MEME KANSERİ TANISI ALMIŞ KADINLARDA SOSYODEMOGRAFİK VERİLER, MEME YOĞUNLUĞU, MENOPOZ VARLIĞI İLE HEMATOLOJİK VE HİSTOPATOLOJİK BULGULARIN DEĞERLENDİRİLMESİ

Amaç: Meme kanseri, kadınlarda en sık görülen kanser türüdür ve kansere bağlı ölümlerin %15’ini oluşturur.Meme kanser gelişiminin en güçlü risk faktörlerinden biri meme yoğunluğunun fazla olmasının yanı sıra yaş,doğum, emzirme, hormon replasman tedavisi gibi faktörler de kanser gelişimini etkilemektedir. Bu çalışmadameme kanseri tanısı almış kadınlarda sosyodemografik veriler, meme yoğunluğu, menopoz varlığı, hematolojikve histopatolojik bulguların değerlendirilmesi amaçlanmıştır.Materyal ve Metot: Meme Ünitesi birimine yönlendirilen ve mamografi tetkiki yapılan hastalardan, tetkiksonrasında kanser şüphesi nedeniyle tru-cut biyopsisi yapılan ve kanser tanısı alan 154 hastanın tetkik,ameliyat ve histopatolojik sonuçları retrospektif olarak incelendi. 140 hasta çalışmaya dahil edildi. Hastalarınyaşı, eğitim ve medeni durumu, ilk adet yaşı, ilk gebelik yaşı, gebelik sayısı, ilk doğum yaşı, hormon replasmantedavisi görüp görmediği ve mamografi raporlarından da BI-RADS sınıflama sonucu ile meme yoğunluğukaydedildi. Histopatoloji raporundan tümör çapı, derecesi, lenf nodu metastaz varlığı ve lenfovaskülerinvazyon olup olmadığı elde edildikten sonra TNM (tümör-lenf nodu-metastaz) sınıflamasına göre gruplaraayrıldı. Hastaların kan sayımı değerlerinden nötrofil lökosit/lenfosit oranı ve trombosit/lenfosit oranlarıhesaplandı.Bulgular: Meme kanseri tanısı alan 140 hastanın 32’si premenopozal, 108’i postmenopozal idi. Premenopozalhastaların vücut kitle indeksi (VKİ) ortalaması 26,53±3,05 kg/m2 iken, postmenopozal hastaların VKİ’nin29,63±5,60 kg/m2 olduğu ve bu hastaların VKİ’sinin premenopozal hastalarınkinden istatistiksel olarakanlamlı şekilde yüksek olduğu görüldü (p

EVALUATION OF SOCIODEMOGRAPHIC DATA, BREAST DENSITY, PRESENCE OF MENOPAUSE AND HEMATOLOGICAL AND HISTOPATHOLOGICAL FINDINGS IN WOMEN DIAGNOSED WITH BREAST CANCER

Objectives: Breast cancer is the most common type of cancer in women and accounts for 15% of cancer-related deaths. One of the strongest risk factors of breast cancer development, as well as high breast density, factors such as age, birth, breastfeeding, hormone replacement therapy also affect cancer development. In this study, it was aimed to evaluate the effects of sociodemographic data, breast density, presence of menopause, hematological and histopathological findings in women diagnosed with breast cancer. Materials and Methods: The examination, surgery and histopathological results of 154 patients who were referred to the Breast Unit and underwent mammography examination and tru-cut biopsy after the examination and diagnosed with cancer were analyzed retrospectively. According to the mammography findings, who underwent tru-cut biopsy due to suspected cancer and subsequently diagnosed as cancer, 154 patients’ examination, surgery and histopathological results were retrospectively reviewed. 140 patients were included in the study. Breast intensity was recorded from the patients' age, education and marital status, first menstrual age, first gestational age, number of pregnancies, age of first delivery, hormone replacement therapy, and BI-RADS classification results from mammography reports. After obtaining tumor diameter, grade, lymph node metastasis and whether there was lymphovascular invasion from the histopathology report, it was divided into groups according to TNM (tumor- lymph node- metastasis) classification. Neutrophilleukocyte/lymphocyte and platelet/lymphocyte ratios were calculated from the blood count values of the patients. Results: Of the 140 patients diagnosed with breast cancer, 32 were premenopausal and 108 were postmenopausal. While the mean body mass index (BMI) of premenopausal patients was 26.53 ± 3.05 kg / m2, the BMI of postmenopausal patients was 29.63 ± 5.60 kg / m2 and their BMI was statistically significantly higher than that of premenopausal patients. (p

PDF

___

1. World Health Organization (WHO)[İnternet]. https://www.who.int/cancer/prevention/diagnosisscreening/breast-cancer/en/ (ErişimTarihi: 12.12.2019 )
2. Smith RA, Duffy SW, Gabe R, Tabar L, Yen AM, Chen TH. The randomized trials of breast cancer screening: what have we learned? Radiol Clin North Am 2004;42:793-806.
3. Rao AA, Feneis J, Lalonde C, Ojeda-Fournier H. A Pictorial Review of Changes in the BI-RADS Fifth Edition. Radiographics 2016;36:623-39.
4. Carney PA, Miglioretti DL, Yankaskas BC et al. Individual and combined effects of age, breast density, and hormone replacement therapy use on the accuracy of screening mammography. Ann Intern Med 2003;138:168-75.
5. Ziv E, Tice J, Smith-Bindman R, Shepherd J, Cummings S, Kerlikowske K. Mammographic density and estrogen receptor status of breast cancer. Cancer Epidemiol Biomarkers Prev 2004;13:2090-5.
6. Nishiyama K, Taira N, Mizoo T et al. Influence of breast density on breast cancer risk: a case control study in Japanese women. Breast Cancer. 2019 Oct 24. (doi: 10.1007/s12282-019-01018-6).
7. Kocaöz S, Korukluoğlu B, Parlak Ö, Doğan HT, Erdoğan F. Comparison of clinicopathological features and treatments between pre- and post menopausal female breast cancer patients: a retrospective study. Menopause Rev 2019;18:1-6.
8. Liu C, Huang Z2, Wang Q2 et al. Usefulness of neutrophil-to-lymphocyte ratio and platelet-tolymphocyte ratio in hormone-receptor-negative breast cancer. Onco Targets Ther. 2016;27;9: 4653- 60.
9. Boyd NF, Byng JW, Jong RA et al. Quantitative classification of mammographic densities and breast cancer risk: results from the Canadian National Breast Screening Study. J Natl Cancer Inst 1995; 87:670-5.
10. Byrne C, Schairer C, Wolfe J et al. Mammographic features and breast cancer risk: effects with time, age, and menopause status. J Natl Cancer Inst 1995;87:1622-9.
11. Kato I, Beinart C, Bleich A, Su S, Kim M, Toniolo PG. A nested case control study of mammographic patterns, breast volume, and breast cancer (New York City, NY, United States). Cancer Causes Control1995;6:431-8.
12. Boyd N, Martin L, Stone J, Little L, Minkin S, Yaffe M. A longitudinal study of the effects of menopause on mammographic features. Cancer Epidemiol Biomarkers Prev 2002;11:1048- 53.
13. Greendale GA, Reboussin BA, Slone S, Wasilauskas C, Pike MC, Ursin G. Postmenopausal hormone therapy and change in mammographic density. J Natl Cancer Inst 2003;95:30-7.
14. Greendale GA, Reboussin BA, Sie A et al. Effects of estrogen and estrogen-progestin on mammographic parenchymal density. Postmenopausal Estrogen/Progestin Interventions (PEPI) Investigators. Ann Intern Med 1999;130:262-9.
15. El-Bastawissi AY, White E, Mandelson MT, Taplin SH. Reproductive and hormonal factors associated with mammographic breast density by age (United States). Cancer Causes Control 2000;11: 955-63.
16. Taira N, Arai M, Ikeda M et al. The Japanese Breast Cancer Society clinical practice guidelines for epidemiology and prevention of breast cancer, 2015 edition. Breast Cancer 2016;23:343-56.
17. Sala E, Warren R, McCann J, Duffy S, Luben R, Day N. High risk mammographic parenchymal patterns and anthropometric measures: a case-control study. Br J Cancer 1999;81:1257-61.
18. Ishihara S, Taira N, Kawasaki K et al. Association between mammographic breast density and lifestylein Japanese women. Acta Med Okayama. 2013;67:145-51.
19. Nattenmüller CJ, Kriegsmann M, Sookthai D et al . Obesity as risk factor for subtypes of breast cancer: results from a prospective cohort study. BMC Cancer 2018;18:616.
20. Singletary SE. Rating the risk factors for breast cancer. Ann Surg 2003;237:474-82.
21. Scoccianti C, Cecchini M, Anderson AS et al. European Code against Cancer 4th Edition: Alcohol drinking and cancer. Cancer Epidemiol 2016;45:181-8.
22. Goddard ET, Bassale S, Schedin T et al. Association Between Postpartum Breast Cancer Diagnosis and Metastasis and the Clinical Features Underlying Risk. JAMA Netw Open 2019;2:e186997.
23. Andrieu N, Goldgar DE, Easton DF et al. Pregnancies, breast-feeding, and breast cancer risk in the International BRCA1/2 Carrier Cohort Study (IBCCS). J Natl Cancer Inst 2006;98:535-44.
24. Gail MH, Brinton LA, Byar DP et al. Projecting individualized probabilities of developing breast cancer for white females who are being examined annually. J Natl Cancer Inst 1989;81:1879-86.
25. Parker CC, Damodaran S, Bland KI, Hunt KK. Risk Factors for Breast Cancer, The Breast, Brunicardi FC, Andersen DK, Billiar TR, Dunn DL, Hunter JG, Kao LS , Matthews JB, Pollock RE (editors). Schwartz's Principles of Surgery,10th Edition. New York City, United States, McGraw-Hill Education; 2014:511.
26. Hanahan D, Weinberg RA. Hallmarks of cancer: the next generation, Cell 2011;144:646-74.
27. Mantonavi A, Allavena P, Sica A, Balkwill F. Cancer-related inflammation. Nature 2008;454:436-44.
28. Gooden MJM, de Bock GH, Leffers N, Daemen T, Nijman HW. The prognostic influence of tumourinfiltrating lymphocytes in cancer: a systematic review with meta-analysis. Br J Cancer 2011;105: 93- 103.
29. Templeton AJ, McNamara MG, Seruga B et al. Prognostic Role of Neutrophil-to- Lymphocyte Ratio in Solid Tumors: A Systematic Review and Meta-Analysis. J Natl Cancer Inst 2014;106:dju124.
30. Guthrie GJK, Charles KA, Roxburgh CSD, Horgan PG, McMillan DC, Clarke SJ. The systemic inflammation-based neutrophil-lymphocyte ratio: experience in patients with cancer. Crit Rev Oncol Hematol 2013;88:218-30.
31. Krenn-Pilko S, Langsenlehner U, Thurner EM et al. The elevated preoperative platelet-to- lymphocyte ratio predicts poor prognosis in breast cancer patients. Br J Cancer 2014;110(10):2524-30.
32. Koh CH, Bhoo-Pathy N, Ng KL et al. Utility of pre-treatment neutrophil–lymphocyte ratio and platelet– lymphocyte ratio as prognostic factors in breast cancer. Br J Cancer 2015;113(1):150-8.
33. Asano Y, Kashiwagi S, Onoda N et al. Platelet-Lymphocyte Ratio as a Useful Predictor of the Therapeutic Effect of Neoadjuvant Chemotherapy in Breast Cancer. PLoS One 2016;11:e0153459.