Person: GÖKGÖZ, MUSTAFA ŞEHSUVAR
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GÖKGÖZ
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MUSTAFA ŞEHSUVAR
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Publication A case of extensive ductal carcinoma in situ and sclerosing adenosis with metastasis on sentinel lymph node(Sage Publications Ltd, 2019-08-28) NARTER, SELİN; HASDEMİR, SEÇİL; Hasdemir, Seçil; Gökgöz, Şehsuvar; GÖKGÖZ, MUSTAFA ŞEHSUVAR; Tolunay, Şahsine; TOLUNAY, ŞAHSİNE; Tıp Fakültesi; Patoloji Ana Bilim Dalı; 0000-0003-1769-7484; AAI-1612-2021Introduction: Sclerosing adenosis is a form of adenosis characterized by lobulocentric architecture, glandular and stromal proliferation in which the stromal component compresses and distorts the glandular structures. Atypical epithelial proliferations such as atypical lobular hyperplasia, lobular carcinoma in situ, and ductal carcinoma in situ may accompany areas of sclerosing adenosis. We present a case of ductal carcinoma in situ and sclerosing adenosis with metastatic carcinoma on sentinel lymph node. Case description: A 40-year-old woman presented with a palpable mass in her left breast. Radiologic studies showed a lesion suggesting malignancy in the left breast and atypical lymph node in the left axillary region. Left lumpectomy and sentinel lymph node biopsy was performed. Histopathologic examination revealed lobulocentric lesions with glandular proliferation and hyalinizing stroma in between. Foci of high-grade cribriform and solid type ductal carcinoma in situ were observed. Sentinel lymph node biopsy showed micrometastasis in one lymph node section. Based on these findings, the patient was diagnosed with high-grade ductal carcinoma in situ with sclerosing adenosis. However, the presence of micrometastasis in the lymph node suggested occult invasion that we were not able to detect. Conclusion: Ductal carcinoma in situ with sclerosing adenosis can mimic invasive carcinoma both radiologically and histologically. It should be kept in mind that there may be occult invasive carcinoma in patients with ductal carcinoma in situ whether the lesion is accompanied by sclerosing adenosis or not. Multiple sections and immunohistochemical studies can be of help.Publication Prediction of breast cancer metastasis risk using circulating tumor markers: A follow-up study(Assoc Basic Medical Sci Federation Bosnia & Herzegovina Sarajevo, 2019-01-01) Çetintaş, Sibel; Tezcan, Gülçin; Tunca, Berrin; Egeli, Ünal; Gökgöz, Mustafa Şehsuvar; Çecener, Gülsah; ÇETİNTAŞ, SİBEL; TUNCA, BERRİN; EGELİ, ÜNAL; GÖKGÖZ, MUSTAFA ŞEHSUVAR; ÇEÇENER, GÜLŞAH; Tıp Fakültesi; Genel Cerrahi Ana Bilim Dalı; 0000-0002-1619-6680; 0000-0001-7904-883X; 0000-0002-3820-424X; EWY-5692-2022; AAA-7047-2020; AAH-1420-2021; ABI-6078-2020; AAP-9988-2020Distant organ tumor dissemination is a major cause of breast cancer-related deaths. In 2010, we analyzed the prognostic importance of the circulating tumor markers (CTMs) cytokeratin 19 (CK19), CK20, epidermal growth factor receptor (EGFR) and human epidermal growth factor receptor 2 (HER2) in relation to the clinical and pathological characteristics of patients with breast cancer (BC). To assess the clinical utility of CK19, CK20 and EGFR in predicting distant metastasis in BC, here we report 7-year follow-up results of 77 patients. The patients with at least one positive CTM were classified as CTM(+) and those negative for all CTMs were assigned to CTM(-) group. In patients who received no treatment following CTM analysis, 25.0% had metastasis in CTM(+) and 10.0% in CTM(-) group. In patients who received one of the following therapies: chemotherapy, radiotherapy or hormone therapy, or the combinations of these therapies, the rate of metastasis was 33.3% in CTM(+) and 20.0% in CTM(-) group. Disease-free time was shorter in CTM(+) patients compared to CTM(-) group (28.83 +/- 10.76 and 41.38 +/- 9.5 months, respectively). According to multivariate Cox proportional hazard regression analysis, the presence of regional lymph node metastasis, Ki-67 expression, higher tumor grade and CTM expression status were predictors of poor prognosis associated with distant metastasis (p < 0.05). Also, CTM positivity was a factor associated with metastasis-related poor prognosis (HR = 0.492, p = 0.026). The mean survival for CTM(+) patients was shorter than that for CTM(-) patients (90.671 +/- 2.66 and 101.23 +/- 3.92 months, respectively; p > 0.05). Our findings demonstrate that CTM positivity may indicate a high metastasis risk; however, CTM negativity does not guarantee low metastasis risk. These results may encourage further preclinical investigation of CTMs, to evaluate the possible implications of these findings to the clinical setting.Publication Prognostic significance of estrogen receptor, progesterone receptor, her2/neu, ki-67, and nm23 expression in patients with invasive breast cancer(Imprimatur Publications, 2013-04-01) Ölmez, F.; Çubukçu, E.; ÇUBUKÇU, ERDEM; DELİGÖNÜL, ADEM; Kanat, O.; Ölmez, O. Fatih; Kabul, S.; KABUL, SELVA; Canhoroz, M.; Avcı, N.; Deligönül, A.; Hartavi, M.; Çubukçu, S.; ÇUBUKÇU, SİNEM; Kurt, E.; Evrensel, T.; EVRENSEL, TÜRKKAN; Gökgöz, S.; GÖKGÖZ, MUSTAFA ŞEHSUVAR; Manavoğlu, O.; Tıp Fakültesi; Patoloji Ana Bilim Dalı; AAJ-1027-2021Purpose: To determine the prognostic significance of estrogen receptor (ER), progesterone receptor (PR), HER2/neu, Ki-67, and nm23 immunohistochemical expression with respect to progression free survival (PFS) and overall survival (OS) in Turkish patients with invasive breast cancer (IBC).Methods: Patients with IBC (n = 81; mean age = 51.9 +/- 11.1 years) were prospectively enrolled at the Department of Oncology, Uludag University Medical Center, Bursa, Turkey. Immunohistochemistry was performed on formalin-fixed, paraffin-embedded tissue sections.Results: We did not find any significant association between immunohistochemical expression of ER, PR, HER2/neu, Ki-67, and nm23 and the baseline characteristics of IBC patients. The median patient PFS was 30 months (range 22-45), and the median OS was 32 months (range 23-46). Stratification of the patient population according to nm23 immunohistochemical expression revealed a statistically significant difference in terms of both OS (p < 0.05) and DFS (p < 0.05). Multivariate Cox regression analysis indicated that tumor grade, axillary lymph node status, and nm23 immunohistochemical expression were the 3 main independent prognostic factors for PFS and OS in IBC patients.Conclusion: Reduced nm23 immunohistochemical expression is an independent negative prognostic factor for OS and PFS. Patients with negative nm23 expression may require a more intensive follow-up.Publication Metastatic neoplasms to the breast(Sage Publications Inc, 2023-10-29) Özsen, Mine; Tolunay, Şahsine; Polatkan, Seyit Ali Volkan; Şenol, Kazım; Gökgöz, Mustafa Şehsuvar; ÖZŞEN, MİNE; TOLUNAY, ŞAHSİNE; POLATKAN, SEYİT ALİ VOLKAN; ŞENOL, KAZIM; GÖKGÖZ, MUSTAFA ŞEHSUVAR; Tıp Fakültesi; Patoloji Ana Bilim Dalı; 0000-0001-6273-0664; JIT-5311-2023; AAI-1612-2021; FSB-8576-2022; KGQ-4411-2024; EWY-5692-2022Objective: When the clinical presentation is related to the metastatic mass and a radiologically solitary tumor focus is detected, especially in cases where clinical information is not taken into account or is insufficient, if a possible metastatic neoplasia is not kept in mind then it is possible to evaluate the tumor as a primary breast neoplasm. In this study, it is aimed to present our cases of non-hematopoietic metastatic neoplasms and to evaluate the clinicopathological features that may aid in distinguishing metastatic from primary neoplasms. Material and Methods: This study includes cases diagnosed with metastatic non-hematopoietic breast neoplasm in breast resection materials in our center, between the years 2010-2023. All cases were analyzed retrospectively by evaluating clinicopathological features. Results: Of the 15 subjects included in the study, 11 (73%) were female and 4 (27%) were male. The mean age of the patients were 46.9 ranged from 22 to 63 years. The most frequent metastatic malignancy was carcinoma (60%), followed by melanoma (33%) and sarcoma (7%). Of the 9 patients with metastatic carcinoma, the primary tumor originated from the lungs in 4, from gastrointestinal system in 2, female genital tract in 2, and kidney in 1 patient. Sarcoma diagnosis was given in a single patient and the histology was a leiomyosarcoma originating from kidney. Conclusion: A careful histomorphological and immunohistochemical evaluation and a detailed examination of the clinicoradiological data are critical to establish the right course in patient management, treatment plan and to correctly predict the prognosis.Publication A multicenter study of genotype variation/demographic patterns in 2475 individuals including 1444 cases with breast cancer in Turkey(Galenos Yayınevi, 2023-07-01) Boğa, İbrahim; Sağ, Şebnem Özemri; Duman, Nilgün; Özdemir, Sevda Yeşim; Ergören, Mahmut Çerkez; Dalcı, Kubilay; Mujde, Cem; Parsak, Cem Kaan; Rencuzoğullari, Çağla; Sönmezler, Özge; Yalav, Orçun; Alemdar, Adem; Aliyeva, Lamiya; Bozkurt, Özlem; Çetintaş, Sibel; Çubukcu, Erdem; Deligönül, Adem; Doğan, Berkcan; Ergüzeloğlu, Cemre Örnek; Evrensel, Türkkan; Gökgöz, Şehsuvar; Şenol, Kazım; Tolunay, Şahsine; Akyürek, Esra; Başgöz, Neslihan; Gökçe, Nuriye; Dündar, Bilge; Öztürk, Figen; Taşkın, Duygu; Demirtaş, Mercan; Çağ, Murat; Diker, Ömer; Olgun, Polat; Bozdoğan, Sevcan Tuğ; Dündar, Munis; Bişgin, Atıl; Temel, Şehime Gülsün; ÖZEMRİ SAĞ, ŞEBNEM; ALIYEVA, LAMIYA; DOĞAN, BERKCAN; TEMEL, ŞEHİME GÜLSÜN; ALEMDAR, ADEM; Ergüzeloğlu, Cemre Örnek; EVRENSEL, TÜRKKAN; BOZKURT, ÖZLEM; TOLUNAY, ŞAHSİNE; ÇETİNTAŞ, SİBEL; ÇUBUKÇU, ERDEM; DELİGÖNÜL, ADEM; GÖKGÖZ, MUSTAFA ŞEHSUVAR; ŞENOL, KAZIM; Tıp Fakültesi; Tıbbi Onkoloji Ana Bilim Dalı; 0000-0001-8061-8131 ; IYV-1877-2023; CCG-4609-2022; AAD-5249-2020; IRT-7350-2023; HIZ-7332-2022; EXQ-7887-2022; EXZ-0745-2022; IJL-9778-2023; AAI-1612-2021; EOI-5652-2022; ETP-1691-2022; ESM-4544-2022; EXK-4525-2022; KGQ-4411-2024; GZC-2526-2022Objective: Breast cancer (BC) is the most common cancer type in women and may be inherited, mostly in an autosomal dominant pattern. The clinical diagnosis of BC relies on the published diagnostic criteria, and analysis of two genes, BRCA1 and BRCA2, which are strongly associated with BC, are included in these criteria. The aim of this study was to compare BC index cases with non-BC individuals in terms of genotype and diagnostic features to investigate the genotype/demographic information association. Materials and Methods: Mutational analyses for the BRCA1/BRCA2 genes was performed in 2475 individuals between 2013-2022 from collaborative centers across Turkey, of whom 1444 with BC were designated as index cases.Results: Overall, mutations were identified in 17% (421/2475), while the percentage of mutation carriers in cases of BC was similar, 16.6% (239/1444). BRCA1/BRCA2 gene mutations were detected in 17.8% (131/737) of familial cases and 12% (78/549) of sporadic cases. Mutations in BRCA1 were found in 4.9%, whereas 12% were in BRCA2 (p<0.05). Meta-analyses were performed to compare these results with other studies of Mediterranean-region populations.Conclusion: Patients with BRCA2 mutations were significantly more common than those with BRCA1 mutations. In sporadic cases, there was a lower proportion with BRCA1/BRCA2 variants, as expected, and these results were consistent with the data of Mediterranean-region populations. However, the present study, because of the large sample size, revealed more robust findings than previous studies. These findings may be helpful in facilitating the clinical management of BC for both familial and non-familial cases.Publication Incidentally discovered extensive squamous metaplasia within borderline phyllodes tumor: Presentation of a rare tumor(Federation Turkish Pathology Soc, 2016-01-01) ÖZ ATALAY, FATMA; UĞRAŞ, NESRİN; Uğraş, Nesrin; Tolunay, Sahsine; TOLUNAY, ŞAHSİNE; Gökgöz, Sehsuvar; GÖKGÖZ, MUSTAFA ŞEHSUVAR; Tıp Fakültesi; PatolojicAna Bilim Dalı; 0000-0002-7188-6115; AAH-2716-2021; AAI-1612-2021Phyllodes tumors are uncommon biphasic fibroepithelial neoplasms of breast, comprising less than 1% of all breast neoplasms. We therefore aimed to present the case with its microscopic findings. In this article, we report a 59-year-old female admitted to the general surgery department with a rapidly, enlarging, palpable mass in right breast. After histopathological examination, it was diagnosed as borderline phyllodes tumor with extensive squamous metaplasia. Metaplastic changes are infrequent in the stromal and epithelial component of these tumors. Extensive squamous metaplasia within phyllodes tumor is rare and may occur in benign, borderline and malign subtypes.Publication Phyllodes tumor of the breast: A clinicopathological evaluation of 55 cases(Aves, 2020-01-01) Hasdemir, Seçil; Tolunay, Şahsine; Özşen, Mine; Gökgöz, Mustafa Şehsuvar; HASDEMİR, SEÇİL; TOLUNAY, ŞAHSİNE; ÖZŞEN, MİNE; GÖKGÖZ, MUSTAFA ŞEHSUVAR; Tıp Fakültesi; Patoloji Ana Bilim Dalı; 0000-0003-1769-7484; 0000-0002-9038-0515; 0000-0002-5771-7649; 0000-0003-1394-2630; GBY-7549-2022; AAI-1612-2021; AAI-1609-2021; JKX-1058-2023Objective: Phyllodes tumors are biphasic tumors consisting of epithelial and stromal components that account for less than 1% of all breast tumors. According to the World Health Organization (WHO) phyllodes tumors are classified into three categories as benign, borderline and malignant. It has been reported that these tumors are usually benign and both the stromal component and the epithelial component may progress to malignancy. In this descriptive study, it was aimed to present the cases of phyllodes tumor and to evaluate the clinicopathological features of these tumors in the light of the literature.Materials and Methods: In our study, 55 cases of phyllodes tumor diagnosed between 2005-2018 in the Department of Medical Pathology were retrospectively studied. A total of 55 cases were included in the study.Results: All cases were female with a mean age of 39.7+15.2 years. Fifty-seven tumors diagnosed in 55 cases were classed as benign in 20 cases (35.1%), borderline in 14 cases (24.6%) and malignant phyllodes tumors in 23 cases (40.3%). Ductal carcinoma in situ (solid and cribriform type) were detected in one case with malignant phyllodes tumor, whereas invasive ductal carcinoma was detected in one case. Bilateral ductal carcinoma in situ was present in the patient with invasive ductal carcinoma.Conclusion: These tumors which rapidly grow into large masses can be clinically and pathologically confused with benign lesions, macroscopic and microscopic evaluation of concomitant in situ-invasive carcinomas should be considered. Phyllodes tumors have an important role in breast surgery and pathology.Publication Granulomatous lobular mastitis: Clinicopathologic presentation of 90 cases(Türk Patoloji Derneği, 2018-09-01) Özşen, Mine; Tolunay, Şahsine; Gökgöz, Mustafa Şehsuvar; ÖZŞEN, MİNE; TOLUNAY, ŞAHSİNE; GÖKGÖZ, MUSTAFA ŞEHSUVAR; Tıp Fakültesi; Meme Cerrahisi Ana Bilim Dalı; 0000-0002-5771-7649; AAI-1612-2021; AAI-1609-2021; JKX-1058-2023Objective: Granulomatous lobular mastitis is a rare benign chronic breast disease first described by Milward in 1970, and then by Kessler and Wolloch in 1972. In this study, we aimed to present clinicopathologic features of granulomatous lobular mastitis with literature data.Material and Method: In this study, the archives of Uludag University Medical Faculty Department of Pathology were screened for granulomatous lobular mastitis cases between 2005 and 2017.Results: A total of 90 patients with granulomatous lobular mastitis diagnosed between 2005 and 2017 were identified. All of the cases were female. The mean age was 34 t8.3 (range 21-60 years). There was sarcoidosis in one case and tuberculosis in another case, but no systemic disease was found in the charts of the other cases. Histopathological evaluation of 90 cases revealed non-necrotizing granulomas involving lobule-restricted, epithelioid histiocytes and Langhans-type multinuclear giant cells. There was no case of necrosis, including our only case with a history of tuberculosis.Conclusion: We conclude that our granulomatous lobular mastitis cases have similar characteristics with the series reported earlier, when all features are taken into consideration.Publication Identification of CHEK2 germline mutations in BRCA1/2- and PALB2-negative breast and ovarian cancer patients(Karger, 2022-08-01) Aksoy, Fuat; Tezcan Ünlü, Havva; Çeçener, Gülşah; Güney Eskiler, Gamze; Egeli, Ünal; Tunca, Berrin; Efendi Erdem, Ecem; Şenol, Kazım; Gökgöz, Mustafa Şehsuvar; AKSOY, FUAT; Tezcan Ünlü, Havva; ÇEÇENER, GÜLŞAH; EGELİ, ÜNAL; TUNCA, BERRİN; Efendi Erdem, Ecem; ŞENOL, KAZIM; GÖKGÖZ, MUSTAFA ŞEHSUVAR; Tıp Fakültesi; Genel Cerrahi Ana Bilim Dalı; 0000-0001-5808-9384; 0000-0002-0910-4258; 0000-0002-3820-424X; 0000-0001-7904-883X; 0000-0002-1619-6680; 0000-0001-6273-0664; HII-8895-2022; AAP-9988-2020; GYU-0252-2022; AAH-1420-2021; ABI-6078-2020; GWP-6104-2022; KGQ-4411-2024; EWY-5692-2022Introduction: The CHEK2 gene is known to be an important signal transducer involved in DNA repair, apoptosis, or cell cycle arrest in response to DNA damage. The mutations in this gene have been associated with a wide range of cancers, both sporadic and hereditary. Germline CHEK2 mutations are linked to an increased risk of breast cancer. Therefore, the aim of this study was to identify the prevalence of CHEK2 variants in BRCA1/2- and PALB2-negative early-onset patients with breast cancer and/or ovarian cancer in a Turkish population for the first time. Methods: The study included 95 patients with BRCA1/2- and PALB2-negative early-onset breast cancer and/or ovarian cancer and also 60 unaffected women. All the intron/exon boundaries and coding exons of CHEK2 were subjected to mutational analysis by heteroduplex analysis and DNA sequencing. Results: A total of 16 CHEK2 variants were found in breast cancer patients within the Turkish population. CHEK2 c.1100delC mutation most frequently studied in the CHEK2 gene was not detected in our study. The prevalence of variants of uncertain significance in CHEK2 was found to be 7.3% (n = 7) in BRCA1/2 and PALB2 mutation-negative Turkish patients with early-onset breast and/or ovarian cancer. Conclusion: The present study may shed light on alternative variations that could be significant for understanding the prevalence and clinical suitability of the CHEK2 gene.Publication Primary mucinous cystadenocarcinoma of the breast: Clinicopathological analysis of a case and difficulties encountered in a biopsy(Sage Publications Inc, 2023-12-10) Özsen, Mine; TOLUNAY, ŞAHSİNE; ÖZŞEN, MİNE; GÖKGÖZ, MUSTAFA ŞEHSUVAR; Gökgöz, Mustafa Şehsuvar; Deligönül, Adem; DELİGÖNÜL, ADEM; Tıp Fakültesi; Onkoloji Ana Bilim Dalı; 0000-0002-5771-7649Background. With <40 case reports published in the English literature, mucinous cystadenocarcinoma of the breast is quite rare compared to its counterparts in the ovary, pancreas, and appendix. The purpose of this case report is to enrich scientific data by sharing the clinicopathological features of this new and extremely rare entity and present possible difficulties encountered in the biopsy materials. Case Report. A 34-year-old female patient presented with the complaint of white discharge from her left nipple lasting 8 months. Physical and radiological examination of the patient revealed a mass in the lower quadrant of the left breast and tru-cut biopsy was performed. The diagnosis of invasive breast carcinoma of no special type was reported. After neoadjuvant chemotherapy, left subcutaneous mastectomy and left sentinel lymph node biopsy were performed. Microscopic evaluation of the mastectomy material revealed a tumor consisting of stratified columnar cells with basally located nuclei and intracytoplasmic mucin, showing papillary structures and tufting toward the lumen. Peripheral myoepithelial cells were not identified with p63 and calponin immunohistochemistry. The diagnosis of mucinous cystadenocarcinoma was given through histomorphological and immunohistochemical evaluations. Conclusion. Clarifying unknown points about this rare malignancy of the breast and understanding the tumor biology is possible through evaluation of case reports. For this purpose, our case of primary mucinous cystadenocarcinoma is presented and its clinicopathological features are briefly discussed.