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

�nal, �zlem; Korukluo�lu, Birol

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Evaluation of Sociodemographic Data, Breast Density, Presence of Menopause and Hematological and Histopathological Findings in Women Diagnosed with Breast Cancer [Ankara Med J]

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

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

�zlem �nal¹, Birol Korukluo�lu²
¹Department of Radiology, Faculty of Medicine, Y�ld�r�m Beyaz�t 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.

Meme Kanseri Tan�s� Alm�� Kad�nlarda Sosyodemografik Veriler, Meme Yo�unlu�u, Menopoz Varl�� ile Hematolojik ve Histopatolojik Bulgular�n De�erlendirilmesi

�zlem �nal¹, Birol Korukluo�lu²
¹Ankara Y�ld�r�m Beyaz�t �niversitesi T�p Fak�ltesi, Radyoloji Ana Bilim Dal�,Ankara
²Ankara �ehir Hastanesi, Meme Endokrin Cerrahi Klini�i, Ankara, T�rkiye

G�R�� ve AMA�: Meme kanseri, kad�nlarda en s�k g�r�len kanser t�r�d�r ve kansere ba�l� �l�mlerin %15�ini olu�turur. Meme kanser geli�iminin en g��l� risk fakt�rlerinden biri meme yo�unlu�unun fazla olmas�n�n yan� s�ra ya�, do�um, emzirme, hormon replasman tedavisi gibi fakt�rler de kanser geli�imini etkilemektedir. Bu �al��mada meme kanseri tan�s� alm�� kad�nlarda sosyodemografik veriler, meme yo�unlu�u, menopoz varl��, hematolojik ve histopatolojik bulgular�n de�erlendirilmesi ama�lanm��t�r.
Y�NTEM ve GERE�LER: Meme �nitesi birimine y�nlendirilen ve mamografi tetkiki yap�lan hastalardan, tetkik sonras�nda kanser ��phesi nedeniyle tru-cut biyopsisi yap�lan ve kanser tan�s� alan 154 hastan�n tetkik, ameliyat ve histopatolojik sonu�lar� retrospektif olarak incelendi. 140 hasta �al��maya dahil edildi. Hastalar�n ya��, e�itim ve medeni durumu, ilk adet ya��, ilk gebelik ya��, gebelik say�s�, ilk do�um ya��, hormon replasman tedavisi g�r�p g�rmedi�i ve mamografi raporlar�ndan da BI-RADS s�n�flama sonucu ile meme yo�unlu�u kaydedildi. Histopatoloji raporundan t�m�r �ap�, derecesi, lenf nodu metastaz varl�� ve lenfovask�ler invazyon olup olmad�� elde edildikten sonra TNM (t�m�r-lenf nodu-metastaz) s�n�flamas�na g�re gruplara ayr�ld�. Hastalar�n kan say�m� de�erlerinden n�trofil l�kosit/lenfosit oran� ve trombosit/lenfosit oranlar� hesapland�.
BULGULAR: Meme kanseri tan�s� alan 140 hastan�n 32�si premenopozal, 108�i postmenopozal idi. Premenopozal hastalar�n v�cut kitle indeksi (VK�) ortalamas� 26,53�3,05 kg/m2 iken, postmenopozal hastalar�n VKݒnin 29,63�5,60 kg/m2 oldu�u ve bu hastalar�n VKݒsinin premenopozal hastalar�nkinden istatistiksel olarak anlaml� �ekilde y�ksek oldu�u g�r�ld� (p<0,001). Meme kanserli hastalar�n ya� ile v�cut kitle indeksi artarken mamografide meme yo�unlu�unun azald�� saptand� (p<0,001, p=0,013 s�ras�yla). �lk gebelik ve ilk do�um ya��n�n ileri oldu�u hastalarda mamografik meme yo�unlu�unun artt�� tespit edildi (p<0,001). Postmenopozal hastalar�n mamografi raporlamas�nda BI-RADS 5 ve 6 premenopozal hastalardan daha s�kl�kla rapor edildi (p=0,03). Hematolojik parametrelerden premenopozal hastalar�n kan say�m�ndaki trombosit say�s� ortalamas� 257,38�65,70 (bin) iken postmenopozal hastalar�n trombosit say�s� ortalamas� 293,31�75,02 (bin) olarak saptand�. Trombosit say�s�/lenfosit say�s� oran�n�n ortalamas� premenopozal hastalarda 131,31�33,76 iken postmenopozal hastalarda bu oran�n ortalamas�n�n 161,11�59,26 oldu�u g�r�ld�. Postmenopozal hastalar�n trombosit say�s� ve trombosit/lenfosit oran� istatistiksel olarak anlaml� �ekilde daha y�ksekti (s�ras�yla p=0,011 ve p<0,001). N�trofil ve lenfosit say�s�nda istatistiksel olarak anlaml� fark saptanmad�.
TARTI�MA ve SONU�: Sonu� olarak, bu �al��ma meme yo�unlu�u fazla olan postmenopozal hastalarda trombosit/lenfosit oran� y�ksek ise aile hekimleri ve klinisyenler a��s�ndan bu durumun k�t� bir prognostik fakt�r olarak de�erlendirilmesi gerekti�ini g�stermektedir. Hastalar de�erlendirilirken meme yo�unlu�u, menopoz varl�� ve sosyo-demografik veriler de ayr�ca g�z �n�nde bulundurulmal�d�r.

Anahtar Kelimeler: Hematolojik parametreler, meme yo�unlu�u, meme kanseri, menopoz.

Corresponding Author: �zlem �nal, T�rkiye
Manuscript Language: Turkish

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

Meme Kanseri Tan�s� Alm�� Kad�nlarda Sosyodemografik Veriler, Meme Yo�unlu�u, Menopoz Varl��� ile Hematolojik ve Histopatolojik Bulgular�n De�erlendirilmesi

Meme Kanseri Tan�s� Alm�� Kad�nlarda Sosyodemografik Veriler, Meme Yo�unlu�u, Menopoz Varl�� ile Hematolojik ve Histopatolojik Bulgular�n De�erlendirilmesi