Hasan Karanlik

Istanbul University · Institute of Oncology

Purpose This study aimed to determine estrogen receptor (ER) expression in stromal cells in postchemotherapy tumor bed (PCTB) and its relationship with tumor regression and tumor characteristics. Methods The study included 490 breast cancer patients who received neoadjuvant chemotherapy (NAC). We performed ER in stromal cells in all resection spec...

Importance Increasing evidence supports the oncologic safety of de-escalating axillary surgery for patients with breast cancer after neoadjuvant chemotherapy (NAC). Objective To evaluate the oncologic outcomes of de-escalating axillary surgery among patients with clinically node (cN)–positive breast cancer and patients whose disease became cN nega...

Despite advances in cancer treatment, breast cancer (BC) remains one of the most common cancers affecting women worldwide. This study aimed to determine serum circFBXW7, circABCB10, and circ0103552 levels and compare BC patients and healthy controls to investigate their roles in the molecular mechanism of BC and the significance of these circRNAs i...

The combined analysis of the retrospective multicentre and prospective multicenter cohort registry trial NEOSENTITURK MF18-02/18-03 (NCT04250129) investigated the outcomes and factors associated with recurrence in patients with cT1-4N1-3M0 who underwent a succesful sentinel lymph node biopsy or targeted axillary dissection (n = 1470), with or witho...

This study aims to identify factors predicting recurrence and unfavorable prognosis in cN+ patients who have undergone sentinel lymph node biopsy (SLNB) following neoadjuvant chemotherapy (NAC). The retrospective multi-centre “MF18-02” and the prospective multi-centre cohort registry trial “MF18-03” (NCT04250129) included patients with cT1-4N1-3M0...

PURPOSE The nodal burden of patients with residual isolated tumor cells (ITCs) in the sentinel lymph nodes (SLNs) after neoadjuvant chemotherapy (NAC) (ypN0i+) is unknown, and axillary management is not standardized. We investigated rates of additional positive lymph nodes (LNs) at axillary lymph node dissection (ALND) and oncologic outcomes in pat...

Background Sentinel lymph node biopsy (SLNB) is widely used in patients who receive neoadjuvant chemotherapy (NAC). Still, axillary lymph node dissection (ALND) is recommended for patients with any axillary residual disease after NAC. The necessity of ALND in patients with minimal axillary disease is unclear. We aim to investigate regional recurren...

Background The omission of axillary lymph node dissection (ALND) remains controversial for patients with residual axillary disease after neoadjuvant chemotherapy (NAC), regardless of the residual burden. This study evaluated the oncologic safety and factors associated with outcomes in patients with residual axillary disease. These patients were tre...

OBJECTIVE Breast cancer is the most diagnosed cancer in females. Cancer screening programs increase the detection of early-stage breast cancer. This study aimed to assess the long-term outcomes and the effect of adjuvant therapies for recurrence in stage I breast cancer patients. METHODS We recorded clinicopathological and treatment features of the...

Background Sentinel lymph node biopsy(SLNB) is widely used in patients who receive neoadjuvant chemotherapy(NAC). Still, axillary lymph node dissection(ALND) is recommended for patients with any axillary residual disease after NAC. The necessity of ALND in patients with minimal axillary disease is unclear. We aim to investigate regional recurrence...

Background Any advantage of performing targeted axillary dissection (TAD) compared to sentinel lymph node (SLN) biopsy (SLNB) is under debate in clinically node-positive (cN+) patients diagnosed with breast cancer. Our objective was to assess the feasibility of the removal of the clipped node (RCN) with TAD or without imaging-guided localisation b...

Background: Previous prospective studies reported decreased false negative rates in patients presenting with T1-3/cN1 disease, with the removal of 2 or more sentinel lymph nodes (SLNs), using combined technique for SLN biopsy (SLNB), and by targeted axillary dissection (TAD) in initially clinically node-positive patients after neoadjuvant chemother...

Background: In current guidelines, there is no definite recommendation regarding postmastectomy radiation therapy (PMRT) in patients with luminal pT3N0M0 breast cancer (BC). The goal of this study is to determine whether PMRT could be safely omitted for a specific subgroup of those patients. Methods and Materials: There were 202 women from 16 cente...

Introduction: The impact of loco-regional treatment (LRT) on survival in de novo bone-only metastatic breast cancer (BC) is controversial. The aim of this study is to assess the effect of LRT on survival utilizing international, prospectively acquired data in this cohort of patients. Materials and Methods: Patients with de novo metastatic BC with b...

Background Individualized treatment strategies are highlighted for breast cancer patients in the last decades. Therefore aggressive surgical approaches have begun to evolve towards minimally invasive tailored interventions. SLNB is widely used in patients who received neoadjuvant treatment (NAC) and axillary lymph node dissection (ALND) is recommen...

Background: In patients with micro- and macrometastases in the sentinel lymph node (SLN) after neoadjuvant chemotherapy (NAC), additional positive nodes are found in >60% of cases and axillary lymph node dissection (ALND) is currently considered standard of care. The likelihood of finding additional positive lymph nodes in patients with residual is...

Importance Data on oncological outcomes after omission of axillary lymph node dissection (ALND) in patients with breast cancer that downstages from node positive to negative with neoadjuvant chemotherapy are sparse. Additionally, the best axillary surgical staging technique in this scenario is unknown. Objective To investigate oncological outcomes...

Metaplastic breast carcinoma (MBC) -rare but fatal subtype of invasive breast carcinomas- provides limited benefit from conventional triple-negative breast carcinoma chemotherapy. We aimed to determine the immune density of this tumor and to evaluate of programmed death-ligand 1 (PD-L1) and chemokine receptor type 4 (CXCR4) expressions to determine...

Introduction: We aimed to report the long-term surgical outcomes of extreme oncoplasty techniques in selected patients with unifocal (UF)/cT3 or multifocal-multicentric tumors (MFMC). Material and methods: Patients who were initially recommended to have mastectomy underwent extreme oncoplastic breast-conserving surgery (eOBCS) including therapeu...

Background: Whether axillary lymph node dissection (ALND) following sentinel lymph node biopsy (SLNB) could be spared in patients with initially clinically positive axilla after neoadjuvant chemotherapy (NAC) is still controversial even though recent studies indicate that axillary recurrence seems to be a rare event. Our aim is to find out whether...

Background and objectives: This trial aimed to investigate the effects of circumferential shaving on reducing the reoperation rates during breast-conserving surgery (BCS). Methods: In the study, before 2014, 404 (39.9%) breast cancers (BCs) out of a total of 1012 BCs underwent BCS without intraoperative cavity shaving (ICS) and constituted the n...

Objective: A few studies suggest that mucinous breast carcinoma (MBC) is a rare breast carcinoma with good prognostic features. Therefore, the aim of this study was to evaluate biological features and clinicopathological characteristics of pure mucinous breast carcinoma (PMBC) to determine clinical outcome in PMBC. Materials and methods: The dat...

Background: One fourth of early-stage breast cancer cases become metastatic during the follow-up period. Limited metastasis is a metastatic disease condition in which the number of metastatic sites and the extent of the disease both are limited, and the disease is amenable to metastatic intervention. This prospective study aimed to evaluate interv...

Background: Metaplastic breast carcinoma (MBC) is a rare type of breast cancer that accounts for 0.2-1% of all breast cancers. To date, there are only few institutional studies comparing survival rates between different subtypes. In this retrospective cohort study, we aim to evaluate factors effecting survival rates of different subtypes of MBC....

Aim . Demand for nipple and skin sparing mastectomy (NSM/SSM) with immediate breast reconstruction (BR) has increased at the same time as indications for post-mastectomy radiation therapy (PMRT) have broadened. The aim of the Oncoplastic Breast Consortium initiative was to address relevant questions arising with this clinically challenging scenari...

Objectives To investigate the efficacy of abbreviated breast magnetic resonance imaging (MRI) in neoadjuvant chemotherapy (NAC) response evaluation. Methods: MR images of 50 locally advanced breast cancer patients who underwent standard protocol (SP) breast MRI before and after NAC, were re-evaluated retrospectively. Abbreviated protocol (AP) was o...

Background: Residual nodal disease at the completion axillary lymph node dissection (ALND) has been reported in over 60% in patients with a positive sentinel lymph node biopsy (SLNB) after neoadjuvant chemotherapy (NAC). This study aimed to explore whether any clinical or histopathological characteristics of patients may be associated with a lower...

The authors’ aim is to provide breast surgeons’ perspectives on the relative importance of the criteria for choosing an appropriate surgery method between mastectomy (total removal of a breast) and breast-conserving surgery (removal of a breast cancer tumor and some of the normal tissue that surrounds it) for women with breast cancer by using the m...

PurposeMetaplastic breast carcinoma (MBC) is a rare type of breast cancer that accounts for 0.2-1% of all breast cancers. To date, there are only few institutional studies comparing survival rates between different subtypes. In this retrospective cohort study, we aim to evaluate factors effecting survival rates of different subtypes of MBC.Methods...

The assessment of immune infiltrate in invasive breast carcinomas (IBCs), most commonly referred to as tumor infiltrating lymphocytes (TILs), is gaining importance in the current quest for optimal biomarker selection and prediction of prognosis. In this study, the impact of intensity of TILs and expressions of cytotoxic T-lymphocyte-associated prot...

Background and objectives: Inflammatory breast cancer (IBC) is a rare and aggressive breast cancer treated up-front with systemic treatment. Both breast-conserving surgery and sentinel lymph node biopsy (SLNB) are controversial issues in the management of IBC. In this study, we aimed to assess the feasibility of SLNB in pathologically proven node-...

Introduction The aim of this randomized clinical trial was to evaluate the overall survival (OS) data of patients diagnosed with de novo stage IV breast cancer (BC) who received locoregional treatment (LRT) over a 10-year follow-up. Study Design The MF07-01 is a 1:1 multicenter, randomized clinical trial to compare the LRT with systemic therapy (S...

Background/objective Since more solid evidence has emerged supporting the effectiveness of loco-regional treatment (LRT), clinicians consider LRT a treatment option for selected de novo stage IV breast cancer (BC) patients. This is the first report on long-term quality of life (QoL) in a cohort of patients who were randomized to receive either LRT...

Purpose: Factors affecting local outcome were evaluated in patients with clinically node-positive (cN+) breast cancer at diagnosis, who underwent sentinel lymph node biopsy (SLNB) alone after neoadjuvant chemotherapy (NAC). Methods: Between 2004 and 2018, 303 cytopathology-proven cN (+) patients in a multicentric registry, who received NAC and u...

BACKGROUND: Omitting axillary lymph node dissection (ALND) following sentinel lymph node biopsy (SLNB) in patients with locally advanced breast cancer (LABC) after neoadjuvant chemotherapy (NAC) is still controversial. In this study, we evaluated factors affecting local recurrence and outcome in patients with LABC, who underwent SLNB alone after NA...

Background More evidence shows that primary surgery for de novo metastatic breast cancer (BC) prolongs overall survival (OS) in selected cases. The aim of this study was to evaluate the role of locoregional treatment (LRT) in BC patients with de novo stage IV bone only metastasis (BOM).Methods The prospective, multicenter registry study BOMET MF14-...

Background: To discuss the diagnostic and prognostic potential of tensin-2 (TNS2) levels in patients with breast cancer (BC). Methods: The study included sixty patients with BC and twenty healthy female controls for a comparative investigation of TNS2 protein and gene expression levels.. Results: Compared to the healthy controls, we found that the...

Purpose To compare the adipose and muscle tissue areas in patients who responded differently to neoadjuvant chemotherapy. Methods One hundred and eighty six patients diagnosed with breast cancer who underwent neoadjuvant chemotherapy between January 2015- October 2019 and were operated after the treatment were retrospectively included in the study...

Background Selection of implant pocket and size is a dilemma for surgeons especially if radiation therapy is envisaged after implant based immediate breast reconstruction (IBR). The aim of this study is to compare complication rates between subpectoral and the dual plane polyglactin mesh supported IBR after nipple-areola sparing mastectomy. Patien...

Background: Idiopathic granulomatous mastitis (IGM) is a rare form of nonlactational mastitis. Due to the small number of case series and consequently inadequate prospective studies, there is still no consensus on the optimal treatment of IGM. In this study, we aimed to compare the efficacy of intralesional steroid injection with concomitant topic...

Cutaneous melanoma and nonmelanoma skin cancer, malignancy of skin appendages, and some kind of soft-tissue sarcomas like epithelioid and clear cell sarcomas, localized in the lower body, perineum, scrotum, penis, vulva, and lower extremity, may metastasize to inguinal and less often pelvic lymph nodes. Nodal metastasis generally occurs unilaterall...

Background. The MF07-01 trial is a multicenter randomized study comparing locoregional treatment (LRT) followed by systemic therapy (ST) with ST alone in de novo Stage IV breast cancer (BC) patients. Aim: To evaluate and finalize the survival data of LRT in patients with the diagnosis of de novo Stage IV BC. Methods. At initial diagnosis, patients...

PURPOSE Breast cancer is the most frequent cancer in women, and there is a great variability in surgical practice for treating that cancer in different countries. The aims of this study were to analyze the effect of guidelines from the Turkish Federation of Breast Diseases Societies on academic institutions that have breast centers and to evaluate...

Background The MF07-01 trial is a multicenter randomized study comparing locoregional treatment (LRT) followed by systemic therapy (ST) with ST alone in de novo stage IV breast cancer (BC) patients. The aim of this study is to evaluate the importance of LRT in patients who lived at least 5 years after the diagnosis of de novo Stage IV BC. Methods...

Recent research focused on prolonged survival has suggested that carboxypeptidase A4 (CPA4) plays a role in both tumor microenvironment formation and distant metastasis in cancer. In some patients, serum and expression (mRNA) levels of CPA4 have been found to be correlated with the aggressiveness and progression of the disease. Accordingly, we cond...

Objectives: To analyze the risk factors for complications associated with the use of totally implantable access ports (TIAPs) in cancer patients. Methods: Data for 2,713 cancer patients who received a TIAP between January 2010 and September 2016 at a single center were analyzed retrospectively. Results: The average age of the patients was 54.2...

Epigenetic changes have major role in the normal development and programming of gene expression. Aberrant methylation results in carcinogenesis. The primary objective of our study is to determine whether primary tumor tissue and cultured tumor cells in 2D and 3D tissue culture systems have the same methylation signature for PAX5 , TMPRSS2 , and SBD...

Surgery is an established part of the management of primary breast cancer. Surgical management of breast cancer patients has evolved significantly over the last several decades. With the arrival of sentinel lymph node biopsy, surgical practice for axillary staging in patients with early stage breast cancer has gradually become less invasive, and fo...

This chapter reviews substantial new evidence on locoregional and systemic therapies for early and advanced breast cancer and in situ carcinoma. In breast cancer, the treatment strategy is chosen based on the features and biology of the tumor and on the patient’s age, general health status and personal preferences. The decision options are based on...

Lobular carcinoma in situ is a marker for an increased risk of breast cancer and a non-obligate precursor of invasive carcinoma. Morphological variants of pleomorphic LCIS are accepted as more complex lesions and are more likely to be associated with invasive carcinoma. Ductal carcinoma in situ (DCIS) is a heterogeneous group of diseases that diffe...

Recent randomized trials have shown that completion axillary lymph node dissection (ALND) is not required in all patients with a positive sentinel lymph node (SLN) who will receive radiation therapy. Although routine intraoperative pathologic assessment (IPA) becomes unnecessary and less indicated by breast surgeons in the United States and some Eu...

Background: Identification and resection of a clipped node was shown to decrease the false-negative rate (FNR) of sentinel lymph node biopsy (SLNB) after neoadjuvant chemotherapy (NAC) for patients presenting with initially node-positive breast cancer. Methods: Between March 2014 and March 2016, a prospective trial analyzed 98 patients with axil...

Background: Primary breast rhabdomyosarcoma (RMS) can occur in children. There is a lack of knowledge regarding radiologic findings and added diffusion-weighted magnetic resonance imaging (MRI) features of RMS in the literature. Case report: A 12-year-old girl was diagnosed with primary alveolar RMS of the breast. Gray scale ultrasound revealed...

Background: The MF07-01 trial is a multicenter, phase III, randomized, controlled study comparing locoregional treatment (LRT) followed by systemic therapy (ST) with ST alone for treatment-naïve stage IV breast cancer (BC) patients. Methods: At initial diagnosis, patients were randomized 1:1 to either the LRT or ST group. All the patients were g...

Aim: To examine whether the real-time ultrasound-guided venipuncture for implantable venous port placement is safer than the traditional venipuncture. Methods: The study analyzed the results of 2153 venous ports placed consecutively from January 2009 to January 2016. A total of 922 patients in group 1 and 1231 patients in group 2 were admitted w...

Background: Idiopathic granulomatous mastitis (IGM) is a rare chronic inflammatory disease of the breast with unknown aetiology. Its treatment is controversial and the recurrence rate is high. The objectives of this study were to examine the demographic, sociocultural and clinical characteristics observed among a large cohort of IGM patients from T...

Objective: The aim of this study was to determine the correlation between the primary tumor (PT) maximum standardized uptake value (SUVmax) and breast cancer prognostic factors, overall survival, and relapse-free survival on the basis of histopathological and molecular characteristics. Patients and methods: In this retrospective study, 436 femal...

Invasive micropapillary carcinoma (IMPC) of the breast is a highly aggressive and a rare subtype of breast cancer. In this study, we aimed to investigate differences between pure and mixed IMPCs of the breast in terms of clinicopathologic features, and also to analyze the significance of expressions of ARID1A and bcl-2 regarding prognosis. Sixty-ni...

Background: The MF07-01 trial is a multicenter phase III randomized controlled trial of treatment naive stage IV BC patients comparing loco-regional surgery (LRS) followed by appropriate systemic therapy (ST) versus ST alone. Aims: To evaluate the importance of loco-regional tumor burden and surgery on overall survival rate in patients with de novo...

Introduction: We report the feasibility and safety of local anesthesia (LA) in patients having breast-conserving surgery (BCS). Methods: 37 patients with American Society of Anesthesiologists (ASA) score of 4 having BCS under LA and 54 age-matched subjects with ASA score of 3-4 having BCS under general anesthesia (GA) were included. Patients wer...

Granulomatous lobular mastitis (GLM) is a rare, but benign inflamatuary process with unknown underlying etiology. It is typically seen in young women. Painful breast masses, draining sinuses, scarring, and breast atrophy are the main clinical manifestations. This disease is a challenge for clinicians to diagnose and manage. 30 years old and 14 week...

Background and objectives: It is not clear whether sentinel lymph node biopsy (SLNB) can be applied to patients with a second breast cancer or recurrence occurring at previously treated breast. The purpose of this study was to assess the feasibility of SLNB procedure in patients with recurrent breast cancer. Methods: Patients with non-metastatic...

Objective: We aimed to evaluate the effect of intraperitoneal cetuximab administration on the healing of anastomosis and development of early adhesion formation in a rat model. Materials and methods: Twenty-four female rats were used. A colon segment was resected and end-to-end anastomosis was performed. The rats were randomized into three group...

Background: The protease-activated receptor 1 (PAR1) is associated with increased invasiveness of breast cancer (BC) cell lines and its overexpression is significantly correlated with advanced stage and poor prognosis. The aim of this study was to determine the clinical significance of the serum PAR1 levels in BC patients. Methods: We enrolled 96 f...

Aim Ovarian cancer is a common cause of death in women worldwide. The purpose of this article was to report a case series and draw physicians’ attention to the benefits of histpathologic techniques in determining uncommon metastatic diseases. Methods In this study, we report a case series of axillary involvement of ovarian cancer in 6 patients. Th...

In breast cancer, the choice of treatment strategy is based on the features and biology of the tumor as well as on the age, general health status, and personal preferences of the patient. The clinical situations in which molecular tests have the greatest relevance for therapeutic decision-making are still being established; however, evidence is als...

This chapter is focused on providing a practical approach to the allocation of available diagnostic procedures and therapies to individual patients in the light of the most recent and reliable information from clinical trials and international guidelines. It reviewed substantial new evidence on locoregional and systemic therapies for early and adva...

Metaplastic breast carcinoma (MBC) differs from classic invasive ductal carcinomas regarding incidence, pathogenesis, and prognosis. The purpose of this study was to compare patients with MBC with clinicopathologic and treatment-matched patients with triple-negative breast carcinoma (TNBC) in terms of response to treatment, progression, and surviva...

The purpose of this study was to evaluate ultrasound-guided surgery for palpable breast cancer by comparing the standard palpation-guided surgery in terms of the extent of healthy breast tissue resection, the percentage of tumor-free margins, and cosmetic outcomes. This was a prospective, observational cohort study conducted from January 2009 to Ju...

Background: Non-HIV related Kaposi sarcoma (NHKS) is a rare indolent neoplasm which is more common around Mediterranean origin. Data concerning factors that influence progression free survival (PFS) for NHKS are insufficient. The purpose of present retrospective analysis was to distinguish the factors affecting PFS in patients with NHKS. Methods:...

The aim of this study is to compare the clinical outcome in T2 breast cancer patients who underwent preoperative chemotherapy (PC) and who did not. The study also tried to define a subgroup of patients, who are more beneficial after PC in terms of lower re-excision rates, better cosmetic results and local recurrence free survival. 251 consecutive p...