Background: Breast cancer is the most common cancer in women. Primary treatment is surgery, with breast conserving surgery (BCS) being widely used for early-stage disease. Due to changes in body image, depressive symptoms can occur after surgery. Here, we evaluate factors that affect patients’ decision on surgery, and investigate differences in the level of depression after mastectomy or BCS in a population of Turkish patients. Patients and Methods: One hundred breast cancer patients who had undergone mastectomy or BCS and were followed up at our institution between 2007 and 2008 were included. Patients were questioned about their involvement in surgical decision-making. Depression was diagnosed according to the Diagnostic and Statistical Manual of Mental Disorders (DSM-III) criteria via a Structural Clinical Interview for DSM (SCID). Severity of depression was evaluated by using the Beck Depression Inventory (BDI). Results: Patients who were older than 50 years, had more than 1 child, a history of lactation, and a positive family history of breast cancer mostly preferred mastectomy. However, patients who sought a second opinion and further information on BCS preferred BCS (p < 0.005). There was no statistical correlation between marital status, first childbearing age, and educational status and the decision on surgery type (p > 0.005). Mastectomy patients were prone to depression, but this was not statistically significant (p = 0.099). Conclusion: Age, parenthood, lactation, and positive familial history, as well as thorough information about the type of surgery were important factors for the patients’ decision. After breast cancer surgery, patients might experience depression affecting treatment and quality of life. Therefore, adequate information and communication are essential.

Ö ÖZ ZE ET T A Am ma aç ç: : Kli ni ği miz de me me ko ru yu cu cer ra hi (MKC) ve son ra sın da rad yo te ra pi uy gu la nan has ta lar ile modi fi ye ra di kal mas tek to mi (MRM) uy gu la nan has ta la rın ame li yat son ra sı ya şam ka li te le ri ni kar şı laş tır mak. G Ge e r re eç ç v ve e Y Yö ön n t te em m l le er r: : Ça lış ma ya kli ni ği miz de Ocak 2006 ile Ocak 2008 ta rih le ri ara sın da me me kan se ri ta nı sı ile ame liyat edi len has ta lar alın mış tır. Ne o ad ju van ke mo te ra pi alan ve mo di fi ye ra di kal mas tek to mi son ra sı rad yo te ra pi gere ken has ta lar ile ASA 3 ve 4 has ta lar ça lış ma dan çı ka rıl mış lar dır. Bi rin ci gru ba mo di fi ye ra di kal mas tek to mi (MRM gru bu), ikin ci gru ba ise me me ko ru yu cu cer ra hi ve son ra sın da rad yo te ra pi (MKC gru bu) ile te da vi edi len has ta lar alın mış lar dır. Has ta la rın ya şam ka li te le ri, te da vi sü reç le ri (cer ra hi, rad yo te ra pi, ke mo te ra pi) ta mam lan dık tan altı ay son ra Tıbbi Sonuç Çalışması-Kısa Form 36 (MOS SF-36) for mu kul la nı la rak de ğer len di ril miş tir. B Bu ul l g gu u l la ar r: : Gruplar ara sın da yaş ve de ğer len di ri len sos yo e ko no mik (eği tim, ge lir, eşin du ru mu) ve kli nik pa ra met re ler (ev re, kompli kas yon, ad ju van ke mo te ra pi en di kas yo nu) ara sın da an lam lı fark yok tu (tüm kar şı laş tır ma lar için p> 0.05). MKC uy gu la nan has ta la rın (s= 27) ya şam ka li te le ri se kiz SF-36 öl çe ği nin al tı sın da (can lı lık, sos yal iş lev ha riç) ge nel Türk top lu mun dan, ye di sin de (can lı lık ha riç) ise Ulusal Cerrahi Adjuvan Meme ve Bağırsak Projesi Protokol-B6 (NSABP BCPT) ça lış ma sın da ki nor mal bi rey le rin or ta la ma de ğer le rin den da ha kö tüy dü. Bu nun ya nın da MKC gru bun da fi zik sel alan sko ru ge nel top lum dan da ha kö tüy ken (45.3'e kar şın 52.6), men tal alan sko ru ge nel top lum la nis peten ben zer di (53.4'e kar şın 51.7). MRM uy gu la nan has ta lar (s= 23) ile MKC uy gu la nan has ta la rın ya şam ka li te le ri kar şı laş tı rıl dı ğın da ise tüm öl çek ler de MKC gru bu nun or ta la ma de ğer le ri nin MRM gru bun dan da ha iyi ol du ğu, ve se kiz öl çe ğin al tı sın da (can lı lık ve sos yal iş lev ha riç) ara da ki far kın is ta tis tik sel ola rak an lam lı ol du ğu bu lun muş -tur (p< 0.05). S So o n nu uç ç: : Me me kan se ri ne de niy le me me ko ru yu cu cer ra hi ve rad yo te ra pi uy gu la nan has ta la rın ya şam ka li te le ri nin sağ lık lı bi rey le re kı yas la fi zik sel açı dan bo zul du ğu, an cak men tal açı dan de ğiş me di ği söy le ne bi lir. Bunun ya nın da, me me ko ru yu cu cer ra hi uy gu la nan has ta la rın ya şam ka li te le ri nin mo di fi ye ra di kal mas tek to mi uygu la nan has ta lar dan hem fi zik sel hem de men tal açı lar dan da ha iyi ol du ğu söy le ne bi lir.A An na ah h t ta ar r K Ke e l li i m me e l le er r: : Me me tö mör le ri; ya şam ka li te si; mas tek to mi, seg men tal A AB BS S T TR RA AC CT T O Ob b j je ec c t ti i v ve e: : The aim of this stu...

Non-small cell lung cancer (NSCLC) is usually at advanced stage when it is diagnosed. There is no consensus about the standard treatment in elderly patients with advanced NSCLC. Generally, data regarding elderly patients with NSCLC are withdrawn from general NSCLC studies based on subgroup analyses and suggestions. We evaluated prognostic factors in elderly patients with advanced NSCLC. We reviewed retrospectively 338 patients from August 2005 to July 2009 in two centers in Turkey. Medical records of the patients≥65 years with advanced NSCLC were collected. Collected data included demographic informations, clinical assessments and information on treatment, toxicities and outcomes. Survival was estimated by using Kaplan-Meier method and prognostic factors were evaluated with log-rank and Cox regression tests. The median overall survival (OS) for the entire group was 15.4 months (95% CI: 12.7-18.0). In univariate analysis, weight loss, stage, combination therapy, second-line chemotherapy and tumor response (P<0.01) and performance status significantly affected OS (P<0.05). The median progression-free survival (PFS) was 10 months (95% CI: 8.4-11.6). In univariate analysis, there was only a significant association between tumor response and PFS (14.6 vs. 8.5 months; P<0.001). Multivariate analysis showed that only response to therapy was an important prognostic factor for OS (P<0.001). Survival of elderly patients with advanced NSCLC is significantly influenced by performance status, weight loss, stage, combination therapy, second-line chemotherapy and response to therapy. Not only age but also these factors may be kept in mind in the treatment planning of the elderly patients with NSCLC. These results may be of benefit in changing clinical practice in elderly patients with NSCLC who are often undertreated.

Breast remodeling by glandular flap displacement after a wide local excision should be the primary aim in patients with breast cancer for better aesthetic outcomes. NAC recentralization is the primary component that could be considered for achieving better results. BCS associated with oncoplastic techniques allows wide excision of larger tumors and provides good and satisfactory aesthetic results at long-term follow-up.

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