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Purpose Breast cancer surgery may be associated with pain and physical symptoms in the upper limbs. Functional impairment and pain-related avoidance of movement may further increase disability level. This study aimed to investigate the potential effects of early postoperative virtual reality (VR) therapy on pain, range of motion (ROM), muscle strength, functionality, and fear of movement. Methods Forty women with breast cancer who had undergone unilateral mastectomy with axillary lymph node dissection and who were receiving adjuvant therapy were included in the study and randomly assigned to two groups: the Kinect-based rehabilitation group (KBRG) and the standardized physical therapy group (SPTG). The KBRG ( n  = 20) received VR therapy using Xbox Kinect-based games and the SPTG ( n  = 20) received standard physiotherapy. Study subjects were assessed at baseline and after the 6-week treatment. Outcome measures were pain (visual analogue scale), grip strength (dynamometer), functionality (disabilities of the arm shoulder and hand questionnaire), muscle strength (handheld dynamometer), ROM (digital goniometer), and fear of movement (Tampa kinesiophobia scale (TKS)). Results Both groups detected s ignificant changes in pain, ROM, muscle strength, grip strength, functionality, and TKS scores after the treatment ( p  < 0.01). Fear of movement was significantly improved in the KBRG and the SPTG displayed more improvement in functionality ( p  < 0.05). There were no differences in ROM, muscle strength, grip strength, and pain between the groups after the treatment ( p  > 0.05). Conclusion Kinect-based VR therapy resulted in significant outcomes that were comparable to those obtained under standard physiotherapy in the early postoperative phase in patients who had undergone breast cancer surgery. Trial registration This study is registered at ClinicalTrials.gov ( ClinicalTrials.gov identifier: NCT03618433).

Objective:We compared the breast cancer patients with invasive lobular carcinoma (ILC), invasive ductal carcinoma (IDC) and mixed invasive ductal and lobular carcinoma (IDLC) in terms of clinicopathological and treatment features, metastatic patterns and long-term survival.Materials and Methods:In a 10 years patient cohort, 3412 patients with unilateral breast carcinoma were enrolled in the study. Tumors were classified histologically according to criteria described by World Health Organization classification.Results:The highest rate of T3 tumors were found in IDLC patients, the lowest in IDC patients, and the difference between groups was significant only in comparison of IDC vs IDLC. Axillary positivity rate was highest in IDLC, lowest in ILC; differences were significant in comparisons of IDLC vs ILC and IDLC vs IDC. There was no significant difference between the patient groups in terms of surgical treatment, mastectomy and breast conserving surgery. Rate of bone metastasis was highest in IDLC, lowest in IDC, with significant difference between IDLC and IDC. Locoregional recurrence-free survival (LRFS) rate was 90.9% in ILC patients, 92.5% in IDC patients, 92.9% in IDLC patients, with no significant difference between the groups; in multivariate Cox analysis, histological type had no prognostic significance (p=0.599). Distant metastasis-free survival (DMFS) rate was 66.2% in ILC patients, 66.7% in IDC patients, 57.1% in IDLC patients; in multivariate Cox analysis, histological type had no prognostic significance (p=0.392).Conclusion:Although these results suggest that IDLC may have a worse prognosis than IDC and ILC, in multivariate analysis LRFS and DMFS were not significantly different among the histological type groups.

Aim. The classic inguinal lymph node dissection is the main step for the regional control of the lower extremity melanoma, but this surgical procedure is associated with significant postoperative morbidity. The permanent lymphedema is the most devastating long-term complication leading to a significant decrease in the patient’s quality of life. In this study we present our experience with modified, saphenous vein sparing, inguinal lymph node dissections for patients with melanoma of the lower extremity. Methods. Twenty one patients (10 women, 11 men) who underwent saphenous vein sparing superficial inguinal lymph node dissection for the melanoma of lower extremity were included in this study. The effects of saphenous vein sparing on postoperative complications were evaluated. Results. We have observed the decreased rate of long-term lymphedema in patients undergoing inguinal lymphadenectomy for the lower extremity melanoma. Conclusion. The inguinal lymphadenectomy with saphenous vein preservation in lower extremity melanoma patients seems to be an oncologically safe procedure and it may offer reduced long-term morbidity.

Primary sarcomas of the breast are rare, malignant tumors arising from the mesenchymal tissue of the mammary gland. The peak incidence of breast liposarcoma occurs in adults between the fourth and the sixth decades. Our case is the third liposarcoma case of the breast in the literature observed in the third decade. We report a case of liposarcoma of the breast and discuss this rare malignant tumor and other types of sarcoma of the breast in the light of the previously published literature.

Abstract Delays in breast cancer (BC) diagnosis and treatment negatively impact survival outcomes. Understanding patient- and provider-related factors behind these delays is crucial. This study aimed to identify nationwide reasons for delayed diagnosis and treatment of locally advanced BC in Turkiye. A prospective, multicenter hospital-based survey was conducted across 35 institutions between 2023 and 2024. Patient- and provider-related delays were assessed via a structured 61-item face-to-face survey, supplemented by clinical data from electronic health records. Delays exceeding 3 months were clinically categorized as significant. A total of 1322 women participated from seven regions across Turkiye. Factors contributing to diagnostic delays on a national level included economic reasons (5.5%), lack of family support (3.3%), lack of knowledge (12.4%), lack of time due to household work (3.8%), difficulty in finding an appointment (6.7%), pregnancy-related reasons (1.1%), fear of losing the breast (8.9%), fear of death (9.8%), and transportation difficulties (5.1%). Provider-related delays were infrequent. About 89.3% of the patients had the initial doctor appointment and 89.6% had the first specialist consultation within one month. Treatment planning was predominantly based on a multidisciplinary team decision in 88.3% of patients. Regarding treatment initiation, 93.2% started required treatment within 1 month of decision. Patient-related factors are the major causes of diagnostic delay in Turkiye. On the other hand, from the provider’s perspective, the presence of multidisciplinary teams, including dedicated breast surgeons, represents a key factor in ensuring the timely implementation of diagnostic procedures and treatment strategies.

OBJECTIVE Virtual reality programs, which have developed rapidly with the advancement of technology, have led to the development of alternative treatment methods preferred in rehabilitation. This study aimed to investigate the acute effects of a video game-based exercise program applied after breast cancer surgery on the upper extremity functionality, pain severity, and the level of fatigue. METHODS Fifteen female patients aged between 30 and 60 years (50.13±8.79) who completed their 12th week after breast cancer surgery and were received adjuvant chemotherapy treatment were randomly included in this pre-test and post-test study. The patients were performed a 30-min video game-based exercise program. The muscle strength, range of motion (ROM), pain and fatigue level assessments were performed before and after the video game-based exercises. The level of exercise pleasure was determined with the modified visual analog scale. RESULTS Shoulder flexion, abduction, and external rotation ROM significantly increased after video game-based exercise program. No difference was detected for shoulder abduction muscle strength (p>0.05) and pain level significantly increased (p<0.05). The average exercise pleasure level is 4.5/5 and the average fatigue level was 11.13/20. CONCLUSION Video game-based exercises provided improvement in ROM of the shoulder joint without causing fatigue. Studies with different treatment durations are needed to minimize the increase in pain level.

To compare intraoperative (IO) and postoperative (po.) boost radiotherapy (RT) in terms of local recurrence and cosmetic outcomes in patients with early-stage breast cancer during breast-conserving therapy (BCT). Patients who received BCT at our clinic in the past 60 months were analyzed based on their recorded data. Ninety-eight patients who received IO boost RT during breast-conserving surgery were classified as group A and 99 who received po. boost whole-breast RT afterward were classified as group B. Patients were graded using the LENT-SOMA (V06-7/2003) scale and compared using the chi-square test based on local recurrence and cosmetic outcomes at 1 year after the end of all RTs. Mean age of patients in groups A and B was 49 and 52 years; mean follow-up was 35 and 38 months; tumor diameter was 18 (4–30) mm and 19 (6–30) mm; and lymph node involvement was observed in 11 and 17 patients, respectively. The molecular subtypes were either luminal A or B in both groups. Histological analysis revealed 90 and 84 invasive ductal carcinomas, 8 and 5 invasive lobular tumors, respectively, and 10 mixed structure in group B. The boost area was planned so as to cover 15–20 mm of the surrounding tumor bed area in both methods. Local recurrence was not detected in group A; however, it was detected in two patients in group B at 20 and 32 months. According to the LENT-SOMA scale, 34 and 24 patients in groups A and B had grade 0, 41 each had grade 1, 21 and 29 had grade 2, and 2 and 5 had grade 3, respectively, but there was no significant difference between the two groups (p > 0.05). Based on the relatively superior results demonstrated by group A, IO boost RT can potentially improve both local control and cosmetic results.

Objective: The coronavirus disease-2019 (COVID-19) pandemic caused some difficulties in the management of breast cancer, so we examined the effect of this challenging condition on the diagnosis and treatment of breast cancer.Methods: In this study, the 26 month period from March 2019 to April 2021 was divided into two periods according to the start date of the pandemic. The previous 13 months were defined as A, the next 13 months as B, and the first 3 months of both periods were defined as A* and B*. All patients diagnosed with breast cancer were evaluated retrospectively based on hospital records, in terms of some characteristics like histopathological, and molecular subtypes of the tumor, primary systemic treatment (PST) frequency and its model, axillary staging method before PST, and surgical method. The results were evaluated with the chi-square test, and p>0.05 was statistically significant.Results: All patients were female, 356 cases were in the A period, 30.3% of them had PST as neoadjuvant chemotherapy (NAC) and 37% (n=40) had sentinel lymph node biopsy before PST. There were 281 patients in period B, 116 cases received PST (41.2%); NAC and neoadjuvant endocrine therapy (NET) were staged radiologically and cytologically if necessary. When the findings of periods A and B (and A*-B*) were compared, the difference in PST in B compared to period A was statistically significant (p=0.005), insignificant for NAC (p=0.849), and highly significant for axillary approach and NET (p=0.000). In period B, more breast-conserving surgery (BCS) was applied, which may have been due to more initiation of PST. Overall, results in A* and B* were broadly similar to periods A and B.Conclusion: During the COVID-19 pandemic, some adjustments were made in breast cancer management plans. PST was applied more often, NET became an option to start treatment, the axillary staging was performed based on a non-invasive method and surgically, BCS was performed more frequently.

Hydatid disease is a parasitic infestation of humans and herbivorous animals, caused by Echinococcus granulosus . A 55-year-old woman had no prior surgery for hydatid disease earlier. Total cystopericystectomy was performed without cyst rupture. Albendazole was given postoperatively. Neither systemic or local complications nor recurrences were found after minimum follow-up of 12 months, and the laboratory test results were within the normal ranges. Since primer muscular hydatidosis is a very rare disease, care should be taken in diagnosis of cystic mass of skeletal muscle, especially in endemic areas.