Sürdürülebilir Kalkınma Amaçları
Yayınlar
- MakaleYalnız künye2012The importance of multifocal/multicentric tumor on the disease-free survival of breast cancer patients: Single center experience
Ustaalioglu, Basak Oven; Bilici, Ahmet; Kefeli, Umut; Şeker, Mesut; Oncel, Mustafa; Gezen, Cem; Gumus, Mahmut; Demirelli, Fuat
OBJECTIVES:: Multifocal/multicentric breast cancers have been comprehensively studied and their outcomes have been compared with unifocal tumors. We evaluated the impact of multifocality and multicentricity on the disease-free survival (DFS) and overall survival of breast cancer patients and tried to analyze the correlation between multifocality/multicentricity (M/M) and other prognostic factors. MATERIAL AND METHODS:: Between 1994 and 2009, we analyzed retrospectively 697 breast cancer patients. Multicentric and multifocal breast cancer were defined as the presence of 2 or more invasive tumor foci within the different quadrants of the same breast or within a same quadrant of the breast, respectively. M/M and other prognostic factors were evaluated using univariate and multivariate analyses. RESULTS:: Multifocal/multicentric tumors were seen in 107 (15.4%) of the 697 breast cancer patients. pT and pN stage were related with the presence of multifocal/multicentric tumors. As tumor size increased and the number of axillary lymph nodes metastasis increased, the incidence of M/M increased significantly (P=0.003 vs. P=0.02, respectively). Overall, the median DFS time of patients with multifocal/multicentric tumors was significantly worse than that of the unifocal tumors (55 vs. 137 mo, P<0.001). Multivariate analysis showed that the presence of M/M was the most important prognostic factor for DFS (P=0.001, hazard ratio (HR): 0.33; 95% confidence interval (CI), 0.18-0.58), as were pN stage and extracapsular extension of the tumor (P=0.01, HR: 1.74; 95% CI, 1.13-2.69) (P=0.03, HR: 1.9; 95% CI, 1.04-3.47, respectively). M/M were not also statistically significant prognostic factors in breast cancer for overall survival (P=0.06). CONCLUSIONS:: M/M imparts an unfavorable prognosis on the DFS of breast cancer patients in comparison to unifocal tumors and the presence of multifocal/multicentric tumors were associated with advanced pT and pN stages.
- MakaleAçık Erişim2011Breast Conserving Surgery and Modified Radical Mastectomy in Turkish Women with Breast Cancer: A Prospective Analysis of Quality of Life
Kement, Metin; Gezen, Cem; Asik, Ayla; Karaöz, Alev; Ustaalioglu, Basak Oven; Bilici, Ahmet; Öncel, Mustafa
Objective: The aim of this study is to compare the postoperative quality of life of the patients who underwent breast conserving surgery followed by radiotherapy (BCT) and the patients who underwent modified radical mastectomy (MRM) in our clinic. Material and Methods: The patients who were operated on with diagnosis of breast cancer in our clinic between January 2006 and January 2008 were included in the study. Those who received neoadjuvant therapy and who required radiotherapy after modified radical mastectomy and those in ASA classes 3 and 4 were excluded. The patients who were treated with modified radical mastectomy were included in the first group (Group MRM) and the patients who were treated with breast conserving therapy and radiotherapy thereafter were included in the second group (Group BCT). Quality of life of the patients were assessed using Medical Outcome Syudy-Short Form 36 (MOS SF-36) form six months after their treatment (surgery, radiotherapy, chemotherapy) was completed. Results: There were no significant differences between two groups in terms of age, evaluated socioeconomic parameters (education, income, marital status) and clinical parameters (stage, complications, adjuvant chemotherapy). Quality of life of the patients who underwent BCT (n=27) was worse than that of general Turkish population in six of eight (except vitality and social function) SF-36 scale and worse than mean values of normal individuals in NSABP BCPT trial in seven of eight (except vitality) scales. Besides, while physical component score was worse than that of general population (45.3 vs 52.6), mental component score (MCS) was relatively similar to general population (53.4 vs 51.7). When quality of life of the patients who underwent MRM (n=23) and BCT were compared, mean values of BCT group were found to be better in all scales and the difference was found to be statistically significant in six out of eight (except vitality and social function) scales (p<0.05). Conclusion: It can be stated that quality of life of the patient who underwent BCT due to breast cancer is impaired in terms of physical status, however did not change in terms of mental status. It can also be stated that quality of life of the patients who underwent breast conserving therapy were better than the ones who underwent modified radical mastectomy in terms of both physical and mental status.