The most common cancer type in women is breast cancer and the lifetime risk for breast cancer is 12% (1). The clinical feature of breast cancer is very heterogeneous because of the variable prognostic factors impact its behaviour (2). To know prognostic factors may help to estimate the prognosis and to choose the most appropriate treatment modality. Age, histopathologic subtypes, tumour size, tumour grade, lymph node involvement, extracapsular extension (ECE), lymphovascular invasion (LVI), and hormonal receptor status are the most important conventional prognostic factors (3).In addition to these factors, to know proliferation pattern of tumour is important for the treatment decision. In routine clinical practice, immunohistochemical evaluation of Ki-67 is frequently utilised to assess proliferative features of tumour cells. Except resting phase (G0), Ki-67 is detected in all proliferative phases of the cell cycle (G1, S, G2, and M). Ki-67 existing cells can be immunochemically marked, imaged, counted and showed as a percentage of total cells (4). It has been used for many years for breast cancer; it is currently utilised to distinguish between Luminal A-like and Luminal B-like subtypes in ER+/HER2-breast cancer and physicians frequently use Ki-67 index for making a decision on adjuvant treatment (5-7).In spite of consistent data about Ki-67 index, the relationship between Ki-67 index and the other prognostic factors remains uncertain. The results of studies evaluating the association between Ki-67 and tumour grade in breast cancer have been varied. Some of the research-

Lesions of brain metastasis from prostate cancer had a large variety of imaging presentation and it is very difficult to distinguish them from the other brain metastasis originating from other types of cancer. Presence of a disseminated disease, high PSA level and high Gleason score can be useful parameters for the prediction of brain metastasis from prostate cancer.

Pre-treatment FDG-PET uptake may be a valuable tool to evaluate prognosis in SCLC patients. Patients with a higher pre-treatment FDG uptake may be considered at increased risk of failure and may benefit from more aggressive treatment approaches.

European Journal of Breast Health (Eur J Breast Health) is an international, scientific, open access periodical published by independent, unbiased, and double-blinded peer-review principles. It is the official publication of the Turkish Federation of Breast Diseases Societies, and Senologic International Society is the official supporter of the journal.

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F-FDG PET/CT uptake before treatment, as determined by SUV, may be a valuable tool to evaluate prognosis in NPC patients.

Cranial radiotherapy (RT) is an irradiated way to treat patients with brain malignancies. Seizure is the most common symptom. Due to the frequency of seizure risk, cranial RT is usually received concomitant with previously initiated antiepileptic drugs (AED). This combination can lead to erythema multiforme (EM) like serious skin reactions starting from the irradiated port site and spreading to whole cutaneous surfaces and mucosal membranes. This clinical entity is named after as an acronym of components which are Erythema Multiforme associated with Phenytoin And Cranial RadiationTherapy as EMPACT syndrome. Most cases of EMPACT syndrome are reported with phenytoin in the literature, but there are no reported cases with levetiracetam to the best of our knowledge in the literature. Here, we report a 62-year-old male with glioblastoma, presented with severe conjunctivitis, extensive bleeding erosions in his oral mucosa and erythematous macular eruptions on the right temporoparietal port region of the scalp, and EM-like generalized lesions involved neck, chest, back, and arms following the end of his cranial RT. He was diagnosed with EMPACT syndrome, related to using levetiracetam concomitant with cranial RT. Early diagnosis is crucial for the complete response of treatment. Physicians should be alert to possible skin and mucosal reactions of patients under levetiracetam treatment, especially co-existing use of cranial RT.

Background/aim: This study aimed to describe the prognostic importance of epidermal growth factor (EGFR), phosphatase and tensin homolog (PTEN), human EGF receptor-2 (HER-2), and insulin-like growth factor 1 receptor (IGF-1R) in gastric cancer patients treated with postoperative chemoradiation therapy. Materials and methods:Sixty-nine patients treated with adjuvant chemoradiation therapy were retrospectively evaluated. Tumor samples were stained immunohistochemically.Results: All patients were treated with 3D conformal radiation therapy with concomitant and adjuvant chemotherapy. Perineural invasion (PNI) (P = 0.042), prechemoradiation therapy albumin levels below 3.5 mg/dL (P = 0.011), and EGFR positivity (P = 0.008) had negative effects on overall survival (OS). The median OS was 26 months for patients with PNI (+), 34.9 months for those with PNI (-), 19.5 months for those with albumin levels below 3.5 mg/dL, and 33.2 months for those with albumin levels above 3.5 mg/dL. IGF-1R (+) (P = 0.035) and history of cigarette smoking (P = 0.033) were observed to have a statistically significantly negative effect on disease-free survival (DFS). The median DFS was 29.2 months for IGF-1R (+) patients, 37.9 months for those with IGF-1R (-), and 26.3 and 40.59 months for smokers and nonsmokers, respectively. Conclusion:IGF-1R and EGFR may be used for patient selection in future prospective studies that evaluate the prognostic importance of these receptors.