Browsing by Author "Tasli, Funda"

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Citation - WoS: 2
Citation - Scopus: 2
A Comprehensive Analysis of Neoadjuvant Chemotherapy in Breast Cancer: Adverse Events, Clinical Response Rates, and Surgical and Pathological Outcomes-Bozyaka Experience
(Mdpi, 2025) Yilmaz, Cengiz; Zengel, Baha; Ureyen, Orhan; Adibelli, Zehra Hilal; Tasli, Funda; Yilmaz, Hasan Taylan; Ilhan, Enver
Objectives: To evaluate the neoadjuvant chemotherapy (NACTx) process in breast cancer (BC), its significant treatment-related adverse events (trAEs), tumor clinical response rates, and surgical and pathological outcomes, and to analyze factors influencing cavity shaving and axillary lymph node dissection (ALND) following sentinel lymph node biopsy (SLNB). Methods: A comprehensive retrospective study was conducted at a single center on patients who received NACTx for BC between 2015 and 2021. Results: Medical records of 242 patients were reviewed. Approximately one-fifth encountered grade >= 3 trAEs (21.5%), leading 3.3% to discontinue chemotherapy. Anthracycline cardiotoxicity (2.2%) caused one death (mortality rate = 0.4%). For clinical response and surgical and pathological outcomes, 229 patients were eligible. Clinical progression occurred in 3.9% of the patients (14% in triple-negative BC, p = 0.004). Breast-conserving surgery (BCS) was performed in 55% of the patients. There was no significant difference between the type of breast surgery (BCS vs. mastectomy) and molecular subtype, histology, tumor size, or tumor's pathological response degree. Cavity shaving was required in one-fifth of the patients who underwent BCS (n = 134) due to an invasive tumor at the surgical margin (SM). Tumor histology (invasive ductal vs. invasive lobular carcinoma; OR: 4.962, 95% CI 1.007-24.441, p = 0.049) and tumor SUVMax value (OR: 0.866, 95% CI 0.755-0.993, p = 0.039) had significant independent efficacy on SM positivity. Initially, 75% underwent SLNB, but nearly half of them needed ALND. ALND rates were significantly higher in the luminal A and LB-HER2(-) groups (87% vs. 69%) than in the HER2(+) and TN groups (43% to 50%) (p = 0.001). All luminal A patients and those with lobular histology required ALND after SLNB, but no patients in the HER2-enriched group required ALND. ER positivity and higher PR expression levels were associated with an increased need for ALND after SLNB, whereas HER2 positivity and higher SUVMax values of LN(s) were associated with a significantly reduced need for ALND. About 27% of the patients achieved overall pCR. No pCR was achieved in the LA group. Conclusions: The BC NACTx process requires close monitoring due to severe AEs and disease progression. NACTx decisions must be made on experienced multidisciplinary tumor boards, considering tumor characteristics and expected targets.
Is There an MRI Characteristic Feature That Distinguishes a Phyllloid Tumor From a Fibroadenoma
(Bayrakol Medical Publisher, 2025) Tuncez, Hulya Cetin; Unverdi, Basak; Adibelli, Zehra Hilal; Zengel, Baha; Tasli, Funda
Aim: Cellular fibroadenomas (CFAs) and phyllodes tumours (PTs) arise from the breast parenchyma and consist of both epithelial and stromal components. In our study, we aimed to investigate and compare magnetic resonance imaging (MRI) characteristics of these lesions to facilitate the process of differentiation and management. Materials and Methods: We retrospectively analysed the breast MRI data of patients pathologically diagnosed with PT and CFA. 25 patients with preoperative MRI who were diagnosed with PT in the last five years and 25 patients with preoperative MRI who were diagnosed with CFA in the last one year were randomly selected and included in the study. MRI findings were classified according to the Breast Imaging Reporting and Database System (BIRADS). Pearson Chi-Square and Fisher's Exact tests were used to calculate the statistical difference between MRI features of CFA and PT. Results: The mean age was calculated 32.68 +/- 7.73 for patients with CFA and 38.32 +/- 10.71 for patients with PT (p=0.038). In fat suppressed T2 weighed imaging (WI) both lesion groups showed similar characteristics; 24 of the CFAs and 19 of the PTs demonstrated an increase in signal intensity. Two CFAs and nine PTs had cystic components (p=0.017). Signal increase in the surrounding tissue in fat suppressed T2WI was seen in 11 (44%) of the PTs, but in only 1 (4%) of the CFAs (p=0.001). On delayed phase T1WI, 10 of the CFAs and 18 of the PTs sustained heterogeneous enhancement characteristics (p=0.023). Discussion: All in all, we found that PTs arise later in life compared to CFAs. Increased signal intensity in the surrounding tissue in fat suppressed T2WI and the presence of a cystic component is more suggestive of PT. In delayed phase T1WI, CFAs appear to be homogenously enhanced, whereas PTs maintain their heterogeneous enhancement.