• Asian Pacific Journal of Cancer Prevention
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• v.16 no.1
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• pp.303-306
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• 2015

Purpose: This study was conducted to determine risk of developing of breast cancer among Turkish women. Materials and Methods: Using a descriptive and cross-sectional approach, data were collected from 231 women. Breast cancer risk was calculated using the National Cancer Institute's on-line verson of called as the Breast Cancer Risk Assessment Tool or the Gail Risk Assesment Tool. Results: The average age of women was $45.0{\pm}8.06$ years. It was revealed that 6.1% of participants reported having first degree relatives who had had breast cancer, with only four women having more than one first-degree relative affected (1.7%). The mean five-year breast cancer risk for all women was $0.88{\pm}0.91%$, and 7.4% of women had a five-year breast cancer risk >1.66% in this study. Mean lifetime breast cancer risk up to age 90 years was $9.3{\pm}5.2%$. Conclusions: The breast cancer risk assessment tool can help in the clinical management of patient seeking advice concerning screening and prevention. Healthcare providers in Turkey can use this approach to estimate an individual's probability of developing breast cancer.

• Asian Pacific Journal of Cancer Prevention
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• v.13 no.11
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• pp.5823-5828
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• 2012

Background: Breast cancer (BC) is one of the most common cancer affecting women worldwide. Although a great deal of progress has been made in the health sciences, early diagnosis, and increasing community awareness, breast cancer remains a life-threatening illness. In order to reduce this threat, breast cancer screening needs to be implemented in all communities where possible. Objective: The purpose of this study was to examine health beliefs, attitudes and behaviors about breast cancer and breast self-examination of Turkish women. Methods: Data were collected from a sample of 656 women, using an adapted Turkish version of Champion's Health Belief Model Scale (CHBMS), between January and May 2011, in Ordu province of Turkey. Results: The results showed that 67.7% of women had knowledge about and 55.8% performed BSE, however 60.6% of those who indicated they practiced BSE reported they did so at irregular intervals. CHBMS subscales scores of women according to women's age, education level, occupation, family income and education level of the women's mothers, family history of breast cancer, friend and an acquaintance with breast cancer, knowledge about breast cancer, BSE and mammography were significantly different. Conclusion: Knowledge of women about the risks and benefits of early detection of breast cancer positively affect their health beliefs, attitudes, and behaviors. Health care professionals can develop effective breast health programs and can help women to gain good health behavior and to maintain health.

• Asian Pacific Journal of Cancer Prevention
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• v.16 no.12
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• pp.4921-4926
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• 2015

Background: Breast cancer is the most common cancer type among women with increasing incidence rates, improved prognosis and survival. According to the localization of the tumor, breast cancer is designated as unilateral (UBC) or bilateral (BBC). BBC can be classified as synchronous (SBBC) or metachronous (MBBC) based on the time interval between the diagnosis of the first and the secondary tumors. According to the guideline of WHO 2012, BBC is generally defined as SBBC when contralateral breast carcinoma is diagnosed within 3 months. The aim of this study was to compare the characteristics and patterns of metastasis of BBC patients with UBC. Materials and Methods: A cohort of 768 patients with breast cancer treated at the Turkish Ministry of Health-Izmir Bozyaka Research and Training Hospital between 1976 and 2012 were studied. Survival analysis was performed comparing UBC and BBC patients. In addition, evaluations were performed in patients with SBBC and MBBC sub-groups. We used a 3-months interval to distinguish metachronous from synchronous. Results: When clinical and histopathological parameters were statistically evaluated, ER status, event-free and overall survival were found to be significant between UBC and BBC patients. In comparison of SBBC and MBBC patients, age, histological type of tumor, event-free and overall survival were found to be significant. Conclusions: BBC cases were found to show worse prognosis than UBC cases. Among BBC, SBBC had the worst prognosis based on overall survival rates.

• Asian Pacific Journal of Cancer Prevention
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• v.17 no.9
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• pp.4241-4246
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• 2016

Background: Dysregulation of miRNA expression may be used as a biomarker for specific tumours because it may contribute to development of cancer. Circulating miRNA profiles have been highlighted for their potential as predictive markers in heterogeneous diseases such as breast cancer. In the literature, there is evidence that miR-195 levels are differentially expressed pre- and post-operative periods in breast cancer patients. At the same time, miRNA expression levels may vary because of ethnic origins. This study aimed to determine expression levels and potential roles of miR-195 in Turkish breast cancer patients. Materials and Methods: The expression patterns of miR-195 were initially examined in breast cancer tissues (luminal A and B type) (n=96). Subsequently, blood samples were prospectively collected from preoperative and postoperative Turkish breast cancer patients and disease free controls. Total RNA was isolated, and the expression level of miR-195 was quantified by real-time PCR. Results: We found that miR-195 level was altered in Turkish breast cancer patients, with down-regulation evident in breast cancer tissues compared to normal adjacent specimens. Furthermore, circulating levels of miR-195 was significantly decreased in post-operative blood samples compared with pre-operative levels (p=0.01 and <0.05). However, miR-195 was significantly increased in pre-operative blood samples of the luminal B type (p=0.04 and <0.05). Conclusions: This study represents the first report of a miR-195 expression profile in Turkish breast cancer patients. Our data suggests that miR-195 levels might be a clinically useful biomarker in the earliest stage of Turkish breast cancer patients.

• Asian Pacific Journal of Cancer Prevention
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• v.15 no.21
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• pp.9199-9202
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• 2014

Background: Kurdish women with breast cancer have more unfavorable prognostic factors than their Turkish and Arab counterparts. However, the effects of these factors on breast cancer survival among these ethnic groups remain unclear. We therefore investigated the impact of ethnicity on survival in breast cancer patients in Turkey. Materials and Methods: Ethnicity, age, stage at diagnosis, tumor characteristics, treatments given (surgery, chemotherapy, radiotherapy and hormone therapy), and survival times were recorded. Kaplan-Meier analysis was used to estimate the overall survival times and survival plots. Log-rank test was used to compare the survival curves.Results: Of the 723 breast cancer patients included in the study, 496 (68.7%) were Turkish, 189 (26.2%) were Kurdish, 37 (5.1%) were Arabic and 1 was Armenian. Kurdish women with breast cancer had larger tumor sizes and higher rates of hormone receptor negative tumors than Turkish and Arab patients. Mean follow-up time was 118.4 [95% Confidence Interval (CI): 95.4-141.3] months, and it was 129.9 (95% CI: 93.7-166.2), 124.2 (95% CI: 108.4-140.1) and 103.1 (95% CI: 85.9-120.4) months for Turkish, Arabic and Kurdish patients, respectively. Conclusions: Kurdish ethnicity is associated with higher rates of hormone receptor negative and triple-negative tumors and with worse survival. Clinical and epidemiological research is warranted to elucidate reasons underlying overall survival, variations in tumor biology, differences in treatment responsiveness, and effects of social factors among ethnic groups in Turkey.

• Asian Pacific Journal of Cancer Prevention
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• v.14 no.5
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• pp.3143-3149
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• 2013

Background: Breast cancer is the most common type of cancer among women in Turkey and around the world. Treatment adversely affects women's physical, psychological, and social conditions. The purpose of this study was to identify the experiences of Turkish women with breast cancer and the facilitating coping factors when they receive chemotherapy. Methods: A phenomenological approach was used to explain the experiences and facilitating factors of breast cancer patients during the treatment period. Data were collected through individual semi-structured interviews. The sample comprised 11 women with breast cancer receiving treatment. Results: At the end of the interviews conducted with women with breast cancer, two main themes were identified: adjustment and facilitating coping factors. The adjustment main theme had two sub-themes: strains and coping. Women with breast cancer suffer physical and psychological strains as well as stress related to social and health systems. While coping with these situations, they receive social support, turn to spirituality and make new senses of their lives. The facilitating coping factors main theme had four sub-themes: social support, disease-related factors, treatment-related factors and relationships with nurses. It has been determined that women receiving good social support, having undergone preventive breast surgery and/or getting attention and affection from nurses can cope with breast cancer more easily. Conclusions: Women with breast cancer have difficulty in all areas of their lives in the course of the disease and during the treatment process. Therefore, nurses should provide holistic care, teaching patients how to cope with the new situation and supporting them spiritually. Since family support is very important in Turkish culture, patients' relatives should be informed and supported at every stage of the treatment.

• Asian Pacific Journal of Cancer Prevention
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• v.15 no.4
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• pp.1693-1697
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• 2014

Background: The Bahcesehir Breast Cancer Screening Project is the first organized population based breast cancer mammographic screening project in Turkey. The objective of this prospective observational study was to demonstrate the feasibility of a screening program in a developing country and to determine the appropriate age (40 or 50 years old) to start with screening in Turkish women. Materials and Methods: Between January 2009 to December 2010, a total of 3,758 women aged 40-69 years were recruited in this prospective study. Screening was conducted biannually, and five rounds were planned. After clinical breast examination (CBE), two-view mammograms were obtained. True positivity, false positivity, positive predictive values (PPV) according to ACR, cancer detection rate, minimal cancer detection rate, axillary node positivity and recall rate were calculated. Breast ultrasound and biopsy were performed in suspicious cases. Results: Breast biopsy was performed in 55 patients, and 18 cancers were detected in the first round. The overall cancer detection rate was 4.8 per 1,000 women. Most of the screened women (54%) and detected cancers (56%) were in women aged 40-49. Ductal carcinoma in situ (DCIS) and stage I cancer and axillary node positivity rates were 22%, 61%, and 16.6%, respectively. The positive predictivity for biopsy was 32.7%, whereas the overall recall rate was 18.4 %. Conclusions: Preliminary results of the study suggest that population based organized screening are feasible and age of onset of mammographic screening should be 40 years in Turkey.

• Asian Pacific Journal of Cancer Prevention
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• v.13 no.9
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• pp.4273-4279
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• 2012

Introduction: The aim of the study was to determine the breast, cervical, and colorectal cancer screening rates and the influencing factors in a group of Turkish females. Methods: This descriptive study was conducted in a School of Nursing. The study sample consisted of 603 females who were the mothers/neighbors or relatives of the nursing students. Data collection forms were developed by the investigators after the relevant literature was screened and were used to collect the data. Results: Of the women aged 30 and over, 32.8% had undergone a pap smear test at least once in their life. Of those aged 50 and over, 48.2% had undergone mammography at least once and FOBT had been performed in 12% of these women in their life. Having heard of the screening tests before, knowing why they are done, and having information on the national cancer screening program were important factors influencing the rates of women having these tests done. Discussion: The results of this study show that the rates of women participating in national cervical, breast, and colorectal cancer screening programs are not at the desired levels. Having heard of the screening tests before, knowing why they are done, and having information on the national cancer screening program were important factors influencing the rates of women having these tests done. It is suggested that written and visual campaigns to promote the service should be used to educate a larger population, thus increasing the participation rates for cancer screening programs.

• Asian Pacific Journal of Cancer Prevention
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• v.15 no.21
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• pp.9327-9333
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• 2014

Breast cancer is the second most common cancer and second leading cause of cancer deaths in women. Phosphatidylinositol-3-kinase (PI3K)/AKT pathway mutations are associated with cancer and phosphatidylinositol-4, 5-bisphosphate 3-kinase catalytic subunit alpha (PIK3CA) gene mutations have been observed in 25-45% of breast cancer samples. Insulin growth factor binding protein-5 (IGFBP-5) can show different effects on apoptosis, cell motility and survival in breast cancer. We here aimed to determine the association between PIK3CA gene mutations and IGFBP-5 expressions for the first time in breast cancer patients. Frozen tumor samples from 101 Turkish breast cancer patients were analyzed with high resolution melting (HRM) for PIK3CA mutations (exon 9 and exon 20) and 37 HRM positive tumor samples were analyzed by DNA sequencing, mutations being found in 31. PIK3CA exon 9 mutations (Q546R, E542Q, E545K, E542K and E545D) were found in 10 tumor samples, exon 20 mutations (H1047L, H1047R, T1025T and G1049R) in 21, where only 1 tumor sample had two exon 20 mutations (T1025T and H1047R). Moreover, we detected one sample with both exon 9 (E542Q) and exon 20 (H1047R) mutations. 35% of the tumor samples with high IGFBP-5 mRNA expression and 29.4% of the tumor samples with low IGFBP-5 mRNA expression had PIK3CA mutations (p=0.9924). This is the first study of PIK3CA mutation screening results in Turkish breast cancer population using HRM analysis. This approach appears to be a very effective and reliable screening method for the PIK3CA exon 9 and 20 mutation detection. Further analysis with a greater number of samples is needed to clarify association between PIK3CA gene mutations and IGFBP-5 mRNA expression, and also clinical outcome in breast cancer patients.

• Asian Pacific Journal of Cancer Prevention
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• v.15 no.8
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• pp.3429-3434
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• 2014

Aims: To identify the psychosocial adjustment of Turkish patients with breast cancer and the effects of perceived social support on their adjustment. Materials and Methods: The sample comprised 100 volunteering patients diagnosed with breast cancer in the last six months reporting to the Outpatient Chemotherapy Unit at the Medical Faculty Hospital in northern Turkey. The data for the study were collected through the Descriptive Information Form, the Psychosocial Adjustment to Illness Scale-Self-reflection (PAIS-SR) and the Cancer-Specific Social Support Scale and analyzed via SPSS 16.0 for Windows. Descriptive statistics, Chi square test, ANOVA and correlation were used to evaluate data. Results: There was a negative significant correlation between mean scores in the sub-scales of the social support scale and the ones in the sub-scales of the psychosocial adjustment to illness scale (p<0.05). Similarly, there was a negative significant correlation between confidence support and health care orientation as well as adjustment to social environment. Likewise, emotional support was in a negative significant correlation with health care orientation, adjustment to domestic environment, extended family relationships and adjustment to social environment. Conclusions: It was concluded that social support for patients with breast cancer had an influence on their psychosocial adjustment to illness. Holistic care should be given to breast cancer patients by oncology nurses especially in the first six months of treatment. It could be concluded that patients should be accompanied by their family/relatives in treatment and care following their diagnosis with breast cancer, that their family should be made more aware of the fact that the patient should be physically and psychologically supported, that patients with breast cancer should be provided with domiciliary care, and that they should be encouraged to participate in social support groups.