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Article: Does F-18 FDG-PET/CT Have an Additional Impact on Axillary Approach in Early-Stage Breast Cancer?

Çelik, Burak / Boge, Medine / Dilege, Ece

European journal of breast health

2023 Volume 20, Issue 1, Page(s) 45–51

Abstract: Objective: Breast cancer (BC) is a significant health concern and one of the most diagnosed cancers in women, both in Turkey and globally. Despite advances in the management of BC, axillary lymph node involvement remains a significant consideration for ... ...

Abstract	Objective: Breast cancer (BC) is a significant health concern and one of the most diagnosed cancers in women, both in Turkey and globally. Despite advances in the management of BC, axillary lymph node involvement remains a significant consideration for treatment planning, local recurrence, and prognosis. We aimed to evaluate the contribution of F-18 fluorodeoxyglucose-positron emission tomography/computed tomography (F-18 FDG-PET/CT) in detecting axillary lymph node metastasis compared to ultrasound (US). Materials and methods: Eighty patients who were diagnosed with stage I and II BC and underwent US and F-18 FDG-PET/CT scans before surgery were enrolled in this study. Those who did not undergo F-18 FDG-PET/CT imaging, patients with distant metastases at the time of diagnosis and patients with micrometastases in the axilla were excluded from the analysis. Imaging results of the status of axillary lymph nodes were verified with the final pathology report of axillary lymph nodes. Results: The sensitivity, specificity, positive predictive value, negative predictive value, and accuracy of F-18 FDG-PET/CT for the detection of ipsilateral axillary lymph node metastases were 75%, 77.27%, 72.97%, 79.07%, and 76.25%. The corresponding values for US were 72.22%, 81.82%, 76.47%, 78.26%, and 77.50%, respectively. When US finding is negative or suspicious in axillary lymph node evaluation, the accuracy of F-18 FDG-PET/CT for the detection of ipsilateral axillary lymph node metastases were 65.38%, 83.33%, 70.83%, and 79.55%, respectively. Conclusion: This study found that F-18 FDG-PET/CT does not provide an additional advantage over US in assessing the axilla in early-stage disease.
Language	English
Publishing date	2023-12-27
Publishing country	Turkey
Document type	Journal Article
ISSN	2587-0831
ISSN	2587-0831
DOI	10.4274/ejbh.galenos.2023.2023-10-6
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Article ; Online: A rare tumor of the male breast "angiolipoma" Case report and review of literature.

Dilege, Ece / Bozkurt, Emre / Kulle, Cemil Burak / Bulutay, Pınar / Agcaoglu, Orhan

Annali italiani di chirurgia

2022 Volume 11

Abstract: Aim: Angiolipoma is uncommon lesion in the breast and has clinical importance due to the potential of confusion with malignant breast lesions. To date, there is no defined diagnosis and treatment algorithm for breast angiolipomas. We aim to contribute ... ...

Abstract	Aim: Angiolipoma is uncommon lesion in the breast and has clinical importance due to the potential of confusion with malignant breast lesions. To date, there is no defined diagnosis and treatment algorithm for breast angiolipomas. We aim to contribute to the literature for the diagnosis and treatment of angiolipomas with this case report and literature review. Case report: A 29-year-old male patient presented with a newly emerged palpable mass in the right breast. Physical examination revealed a palpable mass in the lower inner quadrant of the right breast without any presence of skin changes, nipple discharge or palpable axillary lymph nodes. The lesion was found to be 3 cm in diameter and showed minimal vascularization on Doppler Ultrasound examination. Surgical excision of the lesion was performed and the lesion was diagnosed as angiolipoma. Conclusion: Angiolipomas of the breast in male are rare pathological entities and must always be considered during differential diagnosis, as it can be confused clinically, radiologically and pathologically with other lesions, especially with malignant lesions KEY WORDS: Angiolipoma, Breast, Male breast lesions.
MeSH term(s)	Adult ; Angiolipoma/diagnostic imaging ; Angiolipoma/surgery ; Breast Neoplasms, Male/diagnostic imaging ; Breast Neoplasms, Male/surgery ; Diagnosis, Differential ; Humans ; Male ; Ultrasonography
Language	English
Publishing date	2022-02-25
Publishing country	Italy
Document type	Case Reports ; Journal Article ; Review
ZDB-ID	418927-9
ISSN	2239-253X ; 0003-469X
ISSN (online)	2239-253X
ISSN	0003-469X
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Article ; Online: SPECT/CT Lymphoscintigraphy Accurately Localizes Clipped and Sentinel Nodes After Neoadjuvant Chemotherapy in Node-Positive Breast Cancer.

Dilege, Ece / Celik, Burak / Falay, Okan / Boge, Medine / Sucu, Serkan / Toprak, Safa / Agcaoglu, Orhan / Kapucuoglu, Nilgun / Demirkol, Onur

Clinical nuclear medicine

2023 Volume 48, Issue 7, Page(s) 594–599

Abstract: Purpose: The aim of this study was to evaluate the impact of SPECT/CT lymphoscintigraphy on targeted axillary dissection (TAD) in node-positive breast cancer (BC) patients who had undergone neoadjuvant chemotherapy (NAC).: Methods: Sixty-two female ... ...

Abstract	Purpose: The aim of this study was to evaluate the impact of SPECT/CT lymphoscintigraphy on targeted axillary dissection (TAD) in node-positive breast cancer (BC) patients who had undergone neoadjuvant chemotherapy (NAC). Methods: Sixty-two female BC patients with biopsy-confirmed axillary nodal metastases underwent NAC, followed by breast surgery with TAD. A metallic clip was placed in the sampled LN before NAC. On the day of surgery, a periareolar intradermal 99m Tc-nanocolloid injection was administered, followed by SPECT/CT lymphoscintigraphy. The clipped nodes were localized on CT images, assessed for 99m Tc uptake before surgery, and confirmed during the procedure. Results: T1-4, N1-2 patients were enrolled in the study. All patients underwent sentinel lymph node (SLN) biopsy. The clipped node was the SLN in 54 (88.5%) patients. In 3 patients (4.9%), a clip was found in a nonsentinel lymph node. In 4 patients, the clips were not visible on SPECT/CT images, and lymph nodes were not found during the procedure. SPECT/CT correctly localized the clipped lymph node in all patients. The overall false-negative rate for TAD was 3.33%. The mean follow-up duration was 29 months, and there were no axillary recurrences. Conclusions: SPECT/CT lymphoscintigraphy can accurately localize clipped nodes and SLNs after NAC in patients with node-positive BC.
MeSH term(s)	Humans ; Female ; Breast Neoplasms/diagnostic imaging ; Breast Neoplasms/drug therapy ; Breast Neoplasms/surgery ; Sentinel Lymph Node/diagnostic imaging ; Sentinel Lymph Node/surgery ; Sentinel Lymph Node/pathology ; Neoadjuvant Therapy ; Lymphoscintigraphy ; Lymphatic Metastasis/pathology ; Sentinel Lymph Node Biopsy/methods ; Lymph Nodes/pathology ; Lymph Node Excision/methods ; Single Photon Emission Computed Tomography Computed Tomography ; Lymphadenopathy ; Surgical Instruments ; Axilla/pathology
Language	English
Publishing date	2023-04-17
Publishing country	United States
Document type	Journal Article
ZDB-ID	197628-x
ISSN	1536-0229 ; 0363-9762
ISSN (online)	1536-0229
ISSN	0363-9762
DOI	10.1097/RLU.0000000000004669
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Article ; Online: Sphingosine-1-phosphate reduces atresia of primordial follicles occurring during slow-freezing and thawing of human ovarian cortical strips.

Guzel, Yilmaz / Bildik, Gamze / Dilege, Ece / Oktem, Ozgur

Molecular reproduction and development

2018 Volume 85, Issue 11, Page(s) 858–864

Abstract: We aimed in this study to explore if sphingosine-1-phosphate (S1P) reduces apoptosis of primordial follicles during cryopreservation of human ovarian cortical samples. Ovarian cortical tissue fragments obtained from young patients who underwent ... ...

Abstract	We aimed in this study to explore if sphingosine-1-phosphate (S1P) reduces apoptosis of primordial follicles during cryopreservation of human ovarian cortical samples. Ovarian cortical tissue fragments obtained from young patients who underwent laparoscopic excision of benign ovarian cysts were used for the experiments. The samples were slow-frozen and thawed with and without S1P at 200 and 400 μM, cultured for 1 day, and then were fixed and processed for both histomorphological assessment and detection of apoptosis with immunohistochemistry using apoptosis marker cleaved caspase-3. Follicle counts were expressed as the mean number of follicles per mm
MeSH term(s)	Adult ; Anti-Mullerian Hormone/metabolism ; Apoptosis ; Caspase 3/metabolism ; Cryopreservation ; Estradiol/metabolism ; Female ; Humans ; Lysophospholipids/metabolism ; Oocytes/cytology ; Oocytes/metabolism ; Ovarian Follicle/cytology ; Ovarian Follicle/metabolism ; Sphingosine/analogs & derivatives ; Sphingosine/metabolism
Chemical Substances	Lysophospholipids ; sphingosine 1-phosphate (26993-30-6) ; Estradiol (4TI98Z838E) ; Anti-Mullerian Hormone (80497-65-0) ; CASP3 protein, human (EC 3.4.22.-) ; Caspase 3 (EC 3.4.22.-) ; Sphingosine (NGZ37HRE42)
Language	English
Publishing date	2018-08-14
Publishing country	United States
Document type	Journal Article
ZDB-ID	20321-x
ISSN	1098-2795 ; 1040-452X
ISSN (online)	1098-2795
ISSN	1040-452X
DOI	10.1002/mrd.23043
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Article ; Online: Breast cancer treatment and ovarian function.

Yildiz, Sule / Bildik, Gamze / Benlioglu, Can / Turan, Volkan / Dilege, Ece / Ozel, Melis / Kim, Samuel / Oktem, Ozgur

Reproductive biomedicine online

2022 Volume 46, Issue 2, Page(s) 313–331

Abstract: The aim of this study was to provide an update on ovarian function and the mechanisms of gonadal damage after exposure to chemotherapy in breast cancer survivors. The alkylating agents are toxic to both primordial and growing follicles. However, anti- ... ...

Abstract	The aim of this study was to provide an update on ovarian function and the mechanisms of gonadal damage after exposure to chemotherapy in breast cancer survivors. The alkylating agents are toxic to both primordial and growing follicles. However, anti-metabolite drugs are more likely to destroy preantral and antral follicles. Younger patients are more likely to have a higher ovarian reserve, and therefore, more likely to retain some residual ovarian function after exposure to gonadotoxic regimens. However, there can be significant variability in ovarian reserve among patients of the same age. Furthermore, patients with critically diminished ovarian reserve may continue to menstruate regularly. Therefore age and menstrual status are not reliable indicators of good ovarian reserve and might give a false sense of security and result in an adverse outcome if the patient is consulted without considering more reliable quantitative markers of ovarian reserve (antral follicle count and anti-Müllerian hormone) and fertility preservation is not pursued. In contrast to well-documented ovarian toxicity of older chemotherapy regimens, data for newer taxane-containing protocols have only accumulated in the last decade and data are still very limited regarding the impact of targeted therapies on ovarian function.
MeSH term(s)	Female ; Humans ; Breast Neoplasms/drug therapy ; Ovarian Follicle ; Ovarian Diseases ; Ovarian Reserve ; Anti-Mullerian Hormone
Chemical Substances	Anti-Mullerian Hormone (80497-65-0)
Language	English
Publishing date	2022-09-21
Publishing country	Netherlands
Document type	Journal Article ; Review
ZDB-ID	2113823-0
ISSN	1472-6491 ; 1472-6483
ISSN (online)	1472-6491
ISSN	1472-6483
DOI	10.1016/j.rbmo.2022.09.014
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Article ; Online: Bilateral rhomboid block may provide complete pain relief following bilateral breast surgery.

Gürkan, Yavuz / Manici, Mete / Salgın, Belitsu / Dilege, Ece / Ağcaoğlu, Orhan / Tatar, Sedat / Erçelen, Ömür

Journal of clinical anesthesia

2020 Volume 68, Page(s) 110064

MeSH term(s)	Breast Neoplasms/surgery ; Female ; Humans ; Mastectomy/adverse effects ; Nerve Block ; Pain Management ; Pain, Postoperative/etiology ; Pain, Postoperative/prevention & control
Language	English
Publishing date	2020-10-01
Publishing country	United States
Document type	Letter
ZDB-ID	1011618-7
ISSN	1873-4529 ; 0952-8180
ISSN (online)	1873-4529
ISSN	0952-8180
DOI	10.1016/j.jclinane.2020.110064
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Article ; Online: Tumor-derived CTF1 (cardiotrophin 1) is a critical mediator of stroma-assisted and autophagy-dependent breast cancer cell migration, invasion and metastasis.

Akkoc, Yunus / Dalci, Kubilay / Karakas, Hacer Ezgi / Erbil-Bilir, Secil / Yalav, Orcun / Sakman, Gurhan / Celik, Faruk / Arikan, Soykan / Zeybek, Umit / Ergin, Melek / Akkiz, Hikmet / Dilege, Ece / Dengjel, Joern / Dogan-Ekici, A Isin / Gozuacik, Devrim

Autophagy

2022 Volume 19, Issue 1, Page(s) 306–323

Abstract: Macroautophagy/autophagy is an evolutionarily conserved cellular stress response mechanism. Autophagy induction in the tumor microenvironment (stroma) has been shown to support tumor metabolism. However, cancer cell-derived secreted factors that initiate ...

Abstract	Macroautophagy/autophagy is an evolutionarily conserved cellular stress response mechanism. Autophagy induction in the tumor microenvironment (stroma) has been shown to support tumor metabolism. However, cancer cell-derived secreted factors that initiate communication with surrounding cells and stimulate autophagy in the tumor microenvironment are not fully documented. We identified CTF1/CT-1 (cardiotrophin 1) as an activator of autophagy in fibroblasts and breast cancer-derived carcinoma-associated fibroblasts (CAFs). We showed that CTF1 stimulated phosphorylation and nuclear translocation of STAT3, initiating transcriptional activation of key autophagy proteins. Additionally, following CTF1 treatment, AMPK and ULK1 activation was observed. We provided evidence that autophagy was important for CTF1-dependent ACTA2/α-SMA accumulation, stress fiber formation and fibroblast activation. Moreover, promotion of breast cancer cell migration and invasion by activated fibroblasts depended on CTF1 and autophagy. Analysis of the expression levels of CTF1 in patient-derived breast cancer samples led us to establish a correlation between CTF1 expression and autophagy in the tumor stroma. In line with our
MeSH term(s)	Animals ; Mice ; Autophagy ; Cell Line, Tumor ; Cell Movement ; Fibroblasts/metabolism ; Interleukin-6/metabolism ; Transforming Growth Factor beta/metabolism ; Humans ; Female ; Breast Neoplasms/metabolism ; Cytokines/metabolism
Chemical Substances	cardiotrophin 1 (AJ7U77BR8I) ; Interleukin-6 ; Transforming Growth Factor beta ; Cytokines
Language	English
Publishing date	2022-06-28
Publishing country	United States
Document type	Journal Article ; Research Support, Non-U.S. Gov't
ZDB-ID	2454135-7
ISSN	1554-8635 ; 1554-8627
ISSN (online)	1554-8635
ISSN	1554-8627
DOI	10.1080/15548627.2022.2090693
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Article: BioEnterics intragastric balloon: clinical outcomes of the first 100 patients--a Turkish experience.

Coskun, Halil / Bostanci, Ozgur / Dilege, Ece / Bozbora, Alp

Obesity surgery

2008 Volume 18, Issue 9, Page(s) 1154–1156

Abstract: Background: The BioEnterics Intragrastric Balloon (BIB) together with restricted diet has been used for the treatment of obesity and morbid obesity.: Methods: A prospective study was conducted on 100 patients who had undergone the BIB procedure ... ...

Abstract	Background: The BioEnterics Intragrastric Balloon (BIB) together with restricted diet has been used for the treatment of obesity and morbid obesity. Methods: A prospective study was conducted on 100 patients who had undergone the BIB procedure between February 2005 and February 2007. Results: Mean age, mean weight, and mean BMI of the patients were 35.35 +/- 9.25 years, 113.23 +/- 24.76 kg (range 73-200 kg), and 39.28 +/- 6.98 kg/m(2) (range 30-69.2 kg/m(2)), respectively. Six months after the BIB procedure, mean weight and mean BMI were reduced to 100.46 +/- 26.05 kg (range 58-178 kg) and 34.70 +/- 11 kg/m(2) (range 21.83-61.59 kg/m(2)), respectively. There was a statistically significant reduction in weight and BMI at 6 months after the BIB procedure (p < 0.01). Excess weight loss (EWL) at 6 months ranged between 0 and 28 kg, with a mean value of 12.68 +/- 7.70 kg. The subjects had 0 to 99.2% %EWL (mean 28.63 +/- 19.29). Reduction in BMI at 6 months ranged between 0 and 12.3 kg/m(2), with a mean value of 4.51 +/- 2.85 kg/m(2), and percent excess body mass index loss (%EBMIL) was 38.20 +/- 28.78% (range 0-158%). At 6 months, there was a significant reduction in body weight and BMI (p < 0.01) in both groups. The reduction in BMI of the morbidly obese group was significantly greater than that of the obese group (p = 0.035), and both the %EWL and %EBMIL of the morbidly obese patients were significantly lower than those of the obese patients at 6 months (p = 0.001). Conclusions: BIB application is a reasonable weight loss method with few complications.
MeSH term(s)	Adolescent ; Adult ; Body Mass Index ; Female ; Follow-Up Studies ; Gastric Balloon ; Humans ; Male ; Middle Aged ; Obesity, Morbid/therapy ; Postoperative Complications ; Prospective Studies ; Treatment Outcome ; Turkey ; Weight Loss ; Young Adult
Language	English
Publishing date	2008-06-03
Publishing country	United States
Document type	Journal Article
ZDB-ID	1070827-3
ISSN	1708-0428 ; 0960-8923
ISSN (online)	1708-0428
ISSN	0960-8923
DOI	10.1007/s11695-008-9565-0
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Article ; Online: Is elective cancer surgery feasible during the lock-down period of the COVID-19 pandemic? Analysis of a single institutional experience of 404 consecutive patients.

Kulle, Cemil Burak / Azamat, Ibrahim Fethi / Vatansever, Dogan / Erus, Suat / Tarim, Kayhan / Akyoldas, Goktug / Gokler, Ozan / Deveci, Mehmet Ali / Cakar, Nahit / Ergonul, Onder / Agcaoglu, Orhan / Kiremit, Murat Can / Yavuz, Omer / Kiris, Talat / Unsaler, Selin / Giray, Burak / Korkmaz, Murat / Dilege, Ece / Kilic, Mert /

Cesur, Ezgi / Solaroglu, Ihsan / Altuntas, Ozan / Simsek, Aykin / Tanju, Serhan / Erkan, Mert / Canda, Erdem / Sasani, Mehdi / Hafiz, Aysenur Meric / Kordan, Yakup / Balik, Emre / Bilge, Orhan / Bugra, Dursun / Taskiran, Cagatay / Dilege, Sukru

Journal of surgical oncology

2021 Volume 123, Issue 7, Page(s) 1495–1503

Abstract: Background: We aimed to assess the feasibility and short-term clinical outcomes of surgical procedures for cancer at an institution using a coronavirus disease 2019 (COVID-19)-free surgical pathway during the peak phase of the severe acute respiratory ... ...

Abstract	Background: We aimed to assess the feasibility and short-term clinical outcomes of surgical procedures for cancer at an institution using a coronavirus disease 2019 (COVID-19)-free surgical pathway during the peak phase of the severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) pandemic. Materials and methods: This was a single-center study, including cancer patients from all surgical departments, who underwent elective surgical procedures during the first peak phase between March 10 and June 30, 2020. The primary outcomes were the rate of postoperative SARS-CoV-2 infection and 30-day pulmonary or non-pulmonary related morbidity and mortality associated with SARS-CoV-2 disease. Results: Four hundred and four cancer patients fulfilling inclusion criteria were analyzed. The rate of patients who underwent open and minimally invasive procedures was 61.9% and 38.1%, respectively. Only one (0.2%) patient died during the study period due to postoperative SARS-CoV2 infection because of acute respiratory distress syndrome. The overall non-SARS-CoV2 related 30-day morbidity and mortality rates were 19.3% and 1.7%, respectively; whereas the overall SARS-CoV2 related 30-day morbidity and mortality rates were 0.2% and 0.2%, respectively. Conclusions: Under strict institutional policies and measures to establish a COVID-19-free surgical pathway, elective and emergency cancer operations can be performed with acceptable perioperative and postoperative morbidity and mortality.
MeSH term(s)	Adolescent ; Adult ; Aged ; Aged, 80 and over ; COVID-19/epidemiology ; Child ; Child, Preschool ; Cohort Studies ; Elective Surgical Procedures/methods ; Elective Surgical Procedures/mortality ; Elective Surgical Procedures/statistics & numerical data ; Female ; Humans ; Male ; Middle Aged ; Neoplasms/mortality ; Neoplasms/surgery ; Pandemics ; Postoperative Complications/epidemiology ; Postoperative Complications/virology ; Retrospective Studies ; SARS-CoV-2/isolation & purification ; Turkey/epidemiology ; Young Adult
Language	English
Publishing date	2021-02-23
Publishing country	United States
Document type	Journal Article
ZDB-ID	82063-5
ISSN	1096-9098 ; 0022-4790
ISSN (online)	1096-9098
ISSN	0022-4790
DOI	10.1002/jso.26436
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Article: Effect of gastric banding on ileal mucosa.

Bozbora, Alp / Coskun, Halil / Kasoglu, Ahmet / Dilege, Ece / Barbaros, Umut

Obesity surgery

2005 Volume 15, Issue 2, Page(s) 294–295

MeSH term(s)	Animals ; Biopsy, Needle ; Disease Models, Animal ; Female ; Gastroplasty/adverse effects ; Gastroplasty/methods ; Ileum/pathology ; Immunohistochemistry ; Intestinal Mucosa/pathology ; Obesity, Morbid/surgery ; Random Allocation ; Rats ; Rats, Wistar ; Reference Values ; Risk Factors ; Weight Loss
Language	English
Publishing date	2005-02
Publishing country	United States
Document type	Comparative Study ; Letter
ZDB-ID	1070827-3
ISSN	1708-0428 ; 0960-8923
ISSN (online)	1708-0428
ISSN	0960-8923
DOI	10.1381/0960892053268336
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