Five year survival of women with breast cancer in Yazd

Survival and predictors of breast cancer mortality in South Ethiopia: A retrospective cohort study

BACKGROUND

Breast cancer is the most frequently diagnosed cancer and the leading cause of cancer death in over 100 countries. In March 2021, the World Health Organization called on the global community to decrease mortality by 2.5% per year. Despite the high burden of the disease, the survival status and the predictors for mortality are not yet fully determined in many countries in Sub-Saharan Africa, including Ethiopia. Here, we report the survival status and predictors of mortality among breast cancer patients in South Ethiopia as crucial baseline data to be used for the design and monitoring of interventions to improve early detection, diagnosis, and treatment capacity.

METHODS

A hospital-based retrospective cohort study was conducted among 302 female breast cancer patients diagnosed from 2013 to 2018 by reviewing their medical records and telephone interviews. The median survival time was estimated using the Kaplan-Meier survival analysis method. A log-rank test was used to compare the observed differences in survival time among different groups. The Cox proportional hazards regression model was used to identify predictors of mortality. Results are presented using the crude and adjusted as hazard ratios along with their corresponding 95% confidence intervals. Sensitivity analysis was performed with the assumption that loss to follow-up patients might die 3 months after the last hospital visit.

RESULTS

The study participants were followed for a total of 4,685.62 person-months. The median survival time was 50.81 months, which declined to 30.57 months in the worst-case analysis. About 83.4% of patients had advanced-stage disease at presentation. The overall survival probability of patients at two and three years was 73.2% and 63.0% respectively. Independent predictors of mortality were: patients residing in rural areas (adjusted hazard ratio = 2.71, 95% CI: 1.44, 5.09), travel time to a health facility ≥7 hours (adjusted hazard ratio = 3.42, 95% CI: 1.05, 11.10), those who presented within 7-23 months after the onset of symptoms (adjusted hazard ratio = 2.63, 95% CI: 1.22, 5.64), those who presented more than 23 months after the onset of symptoms (adjusted hazard ratio = 2.37, 95% CI: 1.00, 5.59), advanced stage at presentation (adjusted hazard ratio = 3.01, 95% CI: 1.05, 8.59), and patients who never received chemotherapy (adjusted hazard ratio = 6.69, 95% CI: 2.20, 20.30).

CONCLUSION

Beyond three years after diagnosis, patients from southern Ethiopia had a survival rate of less than 60% despite treatment at a tertiary health facility. It is imperative to improve the early detection, diagnosis, and treatment capacities for breast cancer patients to prevent premature death in these women.

Prognostic factors for cancer-specific survival in 220 patients with breast cancer: A single center experience

OBJECTIVES

Hospital-based breast cancer survival studies are scarce in western Iran. Furthermore, the relationship between breast cancer survival and clinical parameters has been extensively studied, but many of the findings come from developing countries. This paper aims to estimate the survival of hospital-based breast cancer patients and its predictor factors.

METHOD

This retrospective analysis was conducted on 578 patients with primary breast cancer who underwent surgery between 2004 and 2020. Information was collected from medical reports by the Hospital information system in Imam Reza Hospital, Kermanshah, Iran. One-, 2-, 5-, and 10-year breast cancer-specific survival has been calculated using the Kaplan-Meier process. Crude and adjusted Hazard Ratios (HR) were calculated using the Cox proportional regression model.

RESULT

One-, 2-, and 5-year overall breast cancer survival were 219 (99.54%), 196 (89.09%), 159 (72.27%), and 70 (31.81%), respectively. Univariate analysis of breast cancer patients with tumor-related variables revealed that factors such as age, menopause status, lymph node metastasis, number of lymph nodes, organ metastasis, and stage of disease were significantly associated with disease-specific survival (p < .05). Multivariate analysis demonstrated that metastasis (HR = 41.77, 95% CI: 15.3-114.15) and lymph node metastasis (HR = 5.26, 95% CI: 1.9-14.6) were significantly related to survival.

CONCLUSION

The findings demonstrate that survival is relatively low and is consistent with late-stage disease diagnosis. It is believed that this is due to a poor level of awareness, lack of screening programs, and subsequent late access to treatment.

Changes and challenges in sexual life experienced by the husbands of women with breast cancer: a qualitative study

BACKGROUND

Breast cancer (BC) in women can bring various problems to their marital and family life. Sexual life based on the experiences of the husbands of women diagnosed with BC has not been fully understood. Therefore, this research aimed to explore changes and challenges in sexual life experienced by the husbands of women diagnosed with BC.

METHODS

A qualitative research was carried out on 18 men whose wives had been diagnosed with BC at reproductive age. They were selected using purposeful sampling and were interviewed using in-depth semi-structured interviews. Collected data were analyzed using the conventional content analysis method.

RESULTS

'Sexual life suspension' was the main theme of this research. Also, 'unfulfilled sexual expectations', 'perceived barriers to satisfy sexual expectations', and 'efforts to adapt to sexual problems' were subthemes.

CONCLUSIONS

The husbands of women with BC need support to improve their sexual and marital relationships. Education and counseling about sexual life during the treatment of BC should be incorporated into the healthcare program.

Determination of the Risk Factors for Breast Cancer Survival using the Bayesian Method, Yazd, Iran

Background:

There are numerous sophisticated studies which have investigated risk factors of breast cancer (BC). The purpose of this paper is to use benefits of Bayesian modeling to involve such prior information in determining factors affecting the survival of women with BC in Yazd city.

Materials and Methods:

The checklist included the characteristics of the patients and the factors studied. Then, from the records of patients referred to Radiotherapy Center of Shahid Ramezanzadeh, who had BC, from April 2005 to March 2012, the survival of 538 persons was recorded in the census. Data were analyzed by R software version 3.4.2, and 0.05 was considered the significance level.

Results:

The mean age of BC diagnosis was 48.03 ± 11016 years. The Bayesian Cox regression showed that surgery (hazard ratio [HR] =1.631 95% PI; 1.102–2.422), ki67 (HR = 3.260. 95% PI; 1.6308–6.372), stage (HR = 5.620, 95% PI; 4.079–7.731), lymph node (HR = 1.765, 95% PI; 1.127–2.790), and ER (HR = 2. 600 95% PI; 2.023–3.354) were significantly related to survival time.

Conclusion:

The parametric and cox models were compared with standard error, and Cox model was selected as an optimal model. Accordingly, stage, ki67, lymph node, ER, and surgery variables had a positive effect on death hazard.

Epidemiology and trends of gastrointestinal cancer in Iran (2004-2008)

Aim

Gastrointestinal (GI) cancer is among the most common cancers in Iran. The main purpose of this study was to evaluate changes in the time trends of stomach, colon and rectum, and esophageal cancer during the past decade in Iran.

Materials and Methods

In this cross-sectional study, the study population was all cases of GI cancers diagnosed in Iran between 2004 and 2008. Cancer incidence data for the years 2004-2008 were obtained from the cancer registry system of the Ministry of Health. All incidence rates were directly age standardized to the world standard population. Age-Satndardized incidence rate (ASR)per 10⁵ persons was calculated using direct standardization and the world standard population. The crude rate was calculated in this study. Data were analyzed using SPSS (version 17) and Microsoft Office Excel 2007.

Results

During the 2004-2008 period, the ASR and crude rates of GI cancers, including esophagus, stomach, colon and rectum, among males were 5.05, 15.02, and 8.29 and 4.01, 11.81, and 6.4, respectively, and among females were 6.52, 7.055, and 7.75 and 4.40, 4.85, and 5.49, respectively. The most common cancers in women were colon and rectum, and stomach cancer had the highest incidence in males. In this study, most cases of stomach cancer were adenocarcinoma adenocarcinoma (Nos) in both women and men. The most common type of colorectal cancer was adenocarcinoma, which was greater in men than women. The most common type of esophageal cancer was squamous cell carcinoma in both sexes. The north and northwestern regions of Iran have the highest risk of GI cancer.

Conclusion

According to this study, a significant increase was observed in the incidence of cancers in the north and western regions of Iran. Hence, screening and early detection programs are highly recommended in these high-risk areas.

Application of additive hazards models for analyzing survival of breast cancer patients

BACKGROUND

Survival rates for breast cancer (BC) are often based on the outcomes of this disease. The aim of this study was to compare the performance of three survival models, namely Cox regression, Aalen's, and Lin and Ying's additive hazards (AH) models for identifying the prognostic factors regarding the survival time of BC patients.

MATERIALS AND METHODS

This study was a historical cohort study which used 1025 females' medical records that underwent modified radical mastectomy or breast saving. These patients were admitted to Besat and Chamran Hospitals, Tehran, Iran, during 2010-2015 and followed until 2017. The Aalen's and Lin and Ying's AH models and also traditional Cox model were applied for analysis of time to death of BC patients using R 3.5.1 software.

RESULTS

In Aalen's and also Lin and Ying's AH models, age at diagnosis, history of disease, number of lymph nodes, metastasis, hormonal therapy, and evacuation lymph nodes were prognostic factors for the survival of BC patients (P < 0.05). In addition, in the Lin and Ying's AH model tumor size (P = 0.048) was also identified as a significant factor. According to Aalen's plot, metastasis, age at diagnosis, and number of lymph nodes had a time-varying effect on survival time. These variables had a different slope as the times go on.

CONCLUSION

AH model may yield new insights in prognostic studies of survival time of patients with BC over time. Because of the positive slope of estimated cumulative regression function in Aalen's plot, metastasis, higher age at diagnosis, and high number of lymph nodes are important factors in reducing the survival BC, and then based on these factors, the therapists should consider a special therapeutic protocol for BC patients.

A Conditional Probability Model to Predict the Mortality in Patients With Breast Cancer: A Bayesian Network Analysis

BACKGROUND

The aim of this study was to compute the event rate of patients with breast cancer (BC) using Bayesian network (BN) structure.

METHOD

Data for 1,154 patients newly diagnosed with BC were recruited in this study during 2007 and 2016 in Iran. The database was linked to the regional death registration system and active follow-up was performed by referring to hospital information system or calling the patients. BN structure with inverse probability of censoring weighting (IPCW) approach was used to assess the relationship between event rate and underlying risk factors.

RESULTS

The median (25th, 75th percentiles) of patients' survival time was 46.8 (32.6, 69.3) months. There were 217 (18.8%) deaths from BC by the end of the study. The optimal BN structure (Akaike Information Criteria = -8743.66 and Bayesian Information Criteria = -8790.80) indicated that being male (conditional probability [CP] = 0.316), age >50 (CP = 0.215), higher grades (CP = 0.301) and lower survival times (CP = 0.566) had higher event rate. Also lobular carcinoma (CP = 0.157) and ductal carcinoma (CP = 0.178) type of morphology had lower event rate while other types (CP = 0.316) had higher.

CONCLUSIONS

The BN structure in which time was as a mediator of predictors-event relationship could be presented as the optimal tool to compute the event rate of BC. The findings could be used to identify the high risk patients and recommend for health policy making, prevention and planning for decrease the mortality in patients with BC.

Parametric survival model to identify the predictors of breast cancer mortality: An accelerated failure time approach

Background:

Breast cancer (BC) was the fifth cause of mortality worldwide in 2015 and second cause of mortality in Iran in 2012. This study aimed to explore factors associated with survival of patients with BC using parametric survival models.

Materials and Methods:

Data of 1154 patients that diagnosed with BC recorded in the East Azerbaijan population-based cancer registry database between March 2007 and March 2016. The parametric survival model with an accelerated failure time (AFT) approach was used to assess the association between sex, age, grade, and morphology with time to death.

Results:

A total of 217 (18.8%) individuals experienced death due to BC by the end of the study. Among the fitted parametric survival models including exponential, Weibull, log logistic, and log-normal models, the log-normal model was the best model with the Akaike information criterion = 1441.47 and Bayesian information criterion = 1486.93 where patients with higher ages (time ratio [TR] =0.693; 95% confidence interval [CI] = [0.531, 0.904]) and higher grades (TR = 0.350; 95% CI = [0.201, 0.608]) had significantly lower survival while the lobular carcinoma type of morphology (TR = 1.975; 95% CI = [1.049, 3.720]) had significantly higher survival.

Conclusion:

Log-normal model showed to be an optimal tool to model the survival of patients with BC in the current study. Age, grade, and morphology showed significant association with time to death in patients with BC using AFT model. This finding could be recommended for planning and health policymaking in patients with BC. However, the impact of the models used for analysis on the significance and magnitude of estimated effects should be acknowledged.

Breast Cancer Survival and Incidence: 10 Years Cancer Registry Data in the Northwest, Iran

Methods

Data were obtained from East Azerbaijan cancer registry database for the 10-year period between 2007 and 2016. Survival analysis was performed to calculate the breast cancer-specific survival proportions and mortality rates. Joinpoint trend analysis was performed to estimate the incidence trend of the cancer.

Results

A total number of 4989 patients were recorded with primary diagnosis of breast cancer. Of them, we collected follow-up data for 1335 (1309 female and 26 male). The 10-year crude mortality rate was 3.34 (per 100,000). The one-, two-, three-, five-, and ten-year breast cancer-specific survival proportions were 0.92 (95% CI 0.91-0.93), 0.88 (95% CI 0.86-0.90), 0.84 (95% CI 0.83-0.86), 0.77 (95% CI 0.74-0.80), and 0.65 (95% CI 0.60-0.70), respectively. Over the study period, the age-standardized incidence rates increased from 21.68 to 36.99 (per 100,000) with an annual percentage change of 5.5 percent. Older individuals and males patients had significantly worse survival, and patients with high-grade tumors had significantly higher risk of mortality.

Conclusion

A relatively better survival for breast cancer in East Azerbaijan, Iran, was observed compared to the overall breast cancer-specific survival proportions and mortality rates in the country. However, it is still poor compared to the developed countries indicating that inappropriate treatment modalities might have played a role on this.

System Delay in Breast Cancer Diagnosis in Gaza Strip, Palestine

Background

Breast cancer is a major public health problem and the first leading cause of cancer deaths among females in Palestine. Early diagnosis of breast cancer contributes to reduction of morbidity and mortality rates. This study aimed to explore system-related factors affecting the timely diagnosis of breast cancer in the Gaza Strip.

Method and Materials

A mixed method, sequential explanatory design was employed. A quantitative study was conducted first, and it was cross-sectional in nature, followed by a qualitative study. An interviewed questionnaire and an abstraction sheet were used to collect necessary quantitative data among 122 females diagnosed with breast cancer. A purposive sample of five medical specialists were selected for in-depth interview. Descriptive and inferential analyses were used to find differences between variables. Odds ratio and confidence interval at 95% were presented, and P < 0.05 was considered statistically significant.

Results

Around 12.3% of women experienced diagnostic delay for 3 months and more, and 6.6% reported a delay in referral for more than 2 weeks. Regarding imaging delay, around 8.2% and 2.7% of women had reported a delay in performing mammography and ultrasound, respectively. Moreover, one-fourth reported delay in performing biopsy for more than 14 days, and 46.3% reported delay more than 14 days in getting histopathology report. In addition, 9% missed the follow-up after benign findings of the previous breast imaging and no national protocols are available for the diagnosis of breast cancer in the Gaza strip.

Conclusion

There is a long appointment time for diagnostic tools especially in biopsy. The nonmalignant findings from mammography or ultrasound could affect diagnosis time. It is an urgent need to have a national protocol for diagnosis and management of breast cancer and to adopt screening, diagnostic, and follow-up programs under the supervision of the Ministry of Health.

The Global and Regional Survival Rate of Women With Breast Cancer: A Systematic Review and Meta-analysis

Breast cancer is the most common cancer among women in the world. The aim of this study was to measure the global and regional survival rates of women with breast cancer. We searched Medline/PubMed, Web of Science, Scopus, and Google Scholar to identify cohort studies on the survival rate of women with primary invasive breast cancer until the end of June 2017. We used random effect models to estimate the pooled 1-, 3-, 5-, and 10-year survival rates. Subgroup analysis and meta-regression models were used to investigate the potential sources of heterogeneity. One hundred twenty-six studies were included in the meta-analysis. Between-study heterogeneities in the 1-, 3-, 5-, and 10-year survival rates were significantly high (all I²s > 50%; P = .001). The global 1-, 3-, 5-, and 10-year pooled survival rates in women with breast cancer were 0.92 (95% confidence interval [CI], 0.90-0.94), 0.75 (95% CI, 0.71-0.79), 0.73 (95% CI, 0.71-0.75), and 0.61% (95% CI, 0.54-0.67), respectively. Subgroup analysis revealed that survival rates varied in different World Health Organization regions, age and stage at diagnosis, year of the studies, and degree of development of countries. Meta-regression indicated that year of the study (β = 0.07; P = .002) and development of country (β = -0.1; P = .0001) were potential sources of heterogeneity. The survival rate was improved in recent decades; however, it is lower in developing regions than developed ones.

Conflicts women with breast cancer face with: A qualitative study

Background and Aim:

The prevalence of cancer in women under 50 years of age has been increased in recent years. Cancer treatment methods can lead to infertility in women with cancer. Fertility and childbearing, as the most important conflicts in the life of women with breast cancer, significantly affect their quality of life.

Materials and Methods:

This research is a qualitative study of content analysis type. Purposeful sampling and semi-structured individual interviews were performed for data collection. The participants were women with breast cancer referred to the Breast Disease Research Center of Shahid Motahari Clinic in Shiraz. The data were saturated after 15 interviews. To assess the validity and reliability, we used the four criteria provided by Lincoln and Guba. The conventional qualitative data analysis and MAXQDA10 software were used to analyze the qualitative data.

Results:

Explaining the conflicts which women with breast cancer are faced has led to the extraction of four main categories: (1) paradox of decision-making to childbearing, (2) fear, (3) sinister emotions, and (4) challenges. The results showed that the paradox of decision-making on childbearing is the most important challenge with which the patients with breast cancer are faced, causing a state of fear, anxiety, and the emergence of sinister emotions in them.

Conclusion:

It seems that paying more attention to preserving reproductive capacity before starting the treatment plays an important role in solving the biggest conflict in the life of breast cancer patients.

Relationship of Social Determinants of Health with the Three-year Survival Rate of Breast Cancer

Background: Social determinants of health are among the key factors affecting the pathogenesis of diseases. Considering the increasingly high prevalence of breast cancer and the association of social determinants of health with its occurrence, related morbidity and mortality and survival rate, this study sought to assess the relationship of three-year survival rate of breast cancer with social determinants of health. Materials and Methods: This cohort study was conducted on males and females presenting to the Cancer Research Center of Shohada-E-Tajrish Hospital from 2006 to 2010 with definite diagnosis of breast cancer. Data were collected via phone interviews. Kaplan-Meier and Cox regression was fitted using SPSS (version 18) and PH assumption was tested by STATA (version 11) software. Results: The study was performed on 797 breast cancer patients, aged 25-93 years with mean age of 54.66 (SD=11.86) years. After 3 years from diagnosing cancer 700 (87.8%) patients were alive and 97 (12.2%) patients were dead. Using log rank test, there was relationship between 3-year survivals with age, education, childhood residence, sibling, treatment type, and district were significant (p<0.05). Using Cox PH regression, 3-year survival was related to age, level of education, municipal district of residence and childhood condition (p<0.05). Conclusion: Social determinants of health such as childhood condition, city region residency, level of education and age affect the three-year survival rate of breast cancer. Future studies must focus on the effect of childhood social class on the survival rates of cancers, which have been paid less attention to.

Survival Rates for Breast Cancer in Iranian Patients: a Meta- Analysis

BACKGROUND

Breast cancer is the most common cancer among Iranian women. Since development of the disease in Iranian women occurs relatively early, the survival rate matters considerably. In different countries, survival of breast cancer patients varies considerably. Therefore, the one-year, three-year, five-year, and ten- year survival rates for breast cancer in Iran were assessed using a meta-analysis.

MATERIALS AND METHODS

This systematic review and meta-analysis was based on valid Iranian sources including SID, MAGIRAN and IRANMEDEX, along with reliable English databases, namely, PUBMED and SCOPUS. In domestic databases, a search was conducted based on key words of breast cancer and survival rate, and in international databases, with "breast cancer" and the equivalent of "neoplasm" of Mesh Word, "survival rate" and "Iran. " Then all reviewed papers and theses which met the inclusion criteria were selected for investigation. To conduct the analysis STATA 11.2 software and random-effects models were used.

RESULTS

In 24 studies, 22,745 participants were included. The one-year, three-year, five-year and ten-year survival rates were 0.956, 0.808, 0.695 and 0.559, respectively. The minimum and maximum survival rates for 5-years were 0.48 and 0.87. The average age of the onset of the disease was 48.3.

CONCLUSIONS

As in Iran, since the onset of the disease is at low age, in spite of the relatively high survival rate as compared to other cancers, prevention and screening programs at early age for early stage diagnosis seems necessary.

The overall 5-year survival rate of breast cancer among Iranian women: A systematic review and meta-analysis of published studies

INTRODUCTION

Breast Cancer (BC) is the most prevalent cancer and the second leading cause of cancer-related death among Iranian women. A valid estimation of the 5-year survival rate can improve the current BC treatment programs. The present study aimed to assess the 5-year survival rate through a systematic review of published studies.

METHODS

A systematic search of Medline/PubMed, Scopus, and Science direct as well as Iranian databases was conducted to identify the original articles evaluating the 5-year survival rate of BC among women in Iran. Random effects model was used to estimate the pooled 5-year survival rate. The eligible articles were analyzed using the Stata software.

RESULTS

Our comprehensive literature search identified 11 eligible articles 2 of which were excluded due to reporting the results of a single study. The remaining 9 articles that contained 4815 women diagnosed with BC during 1991-2014 were included in the meta-analysis. The combined 5-year survival rate of BC was estimated to be 67.60%.

DISCUSSION/CONCLUSION

The survival rate of BC was relatively low in Iran compared to developed countries. Hence, more effective measures have to be taken to increase these patients' survival.

Survival Rate of Breast Cancer in Iran: A Meta-Analysis

Background:

There has not been a general estimation about survival rates of breast cancer cases in Iran. Therefore, the present study aimed to assess survival using a meta-analysis.

Materials and Methods:

International credible databases such as Scopus, Web of Science, PubMed, Science direct and Google Scholar and Iranian databases such as Magiran, Irandoc and SID, from 1997 to 2015 were searched. All articles covering survival rate of breast cancer were entered into the study without any limits. Quality assessment of the articles and data extraction were performed by two researchers using the modified STROBE checklist, which includes 12 questions. Articles with scores greater than 8 were included in the analysis. A limitation of this meta-analysis was different methods for presenting of results in the papers surveyed.

Results:

A total of 21 articles with a sample of 12,195 people were analyzed. The one-year, three-year, five-year and ten-year survival rates of breast cancer in Iran were estimated to be 95.8% (94.6-97.0), 82.4% (79.0-85.8), 69.5% (64.5-74.5), 58.1% (39.6-76.6), respectively. The most important factors affecting survival of breast cancer were age, number of lymph nodes involved, size of the tumor and the stage of the disease.

Conclusion:

The five- and ten- year survival rates in Iran are lower than in developed countries. Conducting breast cancer screening plan support (including regular clinical examination, mammography), public training and raising awareness should be helpful in facilitating early diagnosis and increasing survival rates for Iranian women.

Advances in Optimal Detection of Cancer by Image Processing; Experience with Lung and Breast Cancers

Clinicians should looking for techniques that helps to early diagnosis of cancer, because early cancer detection is critical to increase survival and cost effectiveness of treatment, and as a result decrease mortality rate. Medical images are the most important tools to provide assistance. However, medical images have some limitations for optimal detection of some neoplasias, originating either from the imaging techniques themselves, or from human visual or intellectual capacity. Image processing techniques are allowing earlier detection of abnormalities and treatment monitoring. Because the time is a very important factor in cancer treatment, especially in cancers such as the lung and breast, imaging techniques are used to accelerate diagnosis more than with other cancers. In this paper, we outline experience in use of image processing techniques for lung and breast cancer diagnosis. Looking at the experience gained will help specialists to choose the appropriate technique for optimization of diagnosis through medical imaging.

Mobile Phone Based System Opportunities to Home-based Managing of Chemotherapy Side Effects

OBJECTIVE

Applying mobile base systems in cancer care especially in chemotherapy management have remarkable growing in recent decades. Because chemotherapy side effects have significant influences on patient's lives, therefore it is necessary to take ways to control them. This research has studied some experiences of using mobile phone based systems to home-based monitor of chemotherapy side effects in cancer.

METHODS

In this literature review study, search was conducted with keywords like cancer, chemotherapy, mobile phone, information technology, side effects and self managing, in Science Direct, Google Scholar and Pub Med databases since 2005.

RESULTS

Today, because of the growing trend of the cancer, we need methods and innovations such as information technology to manage and control it. Mobile phone based systems are the solutions that help to provide quick access to monitor chemotherapy side effects for cancer patients at home. Investigated studies demonstrate that using of mobile phones in chemotherapy management have positive results and led to patients and clinicians satisfactions.

CONCLUSION

This study shows that the mobile phone system for home-based monitoring chemotherapy side effects works well. In result, knowledge of cancer self-management and the rate of patient's effective participation in care process improved.

The spectrum of genetic mutations in breast cancer

Breast cancer is the most common malignancy in women around the world. About one in 12 women in the West develop breast cancer at some point in life. It is estimated that 5%-10% of all breast cancer cases in women are linked to hereditary susceptibility due to mutations in autosomal dominant genes. The two key players associated with high breast cancer risk are mutations in BRCA 1 and BRCA 2. Another highly important mutation can occur in TP53 resulting in a triple negative breast cancer. However, the great majority of breast cancer cases are not related to a mutated gene of high penetrance, but to genes of low penetrance such as CHEK2, CDH1, NBS1, RAD50, BRIP1 and PALB2, which are frequently mutated in the general population. In this review, we discuss the entire spectrum of mutations which are associated with breast cancer.

Demographic survey of four thousand patients with 10 common cancers in North Eastern Iran over the past three decades

BACKGROUND

Cancer is a major cause of mortality in developing countries and correct and valid information about the epidemiology of this disease is the first step in the planning of health care in each region. The aim of this study was to determine the relative frequency, mean age and sex ratio of the most 10 common non-skin cancers in the world and Iran, among patients referred to an oncology clinic.

MATERIALS AND METHODS

This descriptive study was conducted in Mashhad, north east of Iran. The data obtained from the records of patients referred to the private oncology center between the years of 1985-2012." According to the latest report of GLOBOCAN study commonest malignancies included were lung, breast, colorectal, prostate, stomach, liver, cervix, esophageal, bladder cancers and Non-Hodgkin lymphoma.

RESULTS

A total of 4,606 cases were analyzed. The mean age was 55.5±13.8years (male: 59.5±13.9, female: 52.6±12.9). Overall, breast cancer (1,264 cases, relative frequency of 27.4%) was the most prevalent cancer; however the mean ages of diagnosis were not significantly different between 5-year time period divisions (p=0.290). The most common cancer in men was esophageal cancer (26.3%).The lowest mean age was related to women diagnosed with breast cancer (48.5±11.8) and men with non-Hodgkins lymphoma (48.4±17.8). There were statistically significant differences between the mean age of men and women with gastric (p=0.003) and esophageal cancers (p<0.001). Male to female sex ratios in our study for bladder, lung and stomach cancers were 6.57, 2.60 and 2.50 respectively.

CONCLUSIONS

The results showed that breast cancer tends to be found in younger female patients and bladder cancer appears more often in men. Screening in target population in addition to early diagnosis may reduce death and disability.