpable multiple breast lesions. Between August 2005 and August 2010, eight women, aged 40-61 years, with a radiographic evidence of two separate nonpalpable lesions within the same breast underwent ROLL, as we termed it, double-ROLL. Each lesion was localized with Tc-99m-labeled human serum albumin macroaggregate under ultrasonography or mamography control. A gamma probe was used to guide surgical excisions. There was no radiotracer overlapping or extravasation in any case. Out of the 16 resected specimens, histopathologic examination revealed benign findings in 13 lesions and malignancy in 3. There was no lesion involvement at the surgical margins, and no residuals were detected in any of the benign cases during follow-up. Double-ROLL technique is feasible and safe for the identification and excision of such multiple ipsilateral breast lesions.
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http://dx.doi.org/10.1016/j.breast.2011.01.008DOI Listing
June 2011

Surgical treatment of axillary accessory breasts.

Am Surg 2010 Mar;76(3):270-2

Department of General Surgery, Breast Division, Istanbul University, Cerrahpasa Medical Faculty, Istanbul, Turkey.

Accessory breast tissue is a remnant persisting after normal embryological development of the breast. Although accessory breasts may be asymptomatic, they can cause discomfort during menstruation, anxiety, cosmetic problems, pain, or restriction of arm movement. The data of all patients who presented with axillary accessory breasts between January 2000 and September 2008 were recruited from a computer database. Medical charts, outpatient records, operative notes, and pathology reports were reviewed. A total of 29 patients underwent surgical treatment of axillary accessory breasts in the Department of Breast Surgery and Department of Plastic, Reconstructive and Aesthetic Surgery. The ages of the patients at the time of surgery ranged from 19 to 54 years. The mean age was 28.8 years. All patients were female. Sixteen patients had unilateral accessory breast and 13 patients had bilateral accessory breasts. Fourteen patients had breast hypertrophy. Twenty-one patients had excision, five patients had liposuction, and three patients had both. Axillary accessory breasts can be satisfactorily treated with excision, liposuction, or both. In patients with concomitant macromastia, reduction mammaplasty and removal of accessory breasts can be performed at the same time with no additional morbidity.
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March 2010

Radioguided occult lesion localization (ROLL) for non-palpable breast cancer: a comparison between day-before and same-day protocols.

Breast 2010 Jun 18;19(3):226-30. Epub 2010 Feb 18.

Istanbul University, Cerrahpasa Medical School, Department of General Surgery, Istanbul, Turkey.

Background: Although radioguided occult lesion localization (ROLL) has become a widely accepted technique, the optimal time interval between the radioisotope injection and surgery has not yet been determined.

Aim: To delineate the effects of time from the injection of the radionuclide until surgery on the ROLL success rate in a patient population diagnosed as having non-palpable breast cancer.

Methods: Between December 2004 and May 2009, 75 patients underwent ROLL procedure. The day-before protocol and same-day protocols included 50 and 25 breast cancer patients respectively.

Results: The two study groups were comparable in terms of age, localization technique, radiological findings and the type of surgical procedures (P > 0.05). No statistically significant difference was noticed in the pathological diagnosis, cancer size and the surgical margin clearance between the two groups (P > 0.05).

Conclusions: Same-day injection of the radiotracer was not superior to the day-before injection in ROLL. The day-before protocol can be scheduled for the convenience of both patients and hospital staff.
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http://dx.doi.org/10.1016/j.breast.2010.01.017DOI Listing
June 2010

Excision of axillary lymph node recurrences in breast cancer patients with axillary ROLL (A-ROLL).

J Surg Oncol 2010 Feb;101(2):141-4

Department of General Surgery, Cerrahpasa Medical School, Istanbul University, Istanbul, Turkey.

Background And Objectives: Conventional surgical exploration to find clinically occult axillary lymph node recurrence of breast cancer can be challenging. The aim of this study was to determine the place of our alternative technique, axillary-ROLL (A-ROLL), in previously treated breast cancer patients with nonpalpable axillary lymph node recurrences.

Methods: Between March 2005 and May 2009, included in this retrospective study were four women (age, 42-51 years) without clinical evidence of distant metastasis who had treatment for breast cancer and were subsequently found to have suspicious axillary lymph node(s) detected by control ultrasonography (US) examination during follow-up. A-ROLL was utilized for the identification of lymph nodes. 0.5-1 mCi (99m)Tc-human serum albumin makroaggregate was injected under US guidance. A gamma probe was then used to guide the excision of the lymph nodes.

Results: The involved lymph nodes were successfully localized by A-ROLL technique and removed surgically. Of all four patients, postoperative histopathologic examination revealed nodal cancer metastases in three patients (75%) and lymphoid hyperplasia in one patient. No complications occurred.

Conclusions: A-ROLL technique has proved to be accurate and safe in the identification and excision of clinically occult axillary lymph node recurrence.
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http://dx.doi.org/10.1002/jso.21450DOI Listing
February 2010

DNA oxidation and antioxidant status in breast cancer.

J Investig Med 2009 Aug;57(6):720-3

Department of Biochemistry, and Department of General Surgery, Istanbul University Cerrahpasa Medical Faculty, Istanbul, Turkey.

Purpose: : Oxidant/antioxidant balance has been suggested as an important factor for initiation and progression of cancer. The objective of this study was to determine 8-hydroxydeoxyguanosine (8-OHdG) level as a marker of oxidative DNA damage, glutathione peroxidase (G-Px), and superoxide dismutase (SOD) activities as antioxidant activity, in sera from women with breast cancer.

Methods: : Forty-nine patients with malign breast tumor were included in the study. Blood samples were collected before the surgical operation. Serum level of 8-OHdG was measured with a competitive enzyme-linked immunusorbent assay kit, SOD, and G-Px activities were measured by spectrophotometric kits.

Results: : 8-Hydroxydeoxyguanosine level and SOD activity were found to be increased in breast cancer group as compared with control group. Glutathione peroxidase activity in the breast cancer group was lower than those in the control group. The ratio of 8-OHdG/G-Px in breast cancer patients was found to be higher than those in the controls. There were correlations between 8-OHdG and CA19-9 (r = 0.77; P < 0.01); age and G-Px (r = -0.84; P < 0.05) in the breast cancer group.

Conclusions: : Data show that serum levels of 8-OHdG and SOD activities are higher in patients with breast cancer. Glutathione peroxidase activity is lower in the breast cancer group. Increased ratio of 8-OHdG/G-Px in breast cancer patients is the evidence for impaired oxidant/ antioxidant balance in breast cancer.
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http://dx.doi.org/10.2310/JIM.0b013e3181adfb5bDOI Listing
August 2009

Relation of serum vascular endothelial growth factor as an angiogenesis biomarker with nitric oxide & urokinase-type plasminogen activator in breast cancer patients.

Indian J Med Res 2007 Jun;125(6):747-51

Department of Biochemistry, Cerrahpasa Medical Faculty, Istanbul University, Istanbul, Turkey.

Background & Objective: The primary mediator of angiogenesis is vascular endothelial growth factor (VEGF). It is well documented that angiogenic activity in human cancer depends on nitric oxide (NO) levels in tissues. Additionally, urokinase type plasminogen activator (u-PA) plays a role in cell adhesion and migration. Serum VEGF and its relationship between NO and u-PA concentrations are poorly reported in breast cancer patients. The aim of this study was to investigate the relationship between serum levels of VEGF and NO and u-PA in patients with breast cancer.

Methods: Serum concentrations of VEGF, NO and u-PA were measured in groups of pre-operative breast cancer patients without metastasis (n=20), post-operative breast cancer patients without metastasis (four wk after the operation, n=20), breast cancer patients with metastasis (n=23), patients with benign breast disease (n=11) and healthy female controls (n=20).

Results: There was no difference in serum concentrations of VEGF, NO and u-PA between controls and patients with benign breast disease. Serum VEGF, NO and u-PA concentrations were significantly higher in pre-operative breast cancer patients than in controls and in patients with benign breast diseases (P<0.01). Post-operative breast cancer patients without metastasis had significantly lower serum VEGF and u-PA concentrations than the pre-operative patients (P<0.01). In breast cancer patients with metastasis, serum VEGF, and u-PA were significantly higher than post-operative nonmetastatic patients (P<0.01). Serum VEGF concentrations were positively correlated with serum uPA in all of the patients groups (r=0.886, P<0.01). Serum VEGF levels were positively correlated with serum NO levels in breast cancer patients with metastasis (r= 0.386, P<0.05).

Interpretation & Conclusion: Our results demonstrated that the angiogenic activity was increased in patients with breast cancer. Elevated VEGF levels as an angiogenesis marker may be associated with uPA. VEGF, NO and uPA seem to be associated with the angiogenetic and metastatic process of breast cancer.
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June 2007

Effects of hyperbaric oxygen and Pgg-glucan on ischemic colon anastomosis.

World J Gastroenterol 2006 Mar;12(9):1421-5

Department of General Surgery, Cerrahpasa Faculty of Medicine, Istanbul, Turkey.

Aim: In colorectal surgery, anastomotic failure is still a problem in ischemia. Here,we analyzed the effects of hyperbaric oxygen and beta-glucan on colon anastomoses in ischemic condition.

Methods: Colonic resection and anastomosis in rectosigmoid region were done in forty Wistar-Albino rats of four groups of equal number. Colon mesentery was ligated to induce ischemia. The first group was the control group. The subjects of second group were treated with hyperbaric oxygen;the third group with glucan and the forth group were treated with both. At the forth day, rats were sacrificed,anastomotic segment was resected and burst pressures and hydroxyproline levels of anastomotic line were measured.

Results: The burst pressure difference of second and third groups from the control group were meaningful (P<0.01); the forth group differed significantly from the control (P<0.001). There was no difference between the treated groups on burst pressure level (P>0.05). The hydroxyproline levels in all treated groups were different from the control group significantly (P<0.001). Hydroxyproline levels in the forth group were higher than those of the second and the third groups (P<0.001). There were no significant differences between the second and the fourth groups in burst pressure and hydroxyproline levels (P>0.05).

Conclusion: Hyperbaric oxygen and glucan improve healing in ischemic colon anastomoses by anti-microbic,immune stimulating properties and seem to act synergistically when combined together.
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http://www.ncbi.nlm.nih.gov/pmc/articles/PMC4124322PMC
http://dx.doi.org/10.3748/wjg.v12.i9.1421DOI Listing
March 2006

Secretory carcinoma of the breast. Case report and review of the literature.

Oncology 2005 7;68(2-3):263-8. Epub 2005 Jul 7.

Department of Internal Medicine, Section of Medical Oncology, Cerrahpasa Medical Faculty, Istanbul University, Istanbul, Turkey.

We report an elderly case of an indolent breast tumor in a 66-year-old woman. The patient presented with a locally advanced mass in the right breast that was present for 13 years, accompanied by bleeding and ulceration since the last 5 years. She had a modified radical mastectomy with axillary dissection. She was found to have secretory carcinoma with a tumor size of 8 x 4 x 4 cm in diameter. Two out of the 22 removed lymph nodes were involved. The secretory material stained positive with lactalbumin, as well as showed positivity with PAS. The patient received six cycles of adjuvant chemotherapy followed by chest wall irradiation. She is disease free with a follow-up period of 24 months. Preoperative chemotherapy should be primarily replaced by curative surgery in such indolent cancers, despite locally advanced disease.
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http://dx.doi.org/10.1159/000086782DOI Listing
August 2005

Gray scale and power Doppler US in the preoperative evaluation of axillary metastases in breast cancer patients with no palpable lymph nodes.

Eur Radiol 2005 Jun 3;15(6):1215-23. Epub 2005 Feb 3.

Cerrahpasa Medical Faculty, Department of Radiology, Istanbul University, Turkey.

The purpose of this study is to evaluate the accuracy of gray scale and Doppler US findings in the detection of axillary metastases in breast cancer patients with no palpable lymph nodes. One-hundred and ninety-eight lymph nodes detected in 83 women were evaluated. The size and longitudinal/transverse axis ratios of each node were documented. Absence of echogenic hilum, asymmetrical cortical thickening, and presence of peripheral flow were prospectively considered signs of malignancy. Histopathologically, there were 93 malignant and 105 benign nodes. The above criteria and a low longitudinal-transverse axis ratio were statistically significant for malignancy. In lymph nodes smaller than 1 cm, only asymmetric cortical thickening and presence of peripheral flow were significant. The sensitivity, specificity, positive predictive value, negative predictive value and accuracy of US were 86.49, 93.62, 91.43, 89.8 and 90.48%, respectively. In conclusion, US is successful and reliable in the determination of axillary metastatic involvement in nonpalpable and small lymph nodes. Inclusion of axillary US in the preoperative diagnostic evaluation would be complimentary to sentinel node biopsy, and also could eliminate the need for it in patients with positive US results, after confirmation with biopsy.
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http://dx.doi.org/10.1007/s00330-004-2605-9DOI Listing
June 2005

Inflammatory myofibroblastic tumor (inflammatory pseudotumor) of the breast.

APMIS 2005 Jan;113(1):66-9

Department of Pathology, Cerrahpasa School of Medicine, Istanbul University, Istanbul, Turkey.

Inflammatory myofibroblastic tumor of the lung has often been reported but extrapulmonary cases are rare. Here we describe a case of inflammatory myofibroblastic tumor of the breast in a 60-year-old woman. This is only the eleventh case reported in the English language literature. The patient was free of disease 85 months after surgery.
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http://dx.doi.org/10.1111/j.1600-0463.2005.apm1130110.xDOI Listing
January 2005

Lymphoepithelioma-like carcinoma of the breast: is it a distinct entity? Clinicopathological evaluation of two cases and review of the literature.

Breast 2004 Dec;13(6):522-6

Department of Pathology, Istanbul University, Cerrahpasa School of Medicine, Istanbul, Turkey.

Lymphoepithelioma-like carcinomas (LELCs) are tumors with morphologic features identical to those of undifferentiated nasopharyngeal carcinoma. They are characterized by a pronounced lymphocytic infiltrate, often obscuring the neoplastic epithelial component. LELCs have been described in several organs, but are extremely rare in the breast. In this report, two cases of LELC of the breast are presented with their histological and immunohistochemical features. In situ hybridization for Epstein-Barr viral genome was negative in both cases. We discuss the differential diagnosis of LELC of the breast and review the reports of this entity that have appeared in the literature.
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http://dx.doi.org/10.1016/j.breast.2004.06.010DOI Listing
December 2004

Effect of intra-abdominal pressure level on gastric intramucosal pH during pneumoperitoneum.

Surg Laparosc Endosc Percutan Tech 2004 Oct;14(5):247-9

Department of General Surgery, Cerrahpasa Medical Faculty, Istanbul University, Istanbul, Turkey.

The present study was designed to examine the effect of intra-abdominal pressure level on gastric intramucosal pH using gastric tonometry during pneumoperitoneum. One hundred patients were prospectively randomized into 5 equal groups (N = 20 each). Intra-abdominal pressure levels were 8, 10, 12, 14, and 16 mm Hg in groups I, II, III, IV, and V, respectively. Intramucosal pH measurement was done 2 times: 30 minutes following insufflation and 1 hour after the ending of the surgery. In the first and second measurements, intramucosal pH values were found as 7.39 +/- 0.02 and 7.36 +/- 0.03 in group I; 7.41 +/- 0.03 and 7.38 +/- 0.03 in group II; 7.37 +/- 0.03 and 7.37 +/- 0.03 in group III; 7.36 +/- 0.03 and 7.37 +/- 0.03 in group IV; and 7.39 +/- 0.03, 7.36 +/- 0.03 in group V, respectively. Statistical significance was not found in the comparison of these values within the groups and between the groups (P > 0.005, for each). In conclusion, intra-abdominal pressure between 8 and 16 mm Hg did not cause significant difference in gastric intramucosal pH.
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http://dx.doi.org/10.1097/00129689-200410000-00002DOI Listing
October 2004