Medullary carcinoma of the breast: ten year clinical experience of the Kuwait cancer control centre

Medullary carcinomas of the breast account for fewer than 7% of all invasive breast cancers. Some investigators include medullary carcinomas in the favourable histologic subtype, despite its aggressive histologic appearance. However, others fail to confirm its favourable prognosis. This was a retrospective analysis of sixty-one [61] cases of breast cancer cases diagnosed with Medullary Carcinoma, presenting to the Kuwait Cancer Control Center between 1995 and 2005. Median survival time was 122 months and the seven-year disease free survival was 82%. Overall survival rate was not assessed as no case died during the study period. No cases were metastatic from the start and only eight cases developed metastases, local recurrence or contralateral breast primary. 68.8% of the cases were Stage I or IIA [i.e. no lymph node affection]. There is no overt favourable prognosis of medullary carcinoma when compared to invasive ductal carcinoma. prognosis is more related to stage than histologic subtyping. The majority of cases were negative estrogen and progesterone receptor status and node negative

Assessment of metabolic response to pre-operative treatment of rectal cancer

In the era of targeted therapy and high precision radiotherapy for patients with cancer, tailoring and individualization of treatment is needed more and more. In part to avoid ineffective administration of a toxic treatment to a patient that unlikely to get any benefit of it. And also to decrease the expenses of treatment and saving the drugs and resources to patients that deserve. Many predictive factors and markers are searched and well-known in many malignancies, but still rectal cancer lacks such predictors. As the pre-operative chemoradiotherapy is becoming the standard of care of treating patients with locally advanced rectal carcinoma, a predictive factor, or at least an early indicator, of patient's response to treatment is needed. First, it may help to modulate the pre-operative treatment by employing another chemotherapeutic or targeted agent e.g. oxaloplatin or cetuximab instead of the standard fluorouracil compounds. It may also help to avoid continuation of unnecessary protracted course of radiotherapy for 5-6 weeks for a patient who is unlikely to achieve a satisfactory response. This will help to avoid the definite toxicity of pelvic irradiation and avoid wasting time before going to surgery. Here comes the role of imaging techniques in predicting the metabolic response such as functional computerized tomography [CT] and magnetic resonance imaging [MRI] or positron-emission tomography [PET] scan. In this review we will go through the principles, indications and benefits of employing such techniques in the assessment of response to pre-operative chemoradiotherapy of rectal cancer

[ survey of age at natural menopause according to determinants factors in Arak city in 2007]

Menopause is a natural period of life. It means the permanent cessation of menstruation and the end of reproductive period which occurs between 45-52 years old. It also serves as an indicator of population health as the occurrence of menopause indicates the increased risk for the onset of several chronic diseases. In this study, the mean age of natural menopause among women in Arak [Central Iran] was investigated, considering their reproductive and socio-economic-demographic factors and their health behaviors. This study was an observational cross-sectional study on a population base, carried out in 2007 year. Interviews and questionnaires were used for gathering data from 458 women resident in Arak city, who had undergone a natural menopause. Sampling was multistaged using postal zones and selecting samples in each zone. Data was analyzed using variance analysis, multiple regression, T and correlation coefficient tests. Findings showed that the mean age of menopause in our sample was 48.2 +/- 2.34 years [95% CI: 47.98- 48.41] and its median was 49 years. The mean age of menopause in women who were never married was less than married women [P= 0.015]. Low income level [P= 0.003], having physical activity [P= 0.004], number of pregnancies [P<0.001], age of last pregnancy [P=0.026] and place of birth [P=0.003] were meaningfull factors in age of menopause. This phenomenon must be documented in Iran because of its strong link with mortality and morbidity of the growing number of women who are reaching advanced ages; whose one forth of life is after menopause. Therefore health education as the best way for changing their lifestyle is suggested