Breast Cancer in Iraqi Female Patients - A Clinicopathological and Immunological Study

Breast cancer is the most common malignant tumor in women worldwide, including our country. It has been claimed that there is the propensity for the disease to affect younger women in developing countries.

The most important negative regularity of cell cycle progression is the tumor suppressor gene TP53, which has been recorded to be altered in 20-40% of human cancer.     
                                          
AIM OF THE STUDY
  1. To assess the demographic characteristic and clinic-pathological presentation of breast cancer in Iraq in two groups (premenopausal versus postmenopausal women).
  2. To assess the frequency of P53 tumor suppressor gene expression immunohistochemically in the randomly selected group of these patients, and correlate that with the age of patients at diagnosis and with tumor stage and grade.
PATIENT AND METHODS
The study comprised 414 patients who presented with a palpable breast lump at the main referral and training center for early detection of breast tumor at Baghdad medical city teaching hospital. These cases were randomly selected from the total population visiting the center during a seven years period (2001 till 2007). All the patients were diagnosed by cytological examination of Fine Needle Aspiration of breast lump proved to be malignant.

The study population was divided into two groups: premenopausal versus postmenopausal depending on last menopausal period and considered the cut off age of 50 years old.

The main parameters included in the comparative study: *the family history of breast cancer,*history of previous abortion,* age at first delivery, *age at onset of menarche, *educational status, *obstetrical history include the number of live birth and *history of breastfeeding.

RESULTS
The highest incidence, of breast cancer, occurred in the fifth decade, 11% of the patients had a family history of the disease, of which 7.4% were first degree relative, 28% of the total had abortion more than once and 16% had abortion only once, there is significant association with the educational status (higher number of postmenopausal women were illiterate compared to the premenopausal group, only 16%of the patients had their menarche before the age of 12 years while 30%of those had their first delivery between (14-19) years.

The P53 gene protein expression found in 29% of the study patients with the higher score in pre-menopausal patients, and those with higher tumor grade and advanced stage.
The frequency of P53 score and nuclear staining were directly related to the grade of the tumor is higher in poorly differentiated carcinoma.

CONCLUSIONS
No remarkable differences noted in the demographic characteristics of breast cancer in Iraq apart from educational status, never the less high score of P53 was demonstrated in premenopausal patients; both nuclear expression and intensity correlating directly with advanced tumor grade   
For more information regarding innovations and advances attend International Conference on Pathology and Surgical Pathology scheduled in September from 06-08, 2018 at Edinburgh, Scotland.

Authors: Dr. Ahmed Ameen: Supervised by Dr. Nada Alwan, Baghdad University

International Conference on Pathology and Surgical Pathology Sept 06-08, 2018 | Edinburgh, ScotlandTo know more visit:  https://goo.gl/F5YC86
   

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