[Comparison of breast cancers diagnosed in and outside the large scale mammography program of L'Ariana state in Tunisia]

To report the anatomoclinical comparison of BC issued from the large scale mammography program in Ariana state of Tunisia to those of the cases "classically" diagnosed in patients consulting for breast symptoms. This retrospective study was done between April 2004 and June 2007. We have included 58 women issued from the large scale mammographic program of the state of Ariana in Tunisia [Group I] and 100 symptomatic women who came to our patient clinic [Group 2]. We have compared epidemiological characters [age, delay of diagnosis...], tumoral size, histological sue and type, grade, hormonal receptors and therapeutic protocols. In the large scale mammographic program, BC are insitu carcinomas in 11.1% and invasive carcinomas in 88.9% of the cases. The mean age was 48 years old in the group I versus 46 years in group 2. In the first group, the mean clinical and histological tumoral size was 20mm and 22 mm versus 45mm and 36 mm for the group 2. The invasive canalar carcinoma was the most frequent histological type in both groups. The lymph nodes were negative in 58.1% of the cases in group I versus 34% in group 2.80% of the patients in group 2 had mastectomy versus 42.8% in the first one. The mortality was 10% in the screened women versus 6.8% in the other group2. The results of large scale mammographic BC program were favourable for the management of breast cancer in terms of clinical and histological tumoral size, number of positive nodes, number of mastectomies and the survival rates

[Satisfaction inquiry within women involved in the pilot program of large scale mammography in the Ariana state in Tunisia]

Evaluate the degree of satisfaction of women included in the large scale mammography program of breast cancer screening in the state of Ariana in Tunisia. Within the women explored by mammography, we have contaced 112 patients who had a positive screening requiring histological checking. We have established a questionnaire concerning: the invitation, the clinical examination, the result announcement and the therapeutic management. The average age of patients was 49 years. 64% had a primary education level. 80 women or 71.4% were satisfied with the process of screening and the method of announcement. The main cause of dissatisfaction for patients with cancer diagnosis was delay and difficult access to adjuvant treatments. Among patients who had histological diagnosis: 47.3% had a malignant disease [53 cases] against 37.5% of benign [42 cases]. 100% of patients who had a pathological result reassuring are satisfied at the end of the screening program. The psychosocial impact of screening must be considered for the development of new programs. The waiting and announcement of results are essential factors that allow us to judge the success of the project, because of patient satisfaction will depend the quality of monitoring and adherence to screening

[Fetal and maternal prognosis of breech presentation at term]

Introduction: Breech presentation is associated with increased fetal, neonatal and maternal risk. The purpose of this study was to assess the prognosis of this presentation near or at term

Patients and methods: This retrospective study included all deliveries with a breech presentation and a gestational age over 34 weeks in our service between January 2000 and December 2005

Results: 243 deliveries were indexed throughout the study period.141 patients delivered by prelabor planned cesarean section and 47 by cesarean section during labor. 2 cord prolapses were found [0.8%]. 8 babies [3,3%] had a 5 minute Apgar scores < 7 and we observed 5 admissions to the neonatal unit. There were 2 birth trauma and 2 perinatal deaths

Conclusion: Breech delivery is a risk for mother and newborns. Development of measures and standards for obstetric practice would help improve its prognosis