Hüseyin EKEN, İsmail ZİHNİ, Oktay KARAKÖSE, Hüseyin PÜLAT, Kazım ÖZÇELİK, Hasan EROL

Erken Evre İnvaziv Duktal Karsinomlu Hastalara Cerrahi Uygulamalarımız

Amaç: Meme kanseri tarama programlarının uygulamadaki artışa bağlı olarakerken evrede tespit edilen meme kanseri oranı artmaktadır. Bu hastalarauygulanan cerrahi teknik tercihinde fikir birliği sağlanamamıştır. Çalışmamızdaerken evrede tespit edilen meme kanserli hastalarımızın klinik özellikleri ilebirlikte pratiğimizde uyguladığımız cerrahi teknikler incelendiGereç ve Yöntemler: Süleyman Demirel Üniversitesi Tıp FakültesiHastanesinde 2013-2015 yılları arasında kliniğimizde erken evrede tanıkonulan 95 hastanın dosyası retrospektif olarak incelendi.Bulgular: Kliniğimiz tanı ve tedavi edilen erken evre invaziv duktal karsinomluhastaların tamamı kadındı. Hastalar ortalama 57 yaşında tanı aldılar.Hastaların %32,6’sına meme koruyucu cerrahi ve sentinel lenf noduörneklemesi; %8,4’üne meme koruyucu cerrahi ve aksiller disseksiyon;%4,2’sine simple mastektomi ve sentinel lenf nodu örneklemesi; ve %54,7’sinede modifiye radikal mastektomi uygulandı. Erken evre meme kanserindeuygulanan cerrahi prosedürler içerisinde meme koruyucu cerrahi %41,4,sentinel lenf nodu örneklemesi %36,8 oranındaydı.Sonuç: Erken evrede tespit edilen meme kanserli hastalara uygulanan memekoruyucu cerrahinin veya mastektominin genel sağkalım ve hastalıksızsağkalım süreleri açısından birbirleri arasında fark izlenmemiştir. Kozmetikaçıdan kuşkusuz daha başarılı olan meme koruyucu cerrahinin bu hastagrubunda ve klinik pratiğimizde artırılması fikrindeyiz.

Surgical Applications to Patients Diagnosed with Early Stage Invasive Ductal Carcinoma

Aim: Early stage breast cancer is being determined at increasing rates associated with an increase in the application of breast cancer screening programs. There is no consensus as to the surgical technique to be applied to these patients. In this study, the surgical techniques applied in our practice were examined together with the clinical characteristics of patients determined with early stage breast cancer. Patients and Methods: A retrospective examination was made of the records of 95 patients diagnosed with early stage breast cancer in our clinic at Süleyman Demirel University Medical Faculty Hospital in 2013 -2015. Results: All the patients diagnosed and treated in our clinic for early stage invasive ductal carcinoma were female. Patients were diagnosed at a median age of 57 years. The treatment applied was breast-conserving surgery and sentinel lymph node sampling in 32,6%, breast-conserving surgery and axillary dissection in 8,4%, simple mastectomy and sentinel lymph node sampling in 4,2% and modified radical mastectomy in 54,7%. Within the surgical procedures applied for early stage breast cancer, breast-conserving surgery was applied at the rate of 41,4% and sentinel lymph node sampling at 36,8%. Conclusion: No difference was determined between the patients with early stage breast cancer who underwent breast-conserving surgery and those who underwent mastectomy in terms of general survival and disease-free survival periods. From a cosmetic aspect, the breast-conserving surgery was without doubt more successful and is being increasingly used in our clinical practice.

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A Isik, H Eken, M Soyturk, D Firat, I Yilmaz A Rare Presentation of Accessory Breast in Axilla Galician Medical Journal 2016; 23, 201645
A Isik, E Karavas, K Peker, M Soyturk, I Yilmaz Male Mondor's Disease is a Rare Entity The Breast Journal 2016;22, 700-701
A Isik, D Firat, M Soyturk, H Eken, O Cimen, I Demiryilmaz, I Yilmaz Gallbladder Duplication Gazi Medical Jounal 2016; 27, 154-155
www.kanser.gov.tr/Dosya/ca_istatistik/ANA_rapor_2012sooonn.pdf (Aralık 2015)
Breast Cancer Clinical Outcome Measures (BCCOM) Project. Analysis of the management of symptomatic breast cancers diagnosed in 2004. 3rd Year Report December 2007.
British Association Of Surgical Oncology (BASO). An audit of screen-detected breast cancers for the year of screening April 2006 to March 2007.
Arriagada R, Lê MG, Rochard F, Contesso G. Conservative treatment versus mastectomy in early breast cancer: Patterns of failure with 15 years of follow-up data. Institut GustaveRoussy Breast Cancer Group. J Clin Oncol 1996;14:1558-64.
Donegan WL. Staging and primary treatment. In: Cancer of the breast. Edited by Donegan WL and Spratt JS, editors. 4th ed. W.B. Saunders Company 1995;375- 442.
Fisher B, Redmond C, Poisson R, Margolese R, Wolmark N, Wickerham L, et al. Eight-year results of a randomized clinical trial comparing total mastectomy and lumpectomy with or without irradiation in the treatment of breast cancer. N Engl J Med 1989;320:822-8.
Fisher B, Anderson S, Redmond CK, Wolmark M, Wickerham DL, Cronin WM. Reanalysis and results after 12 years of follow-up in a randomized clinical trial comparing total mastectomy with lumpectomy with or without irradiation in the treatment of breast cancer. N Engl J Med 1995;333:1456-61.
van Dongen JA, Bartelink H, Fentiman IS, Lerut T, Mignoletb F, Olthuis G, et al. Factors influencing local relapse and survival and results of salvage treatment after breastconserving therapy in operable breast cancer: EORTC trial 10801, breast conservation compared with mastectomy in TNM stage I and II breast cancer. Eur J Cancer 1992;28A:801-5.
Veronesi U, Saccozzi R, Del Vecchio M, Banfi A, Clemente C, De Lena M, et al. Comparing radical mastectomy with quadrantectomy, axillary dissection, and radiotherapy in patients with small cancers of the breast. N Engl J Med 1981;305:6-11.
Ganz PA, Schag CC, Polinsky ML, Heinrich RL, Flack VF. Rehabilitation needs and breast cancer: The first month after primary therapy. Breast Cancer Res Treat 1987;10:243-53.
Schain WS, d'Angelo TM, Dunn ME, Lichter AS, Pierce LJ. Mastectomy versus conservative surgery and radiation therapy: Psychosocial consequences. Cancer 1994;73:1221-8.