Local Regional Recurrance of Breast cancer in Tunisian Center

To evaluate locoregional recurrence rate of breast cancer, determine its anatomoclinical characteristics and discuss the available therapeutic alternatives. Patients and methods A retrospective study including 41 patients with LRR following modified radical mastectomy or conservative surgery of invasive breast carcinoma without metastasis, between January 1993 and December 2002. 38 cases of LRR occurred after mastectomy and 3 cases after conservative surgery. LRR rate was 4.84%. mean follow-up 44.7 months. Mean age of patients was 45 years and LRR mean occurrence time-interval 22.4 months. Recurrence was parietal in 25 cases, mammary in 2 cases, and nodal in 14 cases. 18 patients had to be operated on. Conclusion Prognosis of breast cancer depends on distant metastasis. LRR constitutes the second major risk liable to influence the overall prognosis

[Pronostic factors in squamous cell carcinoma of the vulva. about 35 cases]

To evaluate the pronostic factors of the vulvar cancer. This is a retrospective study, of 35 cases of squamous cell carcinoma of the vulva diagnosed and treated at Farhat Hached Hospital [Sousse] between January 1991 and December 2002. The study of the pronostic factors is based on analysis of the following parameters obtained after a period varying from 6 months to 5 years: clinical data, pre-therapeutique and therapeutic evaluation, pathologic data, outcome and survival rate. The diagnostis was often late with a delay for consultation superior to 6 months in 60% of cases. 80% of the patient were in stages III and IV of FIGO with an average tumorous size of 3.8 cm and palpable lymph node in 74.2% of the cases. 22 patient underwent vulvectomy with bilateral inguinal node dissection. Adjuvant therapy was carried out in 8 cases. The rate of relapses was 22.7%. The global survival at 5 years of the operated patients was of 40%. The main prognostic factors were: the size tumorale, the degrees of stromal invasion and the lymph node invasion. Early detection fo vulvar cancer by regular gynecologic examinations and a biopsy of all suspect lesions, allows an early treatment consequenlly a better prognosis