Melek Ergin

CD44, a stem cell-associated adhesion molecule, and CD47, an anti-phagocytic checkpoint, have been implicated in breast cancer chemoresistance, but their relationship to neoadjuvant response is poorly defined. We assessed both markers by immunohistochemistry in pre-treatment core biopsies from 43 women treated with neoadjuvant therapy at a single center. Total pathological complete response (pCR; ypT0/is ypN0), designated the primary endpoint during peer review, occurred in 12 patients (27.9%), and breast pCR (ypT0/is) in 14 (32.6%). Total pCR rates were 18.2% in CD44-positive and 38.1% in CD44-negative tumors (odds ratio, 0.36; 95% CI, 0.09–1.46; Fisher exact p = 0.185). CD44 positivity was concentrated in rarely responding hormone receptor-positive/HER2-negative tumors, and stratification by subtype moved the odds ratio toward the null (0.62; exact 95% CI, 0.07–5.25). For CD47, the odds ratio per one-point increase in immunoreactivity score was 0.80 (95% CI, 0.54–1.19; p = 0.264), but immunoreactivity was low (only two tumors reached the prespecified high-expression threshold) and possibly technically compromised, so these findings are inconclusive. No statistically detectable association was observed between either marker and total or breast pCR; treatment could not be adjusted for, and only very large effects were detectable. These exploratory data do not provide sufficient evidence to support CD44 or CD47 as response markers.

Background and Objectives: Idiopathic granulomatous mastitis (IGM) is a rare benign inflammatory breast disease with variable response to corticosteroid therapy. This study aimed to identify predictive factors for steroid responsiveness in IGM patients. Materials and Methods: A retrospective analysis of 176 patients with IGM treated at Cukurova University Faculty of Medicine, Department of General Surgery, between 2011 and 2024 was conducted. Patients were divided into steroid-responsive (Group 1, n = 100) and non-responsive (Group 2, n = 76) groups. Demographic characteristics, clinical features, and treatment history were compared using the chi-square test, Mann–Whitney U test, and multivariate logistic regression analysis. Results: Mean age was 39.1 ± 7.6 years. Factors associated with steroid non-responsiveness included extramammary symptoms (40.8% vs. 26.0%, p = 0.038), recurrent disease (21.1% vs. 8.0%, p = 0.012), a higher number of previous attacks (median 2 vs. 1, p < 0.001), previous abscess drainage (31.6% vs. 14.0%, p = 0.005), previous surgical treatment (30.3% vs. 7.0%, p < 0.001), and longer steroid treatment duration (median 6 vs. 4 months, p = 0.006). Multivariate analysis identified recurrent disease (odds ratio [OR] = 0.283, p = 0.015), previous abscess drainage (OR = 0.307, p = 0.007), previous surgery (OR = 0.170, p = 0.001), and steroid treatment duration (OR = 0.880, p = 0.008) as independent predictors of poor steroid response. Conclusions: Steroid non-responsiveness in IGM is associated with disease recurrence, previous abscess drainage, previous surgical intervention, and prolonged steroid therapy. Alternative treatment modalities should be considered in patients with these characteristics.

Purpose: Enhancer of zeste homolog 2 (EZH2) is an epigenetic regulator implicated in the pathogenesis of diffuse large B-cell lymphoma, but the prognostic value of its protein expression is uncertain. We evaluated EZH2 expression and its associations with clinicopathological features and survival.Materials and Methods: We retrospectively studied 50 patients with diffuse large B-cell lymphoma treated with rituximab-based immunochemotherapy. EZH2 expression was assessed by immunohistochemistry using an H-score and classified as high (≥150) or low (

Background/Objectives: In diffuse large B-cell lymphoma (DLBCL), the prognostic value of programmed death-ligand 1 (PD-L1) depends on the immunohistochemical threshold applied. We asked whether tumor-cell PD-L1 adds prognostic information beyond the International Prognostic Index (IPI). Methods: Tumor-cell PD-L1, quantified by the 22C3 tumor proportion score (TPS), was assessed retrospectively in 95 patients with large B-cell lymphoma (87 DLBCL-NOS) given frontline chemoimmunotherapy. TPS was analyzed at the prespecified ≥1% threshold, post hoc at ≥10%, ≥25%, ≥50% and ≥70%, continuously, and with restricted cubic splines. Results: PD-L1 positivity (TPS ≥ 1%) was present in 73 patients (77%). After a median follow-up of 89.8 months, PD-L1 was not independently associated with overall survival (OS; adjusted hazard ratio [HR], 0.73; 95% CI, 0.35–1.53) or progression-free survival (adjusted HR, 0.91; 95% CI, 0.44–1.86); no threshold survived correction for multiplicity. An unadjusted association with OS emerged at TPS ≥ 70% (HR, 2.02; 95% CI, 1.02–4.02), but these patients more often had an IPI ≥ 3 (72% versus 36%) and it was attenuated after adjustment (1.53; 0.74–3.18). No definition improved model fit or discrimination beyond the IPI; the null result held in DLBCL-NOS and R-CHOP subgroups. Conclusions: Tumor-cell PD-L1 did not add prognostic information beyond the IPI for overall survival.

Background: Idiopathic granulomatous mastitis (IGM) is a rare benign inflammatory breast disease with variable response to corticosteroid therapy. This study aimed to identify predictive factors for steroid responsiveness in IGM patients. Methods: A retrospective analysis of 176 patients with IGM treated at Çukurova University Faculty of Medicine, Department of General Surgery between 2011 and 2019 was conducted. Patients were divided into steroid-responsive (Group 1, n=100) and non-responsive (Group 2, n=76) groups. Demographic characteristics, clinical features, and treatment history were compared using the chi-square test, Mann-Whitney U test, and multivariate logistic regression analysis. Results: Mean age was 39.1 ± 7.6 years. Factors associated with steroid non-responsiveness included extramammary symptoms (40.8% vs. 26.0%, p = 0.038), recurrent disease (21.1% vs. 8.0%, p = 0.012), a higher number of previous attacks (median 2 vs. 1, p < 0.001), previous abscess drainage (31.6% vs. 14.0%, p = 0.005), previous surgical treatment (30.3% vs. 7.0%, p < 0.001), and longer steroid treatment duration (median 6 vs. 4 months, p = 0.006). Multivariate analysis identified recurrent disease (OR = 0.283, p = 0.015), abscess drainage (OR = 0.307, p = 0.007), previous surgery (OR = 0.170, p = 0.001), and steroid treatment duration (OR = 0.880, p = 0.008) as independent predictors of poor steroid response. Conclusions: Steroid non-responsiveness in IGM is associated with disease recurrence, previous abscess drainage, previous surgical intervention, and prolonged steroid therapy. Alternative treatment modalities should be considered in patients with these characteristics.

Background and Objectives: Metaplastic breast carcinoma (MBC) is a rare, aggressive malignancy that is often resistant to conventional chemotherapy and characterized by a triple-negative phenotype. While immune checkpoint inhibition shows promise, the prognostic significance and distribution of programmed death-ligand 1 (PD-L1) expression within the heterogeneous architecture of MBC remain poorly understood. This study aimed to evaluate PD-L1 expression and the density of tumor-infiltrating lymphocytes (TILs) to clarify their roles in patient stratification and overall survival (OS). Materials and Methods: We retrospectively analyzed 48 MBC cases diagnosed between 2010 and 2025. PD-L1 expression was quantified using the Combined Positive Score (CPS) with the 22C3 antibody clone across diverse histological components. The density of stromal TIL density was assessed following internationally standardized guidelines. Clinical outcomes and clinicopathological parameters, including metastasis, lymphovascular invasion (LVI), and histological subtype, were correlated with biomarker status using Kaplan–Meier survival analysis and Cox proportional hazards regression models. Results: PD-L1 positivity (CPS ≥1) was identified in 72.9% of cases, one of the highest rates documented in literature. Notably, an inverse relationship was observed with PD-L1-negative tumors, which exhibited significantly higher rates of distant metastasis (46.2% vs. 17.1%; p = 0.039). Multivariate analysis confirmed that low density of TILs (HR = 9.66; p = 0.016), metastasis (HR = 4.40; p = 0.023), and the presence of LVI (HR = 3.84; p = 0.047) were strong independent predictors of mortality. While PD-L1 status alone did not directly dictate overall survival, mean overall survival was markedly reduced in the low TILs cohort (32.2 months) compared to the high TILs group (114.2 months). Conclusions: The high prevalence of PD-L1 expression supports routine screening for immunotherapy eligibility in MBC. Our findings suggest that PD-L1-negative cases represent a high-risk biological subset driven by alternative immune evasion mechanisms. Integrating TIL density with conventional pathological parameters provides a more robust prognostic framework, enabling personalized therapeutic strategies for this challenging malignancy.

Background and Objectives: Metaplastic breast carcinoma (MBC) is a rare, aggressive malignancy often resistant to conventional chemotherapy and characterized by a triple-negative phenotype. While immune checkpoint inhibition shows promise, the prognostic significance and distribution of programmed death-ligand 1 (PD-L1) expression within the heterogeneous architecture of MBC remain poorly understood. This study aimed to evaluate PD-L1 expression and the density of tumor-infiltrating lymphocytes (TILs) to clarify their roles in patient stratification and overall survival (OS). Materials and Methods: We retrospectively analyzed 48 MBC cases diagnosed between 2010 and 2025. PD-L1 expression was quantified using the Combined Positive Score (CPS) with the 22C3 antibody clone across diverse histological components. The density of stromal TILs density was assessed following internationally standardized guidelines. Clinical outcomes and clinicopathological parameters, including metastasis, lymphovascular invasion (LVI), and histological subtype were correlated with biomarker status using Kaplan-Meier survival analysis and Cox proportional hazards regression models. Results: PD-L1 positivity (CPS ≥1) was identified in 72.9/% of cases, one of the highest rates documented in literature. Notably, an inverse relationship was observed with PD-L1 negative tumors exhibited significantly higher rates of distant metastasis (46.2% vs. 17.1%; p=0.039). Multivariate analysis confirmed that low density of TILs (HR=9.66; p=0.016), metastasis (HR=4.40; p=0.023), and the presence of LVI (HR=3.84; p=0.047) were strong independent predictors of mortality. While PD-L1 status alone did not directly dictate overall survival, mean overall survival was markedly reduced in the low TILs cohort (32.2 months) compared to the high TILs group (114.2 months). Conclusion: The high prevalence of PD-L1 expression supports routine screening for immunotherapy eligibility in MBC. Our findings suggest that PD-L1 negative cases represent a high-risk biological subset driven by alternative immune evasion mechanisms. Integrating TILs density with conventional pathological parameters provides a more robust prognostic framework, enabling personalized therapeutic strategies for this challenging malignancy.

Breast cancer is the most common malignancy in women. In the treatment of these patients, pathological complete response is defined as the absence of invasive cancer in breast or lymph node tissue after the completion of neoadjuvant chemotherapy. In this study, we aimed to investigate the relationship of enhancer of zeste homolog 2 and mucin 1 expressions with pathological complete response in patients with breast cancer receiving neoadjuvant chemotherapy. A total of 151 patients were included in the study. Enhancer of zeste homolog 2 and mucin 1 expressions were evaluated in the biopsy materials pre-neoadjuvant chemotherapy and post-neoadjuvant chemotherapy surgical material, and their relationship with pathological complete response was investigated. The pathological complete response rates were significantly higher among the hormone receptor-negative patients, those with a high Ki-67 score, and patients with HER2-positive. Higher pathological complete response rates were obtained from patients with enhancer of zeste homolog 2 expression positivity pre-neoadjuvant chemotherapy. In addition, after neoadjuvant chemotherapy, enhancer of zeste homolog 2 expression was found to be completely negative in materials with pathological complete response; that is, in breast tissues considered to be tumor-free. While there was no significant relationship between mucin 1 expression and pathological complete response pre-neoadjuvant chemotherapy, mucin 1 expression was determined to significantly differ between the tissues with and without pathological complete response among the surgical materials examined. In our study investigating the relationship between enhancer of zeste homolog 2 and mucin 1 expression and pathological complete response in patients who received neoadjuvant chemotherapy, we found that enhancer of zeste homolog 2 expression could be used as a predictive marker for pathological complete response. However, mucin 1 expression was not associated with pathological complete response.

Background: Periductal mastitis (PM) is a rare disease characterized by chronic inflammation of the terminal mammary ducts. Complete removal of terminal lactiferous ducts with Hadfield procedure is a previously defined technique in treatment but carries various complications risks. This study aims to evaluate the effectiveness of modified techniques in the treatment of PM. Methods: Twenty women who underwent surgery due to PM between January 2012 and December 2019 were retrospectively analyzed. Types of PM were determined. All patients were operated on with three different incisions [Hadfield’s operation with periareolar incision (n:11), periareolar combined radial incision (n:7), and round block incision (n:2)]. Results: The mean age was 37.5 ± 6.5 years (range: 24–49). Sixty percent of patients had type 3 PM. In Hadfield’s procedure, NAC retraction (n:2), seroma (n:1), and hematoma (n:1) were seen. In the periareolar incision combined radial incision group only one patient had complications (seroma) and none in the round block method. Follow-up was 12 ± 1.5 months and disease relapse occurred in two patients in the Hadfield group. Patients who underwent round block were more satisfied with the appearance of the nipple. Conclusions: In the treatment of PM, the main principle of surgical treatment is the excision of the affected canal with a clear margin. Apart from the classical Hadfield procedure, the round block method and periareolar combined radial incision techniques can be performed in the treatment of PM.

Aim: Lymphomas are the second most common malignant disease after leukemia and brain tumors in developing contries. Ebstein-Barr virus has a initiator role in the development of lymphoma, but it is known that socioeconomic conditions, genetic features and the immune supressive factors is also important. We aimed to explore the histopathologic subtypes of pediatric lymphomas and their relation with Ebstein-Barr virüs infection in our region.Material and Methods: In this retrospective study, 87 children including 36 cases with hodgkin lymphoma and 51 cases with non-hodgkin lymphoma were included in the study. The pathologic slides were used to investigate immunohistochemical staining with Ebstein-Barr virüs latent membrane protein-1 and in-situ hybridization. Results: The most common histopathological subtype in hodgkin lymphoma cases were mixed cellular classical Hodgkin lymphoma (55.6%) followed by nodular sclerosis classical hodgkin lymphoma (16.6%). The most common histopathological subtype in non-Hodgkin lymphoma cases was Burkitt lymphoma (51.0%) followed by precursor T-cell lymphoblastic leukemia/lymphoma (13.7%). Ebstein-Barr virüs latent membrane protein-1 was positive in 29 Hodgkin lymphoma. All non-Hodgkin lymphoma cases were stained negative with ımmunohistochemical. The positive staining rate of Hodgkin lymphoma cases with in-situ hybridization was 83.3% and this rate was 27.5% in non-Hodgkin lymphoma cases. The differences between groups for both staining methods were statistically significant (p<0.001) Conclusion: The results of this study show that the distribution of histopatholojik subtypes of pediatric lymphomas similar to in developing countries. And we have observed that in-situ hybridization is more specific than immunohistochemistry because Ebstein-Barr virus positivity is more detected in in-situ hybridization.