Ankara Med J. 2020; 20(1): 23-34 | DOI: 10.5505/amj.2020.97658

Meme Kanseri Tanýsý Almýþ Kadýnlarda Sosyodemografik Veriler, Meme Yoðunluðu, Menopoz Varlýðý ile Hematolojik ve Histopatolojik Bulgularýn Deðerlendirilmesi

Özlem Ünal¹, Birol Korukluoðlu^2
1Ankara Yýldýrým Beyazýt Üniversitesi Týp Fakültesi, Radyoloji Ana Bilim Dalý,Ankara
²Ankara Þehir Hastanesi, Meme Endokrin Cerrahi Kliniði, Ankara, Türkiye

GÝRÝÞ ve AMAÇ: Meme kanseri, kadýnlarda en sýk görülen kanser türüdür ve kansere baðlý ölümlerin %15’ini oluþturur. Meme kanser geliþiminin en güçlü risk faktörlerinden biri meme yoðunluðunun fazla olmasýnýn yaný sýra yaþ, doðum, emzirme, hormon replasman tedavisi gibi faktörler de kanser geliþimini etkilemektedir. Bu çalýþmada meme kanseri tanýsý almýþ kadýnlarda sosyodemografik veriler, meme yoðunluðu, menopoz varlýðý, hematolojik ve histopatolojik bulgularýn deðerlendirilmesi amaçlanmýþtýr.
YÖNTEM ve GEREÇLER: Meme Ünitesi birimine yönlendirilen ve mamografi tetkiki yapýlan hastalardan, tetkik sonrasýnda kanser þüphesi nedeniyle tru-cut biyopsisi yapýlan ve kanser tanýsý alan 154 hastanýn tetkik, ameliyat ve histopatolojik sonuçlarý retrospektif olarak incelendi. 140 hasta çalýþmaya dahil edildi. Hastalarýn yaþý, eðitim ve medeni durumu, ilk adet yaþý, ilk gebelik yaþý, gebelik sayýsý, ilk doðum yaþý, hormon replasman tedavisi görüp görmediði ve mamografi raporlarýndan da BI-RADS sýnýflama sonucu ile meme yoðunluðu kaydedildi. Histopatoloji raporundan tümör çapý, derecesi, lenf nodu metastaz varlýðý ve lenfovasküler invazyon olup olmadýðý elde edildikten sonra TNM (tümör-lenf nodu-metastaz) sýnýflamasýna göre gruplara ayrýldý. Hastalarýn kan sayýmý deðerlerinden nötrofil lökosit/lenfosit oraný ve trombosit/lenfosit oranlarý hesaplandý.
BULGULAR: Meme kanseri tanýsý alan 140 hastanýn 32’si premenopozal, 108’i postmenopozal idi. Premenopozal hastalarýn vücut kitle indeksi (VKÝ) ortalamasý 26,53±3,05 kg/m2 iken, postmenopozal hastalarýn VKÝ’nin 29,63±5,60 kg/m2 olduðu ve bu hastalarýn VKÝ’sinin premenopozal hastalarýnkinden istatistiksel olarak anlamlý þekilde yüksek olduðu görüldü (p<0,001). Meme kanserli hastalarýn yaþ ile vücut kitle indeksi artarken mamografide meme yoðunluðunun azaldýðý saptandý (p<0,001, p=0,013 sýrasýyla). Ýlk gebelik ve ilk doðum yaþýnýn ileri olduðu hastalarda mamografik meme yoðunluðunun arttýðý tespit edildi (p<0,001). Postmenopozal hastalarýn mamografi raporlamasýnda BI-RADS 5 ve 6 premenopozal hastalardan daha sýklýkla rapor edildi (p=0,03). Hematolojik parametrelerden premenopozal hastalarýn kan sayýmýndaki trombosit sayýsý ortalamasý 257,38±65,70 (bin) iken postmenopozal hastalarýn trombosit sayýsý ortalamasý 293,31±75,02 (bin) olarak saptandý. Trombosit sayýsý/lenfosit sayýsý oranýnýn ortalamasý premenopozal hastalarda 131,31±33,76 iken postmenopozal hastalarda bu oranýn ortalamasýnýn 161,11±59,26 olduðu görüldü. Postmenopozal hastalarýn trombosit sayýsý ve trombosit/lenfosit oraný istatistiksel olarak anlamlý þekilde daha yüksekti (sýrasýyla p=0,011 ve p<0,001). Nötrofil ve lenfosit sayýsýnda istatistiksel olarak anlamlý fark saptanmadý.
TARTIÞMA ve SONUÇ: Sonuç olarak, bu çalýþma meme yoðunluðu fazla olan postmenopozal hastalarda trombosit/lenfosit oraný yüksek ise aile hekimleri ve klinisyenler açýsýndan bu durumun kötü bir prognostik faktör olarak deðerlendirilmesi gerektiðini göstermektedir. Hastalar deðerlendirilirken meme yoðunluðu, menopoz varlýðý ve sosyo-demografik veriler de ayrýca göz önünde bulundurulmalýdýr.

Anahtar Kelimeler: Hematolojik parametreler, meme yoðunluðu, meme kanseri, menopoz.

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Evaluation of Sociodemographic Data, Breast Density, Presence of Menopause and Hematological and Histopathological Findings in Women Diagnosed with Breast Cancer

Özlem Ünal¹, Birol Korukluoðlu^2
1Department of Radiology, Faculty of Medicine, Yýldýrým Beyazýt University, Ankara, Turkey
²Ankara City Hospital, Breast Endocrine Surgery, Ankara, Turkey

INTRODUCTION: Breast cancer is the most common type of cancer in women and accounts for 15% of cancer-related deaths. One of the strongest risk factors of breast cancer development, as well as high breast density, factors such as age, birth, breastfeeding, hormone replacement therapy also affect cancer development. In this study, it was aimed to evaluate the effects of sociodemographic data, breast density, presence of menopause, hematological and histopathological findings in women diagnosed with breast cancer.
METHODS: The examination, surgery and histopathological results of 154 patients who were referred to the Breast Unit and underwent mammography examination and tru-cut biopsy after the examination and diagnosed with cancer were analyzed retrospectively. According to the mammography findings, who underwent tru-cut biopsy due to suspected cancer and subsequently diagnosed as cancer, 154 patients’ examination, surgery and histopathological results were retrospectively reviewed. 140 patients were included in the study. Breast intensity was recorded from the patients' age, education and marital status, first menstrual age, first gestational age, number of pregnancies, age of first delivery, hormone replacement therapy, and BI-RADS classification results from mammography reports. After obtaining tumor diameter, grade, lymph node metastasis and whether there was lymphovascular invasion from the histopathology report, it was divided into groups according to TNM (tumor- lymph node- metastasis) classification. Neutrophil leukocyte/lymphocyte and platelet/lymphocyte ratios were calculated from the blood count values of the patients.
RESULTS: Of the 140 patients diagnosed with breast cancer, 32 were premenopausal and 108 were postmenopausal. While the mean body mass index (BMI) of premenopausal patients was 26.53 ± 3.05 kg / m2, the BMI of postmenopausal patients was 29.63 ± 5.60 kg / m2 and their BMI was statistically significantly higher than that of premenopausal patients. (p <0.001). It was found that mammographic breast density decreased while the age and body mass index of breast cancer patients increased (p <0.001, p = 0.013 respectively). It was observed that mammographic breast density increased in patients with high gestational age and first birth age (p<0.001). In mammography reporting of postmenopausal patients, BI-RADS was reported more frequently than 5 and 6 premenopausal patients (p=0.03). In mammography reporting of postmenopausal patients, BI-RADS 5 and 6 were reported more frequently than premenopausal patients (p=0.03). The mean platelet count of premenopausal patients, which is one of the hematological parameters, was 257.38 ± 65.70 (thousand), while that of postmenopausal patients was 293.31 ± 75.02 (thousand). The mean platelet / lymphocyte ratio was 131.31 ± 33.76 in premenopausal patients, while it was 161.11 ± 59.26 in post-menopausal patients. Platelet count and platelet / lymphocyte ratio were statistically significantly higher in postmenopausal patients (p=0.011 and p<0.001, respectively). No statistically significant difference was found in neutrophil and lymphocyte count.
DISCUSSION AND CONCLUSION: In conclusion, this study shows that if the platelet / lymphocyte ratio is high in postmenopausal patients with high breast density, this should be considered as a bad prognostic factor for family physicians and clinicians. During the evaluation of patients, breast density, presence of menopause and social-demographic data should also be taken into consideration.

Keywords: Hematologic parameters, Mammography density, breast cancer, menopause.

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