SUMMARY OBJECTIVE: Perineural invasion is a well-established adverse prognostic factor in several malignancies, yet its prognostic role in breast cancer remains controversial. METHODS: We retrospectively analyzed 400 breast cancer patients treated with neoadjuvant chemotherapy between 2012 and 2025 who had residual disease (non-pCR) at surgery. Clinicopathological variables, recurrence-free survival, and overall survival were evaluated using Cox proportional hazards models. RESULTS: Perineural invasion was identified in 42.5% of the cohort and associated with larger tumor burden, lymphovascular invasion, and nodal metastasis (p<0.01). Perineural invasion-positive status correlated with significantly inferior median recurrence-free survival (100.5 vs. 120.4 months; HR 1.77, p=0.008) and overall survival (108.5 vs. 133.6 months; HR 3.11, p<0.001). Multivariate analysis confirmed perineural invasion as a robust independent predictor of shorter recurrence-free survival and overall survival. The adverse impact was evident across all molecular subtypes, particularly HR+/HER2- and HER2+ groups. CONCLUSION: Perineural invasion is a strong independent prognostic factor for recurrence-free survival and overall survival in breast cancer patients with residual disease after neoadjuvant chemotherapy. Reporting perineural invasion status in routine pathology evaluations may aid in risk stratification for this high-risk population.

Spirulina, Arthrospira platensis ve Arthrospira maxima içeren iki siyanobakter türünü tanımlamak için verilen ticari bir isimdir. Dünya çapında en çok yetiştirilen alg türüdür. Günümüzde üretilen Spirulina biyokütlesinin çoğu, "süper gıda" olarak tanıtılan ve kurutulmuş toz, pul veya kapsül olarak satılan bir besin takviyesi olarak tüketilmektedir. Spirulina'nın Uluslararası Uygulamalı Mikrobiyoloji Derneği tarafından gıda kaynağı olarak tanınması 1967 yılından sonra gerçekleşmiştir. Spirulina proteinler, lipidler,vitaminler ve mineraller açısıdan zengindir. Özellikle fikosiyanin meme kanserinde, akciğer kanserinde ve hepatosellüler kanserde in vitro ve in vivo olarak anti-kanser etkisi gösterdiği tespit edilmiştir. Tıbbi onkoloji alanında spirulina faydalı olabileceği gösteren fare çalışmaları mevcuttur. Belirgin yan etkileri saptanmamıştır. Ancak etkilerinin daha iyi aydınlatılabilmesi için geniş kapsamlı daha çok çalışmaya ihtiyaç vardır. Spirulina is a trade name given to describe two species of cyanobacteria, Arthrospira platensis and Arthrospira maxima. It is the most widely cultivated algae species worldwide. Most of the Spirulina biomass produced today is consumed as a dietary supplement, promoted as a "superfood" and sold as dried powder, flakes or capsules. It was not until 1967 that Spirulina was recognized as a food source by the International Society for Applied Microbiology. Spirulina is rich in proteins, lipids, vitamins and minerals. In particular, phycocyanin has been found to have anti-cancer effects in vitro and in vivo in breast cancer, lung cancer and hepatocellular cancer. There are mouse studies showing that spirulina may be useful in medical oncology. No significant side effects have been detected. However, more extensive studies are needed to better elucidate its effects.

Aim: Muscle-invasive bladder cancer requires systemic treatment due to its high risk of metastasis. However, studies comparing neoadjuvant and adjuvant therapy regimens are currently limited. Our goal in this study was to compare the treatment efficacy of patients receiving neoadjuvant or adjuvant treatment in locally advanced bladder cancer. Material and Methods: We retrospectively included 107 bladder cancer patients from 6 centres who underwent radical cystectomy and received perioperative chemotherapy. Patients were divided into 2 categories: (i) neoadjuvant chemotherapy (n=54) and (ii) adjuvant chemotherapy (n=53). Results: Median follow-up was 31.6 months (95%CI 21.8-41.4). 30-month disease-free survival (DFS) was 58.9% in the whole group, 56.3% in neoadjuvant and 61.5% in adjuvant. 30-month DFS after neoadjuvant treatment was 70.1% in

Meme kanseri, kadınlarda tüm dünyada olduğu gibi ülkemizde de en sık görülen kanser türüdür. Ülkemizde tanı konulan her 4 kadın kanserinden 1’i meme kanseridir. Ülkemizde meme kanseri evreleri incelendiğinde, vakaların %48,2’sinin lokal evrede tanı aldığı görülmektedir. İnvaziv meme kanseri, Luminal A, Luminal B, HER-2 pozitif ve triple negatif meme kanseri olarak temel 4 moleküler sınıflama altında incelenir. Erken evre meme kanseri ve lokal ileri kanser hastaları, neoadjuvan kemoterapi ve cerrahi açısından multidisipliner olarak değerlendirilmelidir. Hastalar, cerrahi sonrasında patolojik yanıt durumuna göre medikal tedavileri düzenlenmelidir. Hastalara, primer tedaviden sonraki ilk 3 yıl boyunca her 3 ile 6 ayda bir, 4. ve 5. yıllarda her 6 ile 12 ayda bir ve daha sonra yılda bir mutlaka fizik muayene yapılmalıdır. Tedavi sonrası ilk mamografi, tanıya yol açan ilk mamografiden 1 yıl sonra, ancak kesin radyasyon tedavisinden en erken 6 ay sonra çekilmelidir. Tüm kadınlar için düzenli jinekolojik takip önerilir; tamoksifen alan hastalara herhangi bir vajinal kanamayı bildirmeleri tavsiye edilmelidir. Hastalarda takipte, tümör markerları, PET-CT veya meme MR görüntülemesi, hemogram veya karaciğer fonksiyon testlerine bakılması önerilmemektedir. Breast cancer is the most common type of cancer in women in our country as in the whole world. In our country, 1 out of every 4 female cancers diagnosed is breast cancer. When the stages of breast cancer are analysed in our country, it is seen that 48.2% of the cases are diagnosed at the local stage. Invasive breast cancer is analysed under 4 molecular classifications as Luminal A, Luminal B, HER-2 positive and triple negative breast cancer. Early stage breast cancer and locally advanced cancer patients should be evaluated multidisciplinarily for neoadjuvant chemotherapy and surgery. After surgery, medical treatment should be arranged according to the pathological response status. Patients should undergo physical examination every 3 to 6 months for the first 3 years after primary treatment, every 6 to 12 months in the 4th and 5th years, and annually thereafter. The first post-treatment mammogram should be performed 1 year after the first mammogram that led to the diagnosis, but no earlier than 6 months after definitive radiation therapy. Regular gynaecological follow-up is recommended for all women; patients receiving tamoxifen should be advised to report any vaginal bleeding. Tumour markers, PET-CT or breast MRI, haemogram or liver function tests are not recommended at follow-up.

Aim: To assess the impact of surgical approach on recurrence and survival in breast cancer patients with recurrence post-neoadjuvant chemotherapy (NACT). Materials and Methods: A retrospective analysis included 108 female patients (≥18 years) who completed NACT (2010–2024) and developed recurrence. Patients underwent breast-conserving surgery (BCS) or mastectomy (MX), with sentinel lymph node biopsy (SLNB) or axillary lymph node dissection (ALND). Recurrence-free survival (RFS), overall survival (OS), and associated factors were evaluated. Results: Among 108 patients (68 BCS, 40 MX, 18 SLNB, 90 ALND), the median RFS was 23.67 months (BCS: 24.53 vs. MX: 18.97; p=0.65; SLNB: 25.87 vs. ALND: 22.30; p=0.65). Five‑year RFS rates were 1% and 10% in the two groups, respectively. The median OS was 55.57 months (BCS: 56.07 vs. MX: 50.43; p=0.607; SLNB: 75.90 vs. ALND: 48.70; p=0.019). Molecular subtype (HR=2.12, p<0.001) and axillary surgery type (HR=4.41, p=0.005) were independent predictors of OS. The mean follow‑up duration was 59.96 ± 3.62 months. Conclusion: BCS and MX provide comparable RFS and OS in patients with recurrence after NACT. SLNB is associated with significantly improved OS compared with ALND, underscoring the importance of tailoring axillary management to tumor biology and patient-specific factors.