[Conservative treatment of breast cancer - study of 160 cases]

To study the impact of conservative treatment of the breast cancer on overall survival and recurrence free survival and trying to determine the prognostic factors. With a retrospective study over a period of six years [1995 to 2000], about 160 patients diagnosed and treated in Salah Azaiz Institute for early breast cancer. Only 9% of patients had a breast conserving therapy for breast cancer. The mean age was 47 years. The most frequent motive of consultation was breast nodule. The tumour was located in the upper outer quadrant in 43% of the cases. Local excision of the tumour with re excision of the tumour bed associated with lymph node dissection were performed in all patients. Invasive ductal carcinoma was found in 83% of the cases, grade I in 23% of the cases and grade III in 32% of the cases. On the other hand, 35.4% of the removed axillary lymph nodes were involved. Hormone receptors were positive in 61% of the tumours. The follow up of the patients was from 18 to 98 months with a mean period of 55 months. The 5 year overall survival was 92% with recurrence free survival of 94%. The recurrence rate was 3.7% within a period of 5 to 60 months. The 5 year metastases free survival was 82% with metastases rate of 10%. The most frequent localization was the bone [43.5%]. The mean delay of metastases went from 11 to 62 months. The univariate study of prognostic factors showed that histological tumour size had a significant impact on metastases free survival. The invariant study of the prognostic factors on overall survival showed that the tumour size < 3 cm, the absence of the lymph node involvement [P = 0.02], positive hormone receptors [P=0.02] represented good prognostic factors. The rate of conserving therapy remains low in our country, and this is because of the importance of the tumour size at the diagnosis, with survival rate and locoregional recurrence rates similar to the literature data. The augmentation of the number of the patients that can benefit with conserving therapy must imperatively pass through the development and the promotion of early diagnosis and screening by mammography

[Mixed mullerian tumors of uterus - about 25 cases]

The malignant mixed mullerian tumours [MMMT] or carcinosarcoma of the uterus are rare tumours, they represent 1,4% of all uterine neoplasia. They are characterized historically by double components carcinomatous and sarcomatous. We performed a retrospective study about 25 cases of carcinosarcoma of the endometrium, collected in Salah Azaiz Institute over a period of 30 years going from 1970 to 2000. The mean patient age was 60 years, and 68% of patients were menopaused. The metrorrhagia was revealing in 66% of cases. Clinically, an abdominopelvic mass was found in 12% of the cases. The pathological diagnosis was done in 12 endometrial biopsies and 10 biopsies of the tumour exteriorisated by the cervix. Surgery is the mainstay of the treatment. The prognosis remains dismal