Year-end Sale % OFF 
Abstract
To report epidemiologic and anatomoclinical transitions of inflammatory breast cancer (IBC) in Tunisia. Data including clinico-pathological data for208 cases of T4d or PEV 3 non-metastatic breast cancer diagnosed between 2005 and 2010 were collected from patient records. Chi2 and Z tests were used to compare variables with two Tunisian historical series and a series about Arab-American patients. Thirty three percent of our patients had their first child before 23 years of age and 56% had their menarche before 12 years, 75% never receiving oral contraception. Obesity was observed in 42% of women and IBC occurred during pregnancy in 13% of cases. Tumor grade was II-III in 90% of cases, HR was negative in 52%, HER2 was over expressed in 31% and invasion of more than 3 axillary nodes occurred in 18% of patients. We observed a pCR rate of 19% after neoadjuvant treatment (anthracyline-taxane used in 79%, trastuzumab in 27% ). Compared to historical Tunisian series (since 1996), IBC epidemiology remained stable in terms of median age, menopausal status and obesity. However we observed a significant decrease in median clinical tumor size and number of positive axillary lymph nodes. Comparison to IBC in Arab-Americans showed a significant difference in terms of median age, menopausal status, positivity of hormonal receptors and educational level. Our assessment of epidemiologic transition showed a reduction of clinco-pathological stage of IBC, keeping the same characteristics as compared to Tunisian historical series over a period of 14 years. Features seem to be different in Arab-American patients, probably related to migration, "occidentalization" of life style and improvement in socio-economic level.
Highlights
Inflammatory breast cancer (IBC) is a particular entity within Breast Cancers (BC), characterized by highly aggressive clinical and evolutionary patterns and high incidence in emerging countries (North Africa, Egypt) (Levine and Veneroso, 2008)
The incidence of inflammatory breast cancer (IBC) is high in Arab countries (Tunisia 5%, Morocco 11%, Egypt 6%) and it was found higher in Arab-American (OR=1.5, 95%, CI=1.2, 1.9) compared to other American ethnicities (Hispanics, Indians, Alaskans) in the SEER series (Chouchane et al, 2013; Corbex et al, 2014)
Schilichting et al demonstrated that living in a high poverty country, low educational level and low socio-economic level (SEL) is significantly associated with IBC (Schlichting et al, 2012)
Summary
Inflammatory breast cancer (IBC) is a particular entity within Breast Cancers (BC), characterized by highly aggressive clinical and evolutionary patterns and high incidence in emerging countries (North Africa, Egypt) (Levine and Veneroso, 2008). Therapeutic interest to IBC is mainly explained by the young mean age of patients, the high rate of chemo-resistance and the frequency of distant failures (Dawood et al, 2014). Interest to IBC was marked by several publications devoted to epidemiology, histopathology and molecular biology leading to individualization of new molecular targets and therapeutic perspectives. First epidemiologic IBC studies arose from Tunisian American and European teams within an international multicentric collaboration in the seventies. Those studies have been greatly hampered by use of inconsistent diagnostic criteria.
Sign-in/Register to view highlights & summary 
Published Version (
Free)
Talk to us
Join us for a 30 min session where you can share your feedback and ask us any queries you have
Schedule a callDisclaimer: All third-party content on this website/platform is and will remain the property of their respective owners and is provided on "as is" basis without any warranties, express or implied. Use of third-party content does not indicate any affiliation, sponsorship with or endorsement by them. Any references to third-party content is to identify the corresponding services and shall be considered fair use under The CopyrightLaw.
