Dr Zeynep Gamze Kılıçoğlu

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PATHOLOGIC CORRELATION OF MAMMOGRAPHIC-SONOGRAPHIC BI-RADS SCORES

Haydarpaşa Numune Eğitim ve Araştırma Hastanesi Tıp Dergisi

&#; Hikmet Karagüllü, Mehmet Oğuzhan Ağaçlı, Zeynep Gamze Kılıçoğlu, Mehmet Masum Şimşek, Kaan Meriç, Naciye Kış, Fügen Vardar Aker

Ozel  L, Unal A, Unal E, Kara M, Erdoğdu E, Krand O, Güneş P, Karagül H, Demiral S, Izzet Titiz M. Granulomatous mastitis: is it an autoimmune disease? Diagnostic and therapeutic dilem mas. Surg Today. 42(8),

Ozel L,Kara VM, sunamak O, Karagüllü H, sağıroğlu J, İlhan O, Aker F. skin –Areola Nipple Sparing, and Subcutaneous Mastectomy and Immediate Implant-Based Breast reconstruction Using a Titanium- Coated Polypropylene Mesh. J Breast Health (). Jul1;11(3) PMID

Ersöz, L. Özel, H. Karagüllü, A. Ünal, E. Ünal, Meme Kanserli Hastalarda ileri Görüntüleme Yöntemi olan Meme Magnetik Rezonansın Evreleme ve Meme Koruyucu Cerrahi karardaki etkisi, Uluslararası katılımlı 2ci Karadeniz Meme Kongresi,

L.Özel, A. Ünal,M. Kara, P. Güneş, H. Karagüllü, E. Ünal, Granulomatous mastitis is an autoimmune disease? Diagnostic  and therapeutic dilemma, Uluslararası katılımlı 2ci Karadeniz Meme Kongresi,

Özel, H. Tanrıkulu, N. Aksoy, M. Kara, E. Özdemir, M.K. Yıldız, Hikmet Karagüllü, A.Ö. Balık. ‘’Geçirilmiş meme kanseri cerrahisi sonrası gelişmiş iki aksiller bant olgusu’’, Ulusal meme hastalıkları kongresi, Antalya.

Ersöz, A. Ünal, E. Ünal, V. M. Kara, E.Özdemir, H. Karagüllü, L. Özel, ″ Meme kanserli hastalarda ileri görüntüleme yöntemi olan meme magnetic rezonansın evreleme ve meme koruyucu cerrahi karara etkisi&#;. Ulusal Meme Hastalıkları Kongresi, Antalya.

The Value of Magnetic Resonance Imaging For Staging and Planning Breast-Conserving Surgery

Elçin Ersöz Köse1, Leyla Özel2, Gökay Reyhan1, Pınar Ata3, Hikmet Karagüllü4, Gamze Kılıçoğlu4

1Department of Thoracic Surgery, Health Science University, Sultan Abdulhamid Han Training and Research Hospital, Istanbul, Turkey

2Department of General Surgery, Bahcesehir University Faculty of Medicine, Istanbul, Turkey

3Department of Molecular Genetics and Typing Tissue, Health Science University, Haydarpasa Numune Training and Research Hospital, Istanbul, Turkey

4Department of Radiology, Health Science University, Haydarpasa Numune Training and Research Hospital, Istanbul, Turkey

INTRODUCTION: This study aimed to evaluate the effect of breast magnetic resonance imaging (MRI) on staging and surgical planning.

METHODS: Ninety-two females with breast cancer were enrolled in the study. We prospectively evaluated the contribution of MRI compared to mammography (MMG) and ultrasonography (USG) and impact of MRI on surgical treatment and histopathological concordance.

RESULTS: Contribution of breast MRI to the workup and management of breast cancer in our institute was meaningful by upstaging the cases in 23/92 (25%) of the patients and suggesting a change in surgical plan in 21/92 (23%) of the patients. Surgical staging with breast MRI results correlated with the final pathological staging in 18/21 (85%) patients who had a change in surgical plan.

DISCUSSION AND CONCLUSION: The primary therapy modality of early breast cancer is surgery. The overall tumor size, the relationship between tumor size and breast size, tumor localization, tumor stage, and histopathological findings help to shape surgical management. MRI was better than conventional diagnostic techniques in determining correct tumor diameter and in detecting non-invasive cancer areas. Consequently preoperative breast MRI is an important adjunct to conventional imaging (USG and MMG) in the staging of breast cancer and a useful tool in treatment planning.

Keywords: Breast cancer, breast-conserving surgery; magnetic resonance imaging; staging of breast cancer.

Evreleme ve Meme Koruyucu Cerrahi Planlamasında Manyetik Rezonans Görüntülemenin Değeri

Elçin Ersöz Köse1, Leyla Özel2, Gökay Reyhan1, Pınar Ata3, Hikmet Karagüllü4, Gamze Kılıçoğlu4

1Sağlık Bilimleri Üniversitesi, Sultan Abdülhamid Han Eğitim Ve Araştırma Hastanesi, Göğüs Cerrahisi Kliniği, İstanbul, Turkey

2Bahçeşehir Üniversitesi, Genel Cerrahi Kliniği, İstanbul, Turkey

3Sağlık Bilimleri Üniversitesi, Haydarpaşa Numune Eğitim Ve Araştırma Hastanesi, Moleküler Biyoloji Ve Genetik Bölümü, İstanbul, Turkey

4Sağlık Bilimleri Üniversitesi, Haydarpaşa Numune Eğitim Ve Araştırma Hastanesi, Radyoloji Bölümü, İstanbul, Turkey

GİRİŞ ve AMAÇ: Bu çalışmanın amacı meme manyetik rezonans görüntüleme (MRG) &#;nin evreleme ve cerrahi planlama üzerindeki etkisini değerlendirmektir.

YÖNTEM ve GEREÇLER: Yöntem: Çalışmaya meme kanseri tanısı konmuş 92 kadın hasta alındı. MRG&#;nin mamografi (MMG) ve ultrasonografi (USG) ile karşılaştırılması, MRG&#;nin cerrahi tedaviye etkisi ve histopatolojik sonuçlar ile korelasyon açısından prospektif olarak değerlendirildi.

BULGULAR: Bulgular: Meme MRG’nin kurumumuzda meme kanseri tetkik ve tedavi planlamasına katkısı anlamlıydı ve 23/92 (% 25) hastada cerrahi evrelemede artış gösterdi ve 21/92 (% 23) hastada cerrahi planda değişiklik önerdi. Meme MRG sonuçları ile cerrahi planda değişikliğe uğramış 18/21 (% 85) hastadaki nihai patoloji sonucu yapılan patolojik evreleme ile cerrahi evreleme birbiri ile korele bulundu.

TARTIŞMA ve SONUÇ: Tartışma: Erken meme kanserinin birincil terapi modalitesi cerrahidir. Toplam tümör boyutu, tümör boyutu ve meme boyutu arasındaki ilişki, tümör lokalizasyonu, tümör evresi ve histopatolojik bulgular cerrahi tedaviyi şekillendirmeye yardımcı olan faktörlerdir. Doğru tümör çapının saptanmasında ve invazif olmayan kanser alanlarının saptanmasında MRI geleneksel tanı yöntemlerinden daha üstündür.

Sonuç: Preoperatif çekilen meme MRG, meme kanseri evrelemesinde konvansiyonel görüntüleme (USG ve MMG) için önemli bir yardımcıdır ve tedavi planlamasında yararlı bir araçtır.

Anahtar Kelimeler: Meme kanseri, meme koruyucu cerrahi, manyetik rezonans görüntüleme, meme kanseri evrelendirme

Elçin Ersöz Köse, Leyla Özel, Gökay Reyhan, Pınar Ata, Hikmet Karagüllü, Gamze Kılıçoğlu. The Value of Magnetic Resonance Imaging For Staging and Planning Breast-Conserving Surgery. . ; 59(2):

Skin–Areola, Nipple Sparing, and Subcutaneous Mastectomy and Immediate Implant-Based Breast Reconstruction Using a Titanium-Coated Polypropylene Mesh

Leyla ÖzelV. Melih KaraOğuzhan SunamakHikmet KaragüllüJülide SağıroğluOnur İlhanFügen Aker

Eur J Breast Health ; DOI: /tjbh

Mamografi-Sonografik Bi-Rads Skorlarının Patoloji İle Korelasyonu

Mehmet Oğuzhan Ağaçlı, Zeynep Gamze Kılıçoğlu, Mehmet Masum Şimşek, Kaan Meriç, Naciye Kış, Fügen Vardar Aker, Hikmet Karagüllü

Haydarpaşa Numune Hastanesi Eğitim ve Araştırma Hastanesi

GİRİŞ ve AMAÇ: Bu çalışmada, hastanemizde mamografi ve ultrasonografi ile tespit edilen ve sonrasında patolojik değerlendirilmesi yapılan lezyonların BI-RADS skorları ile patolojik sonuçlarının karşılaştırılması, her kategori için sensitivite, spesifisite, pozitif ve negatif prediktif de¤erlerin hesaplanması, bulguların literatür ile karşılaştırılması ve kliniğimizin performansının değerlendirilmesi amaçlanmıştır.

YÖNTEM ve GEREÇLER: Çalışmamıza Mayıs ve Aralık tarihleri arasındaki 32 aylık dönemde, Haydarpaşa Numune Eğitim ve Araştırma Hastanesi Radyoloji Kliniği mamografi ünitesine başvuran olgunun mamografi tetkikleri ve ek olarak yapılan ultrasonografileri dahil edildi. Bu incelemeler ile tespit edilen ve sonras›nda kliniğimizde biyopsi uygulanan ya da hastanemizde opere edilen lezyonların patolojik sonuçları ile BI-RADS skorları karşılaştırıldı.

BULGULAR: Patolojik tanı verilen toplam hastadan kategori 1, 2, 3 grubunda yer alanlar benign yani hastalık açısından radyolojik olarak negatif kabul edildi. Benzer şekilde kategori 4 ve 5 grubunda yer alanlar ise radyolojik olarak malign yani pozitif kabul edildi. Kategori 1, 2 veya 3 grubunda yer alan toplam hastadan ’u benign, 6’sı malign idi. Kategori 4, 5 grubunda ise toplam hastadan ’sı benign, ’i malign idi. Bu şekilde yapılan gruplamalar patoloji sonuçları ile karşılaştırılarak sensitivite, spesifisite, doğruluk, pozitif prediktif de¤er(PPD) ve negatif prediktif değer(NPD) hesaplandı. Kategori gruplaması için sensitivite % 94,5, spesifisite % 55,4, pozitif prediktif değer % 43,0, negatif prediktif değer % 95,6 olarak bulundu.

TARTIŞMA ve SONUÇ: Çalışmamızda elde edilen sensitivite, spesifisite, pozitif prediktif değer ve negatif prediktif değerler literatürdeki benzer çalışmalar ile uyumlu bulunmuştur. Ayrıca çalışmamız sırasında, benign olarak kategorize edilmelerine karşın klinisyenlerin talebiyle çok sayıda hastaya yapılan biyopsilerin, beklendiği gibi benign sonuçlar verdiğini ve bu durumun zaman, emek ve maliyet artışına neden olduğunu gördük. Yani BI-RADS uygulamasının sadece radyoloji kliniği tarafından değil, meme hastalıklarının tanı ve tedavisinde rolü bulunan diğer dallara mensup hekimler tarafı ndan da benimsenmesinin yöntemin etkinliğini artıracağını düşündük.

Anahtar Kelimeler: BI-RADS, mamografi.

Pathologic Correlation Of Mammographic-Sonographic Bi-Rads Scores

Mehmet Oğuzhan Ağaçlı, Zeynep Gamze Kılıçoğlu, Mehmet Masum Şimşek, Kaan Meriç, Naciye Kış, Fügen Vardar Aker, Hikmet Karagüllü

Haydarpaşa Numune Hastanesi Eğitim ve Araştırma Hastanesi

INTRODUCTION: In this study, we aimed to correlate the BI-RADS scores and histopathologic results of lesions detected by mammography and/or sonography in our clinic. Positive and negative predictive values, sensitivity and specificity for each category were also calculated and compared with the literature in order to evaluate quality of care in our department.

METHODS: patients referrring to the mammography department of Haydarpafla Numune Training and Research Hospital between May and December were included in the study. BI-RADS scores obtained with mammography and complementary sonography were compared with pathology findings, as determined by means of fine needle, core needle or excisional biopsies.

RESULTS: lesions in patients received pathological evalution. BI-RADS category 1,2 and 3 were radiologically considered to be benign and those in category 4 or 5 malignant. Out of lesions in category 1, 2 or 3, were benign and 6 malignant; while out of lesions in categoy 4 or 5, lesions were benign and were malignant. The respective sensitivity was calculated as %, specificity as %, positive predictive value 43 % and negative predictive value %.

DISCUSSION AND CONCLUSION: The sensitivity, specificity, positive and negative predictive values calculated in our study were found to be consistent with those from other studies in the literature. However, a high number of biopsy procedures were carried out for lesions in the radiologically benign lesions on the request from other clinicians, revealing benign findings as expected. Thus integrating BIRADS lexicon into the daily practice, not only for radiologists but also for clinicians diagnosing and treating breast diseases, will contribute to the cost-effectiveness and improvement of patient care.

Keywords: BI-RADS, mammography.

Mehmet Oğuzhan Ağaçlı, Zeynep Gamze Kılıçoğlu, Mehmet Masum Şimşek, Kaan Meriç, Naciye Kış, Fügen Vardar Aker, Hikmet Karagüllü. Pathologic Correlation Of Mammographic-Sonographic Bi-Rads Scores. . ; 53(1):

Diagn Cytopathol

. Dec;43(12) doi: /dc Epub Oct

Accuracy of fine-needle aspiration cytology in the diagnosis of breast cancer a single-center retrospective study from Turkey with cytohistological correlation in cases

Fügen Aker 1, Gülistan Gümrükçü 1, Burcu Çelik Onomay 1, Murat Erkan 1, Günay Gürleyik 2, Gamze Kiliçoğlu 3, Hikmet Karagüllü 3

Affiliations expand

PMID: DOI: /dc

Abstract

Background: The triple test, i.e., cytology combined with clinical and radiological findings, is the goal for accurate assessment of palpable breast lesions. Because of the limitations of fine-needle aspiration cytology (FNAC), its utility has somewhat decreased nationwide. We have been using a combination of physical examination, radiological modalities, and FNAC for the diagnosis of palpable/nonpalpable breast mass lesions for the last 23 years. Our institutional experience of the last 10 years is presented here, using FNAC of breast lesions along with an analysis of the diagnostic accuracy.

Methods: breast aspirates in cases were collected from the computer database of Haydarpasa Numune Education and Research Hospital in Istanbul, Turkey. Most of the FNACs were performed under ultrasound guidance and FNAC procedures were performed by radiologists and pathologists who used 22 gauge needles. Cytological diagnoses were classified as &#;unsatisfactory&#;, &#;benign&#;, &#;malignant&#;, &#;atypical/probably benign&#;, &#;atypical/probably malignant&#;, and &#;atypical/NOS&#; (not otherwise specified) and were compared to the histopathological diagnoses obtained from core needle biopsy, lumpectomy or mastectomy to give an assessment of the diagnostic performance of FNAC in aspirates.

Results: The sensitivity, specificity, accuracy, positive and negative predictive value, false positive, and false negative rates of FNAC were , , , , , , and %, respectively.

Conclusions: This study once again shows that FNAC is a reliable method for the initial evaluation and diagnosis of breast masses. In case of any suspicious conditions, FNAC, and core biopsy are considered complementary to one another.

Keywords: breast; efficacy; fine-needle aspiration cytology.

J Breast Health

. Jul 1;11(3) doi: /tjbh eCollection Jul.

Skin-Areola, Nipple Sparing, and Subcutaneous Mastectomy and Immediate Implant-Based Breast Reconstruction Using a Titanium-Coated Polypropylene Mesh

Leyla Özel 1, V Melih Kara 1, Oğuzhan Sunamak 1, Hikmet Karagüllü 2, Jülide Sağıroğlu 3, Onur İlhan 1, Fügen Aker 4

Affiliations expand

PMID: PMCID: PMC DOI: /tjbh

Free PMC article

Abstract

Skin sparing and nipple areola complex sparing subcutaneous mastectomies are both oncologically safe surgical procedures. Although autologuous breast reconstruction has been considered as a standard means of surgical approach, excellent cosmetic results have been obtained by implant based breast reconstruction. In this report, we present the result of titanium coated polypropylene mesh (Tiloop Bra; Pfm Medical, Cologne, Germany), an ultimate support material utilized in the reconstruction of a patient with breast cancer.

Keywords: Breast cancer; Tiloop Bra Mesh; skin sparing mastectomy.