Follow-up and Treatment Options for Breast Cancer Patients in Iraq
DOI:
https://doi.org/10.51699/ijhsms.v2i12.3215Keywords:
Breast, cancer, Iraq, SurgeryAbstract
The purpose of this research was to Follow-up and Treatment Options for Breast Cancer Patients in Iraq. The purpose of this retrospective research was to examine the demographic, clinical, and tumour pathological data of 210 female Iraqi patients with a histological diagnosis of breast cancer. Patients' ages, marital statuses, parities, first delivery ages, occupations, breastfeeding histories, hormone intake, family cancer and breast cancer histories, tumour grades, clinical stages, histological types, and tumour grades were among the variables examined. Immunohistochemistry was used to examine the hormone receptor (ER) and HER2 overexpression content of the main tumours. Surgery, radiation, chemotherapy, hormone replacement, and biological targeted therapy were all part of the therapeutic choices that were on the table. Three years of follow-up allowed us to assess the recurrence rate. out of the total number of breast cancer cases in this research, 8.1% (17 cases) were diagnosed at stage I, 45.7% (96 cases) were diagnosed at stage II, 39.5% (83 cases) at stage III, and 6.7% (14 cases) at stage IV. Two subcategories, IIA and IIB, were used to classify Stage II: 30.0% and 15.7% of the total, respectively. In contrast, stage III was further subdivided into IIIA, IIIB, and IIIC, accounting for 26.2%, 3.8%, and 9.5% of the overall portion, respectively. The evaluating surgeons and oncologists provided treatment choices based on each patient's specific situation. There were 201 patients (95.7% of the total) who had surgery. Chemotherapy was administered to 101 patients (91.0%), whereas 134 cases (63.8%) were scheduled for radiation treatments. Among the patients who were provided hormone therapy as an adjuvant treatment option, 129 patients (61.4%) with ER and/or PR positive tumour contents were given Tamoxifen and Aromatase inhibitors. On the other hand, 58 patients (26.6%) with HER2 positive findings were given Herceptin.
In conclusion, when patients first appear with breast cancer in Iraq, the disease is often well advanced, necessitating severe mastectomies and other forms of palliative care. The future of breast cancer management hinges on early diagnosis. To track the effectiveness of treatment and prevent recurrence, patients must undergo multimodality treatment and undergo long-term, routine follow-up with the help of multidisciplinary tumour boards.
Downloads
References
Globocan 2018. World Health Organization. International Agency for Research on Cancer (IARC) Press. Geneva, Switzerland, 2018.
Iraqi Cancer Board (2016). Results of the Iraqi Cancer Registry 2015. Baghdad, Iraqi Cancer Registry Center, Ministry of Health, 2018.
Alwan N. Breast Cancer among Iraqi Women: Preliminary Findings from a Regional Comparative Breast Cancer Research Project. J Glob Oncol. 2016; 2(5): 255–258.
Alwan, N, Kerr D, Al-Okati D, et al. Comparative study on the clinic- pathological profiles of breast cancer among Iraqi and British patients. The Open Public Health Journal. 2018; (11): 177–191.
Alwan NA, Tawfeeq FN, Maallah MH, et al. The Stage of Breast Cancer at the Time of Diagnosis: Correlation with the Clinicopathological Findings among Iraqi Patients. J Neoplasm. 2017; 2 (3):22
Alwan NAS, Tawfeeq FN, Mallah N. Demographic and clinical profiles of female patients diagnosed with breast cancer in Iraq. Journal of Contemporary Medical Sciences, 2019; 5 (1): 14-19.
Alwan NAS. Tumor Characteristics of Female Breast Cancer: Pathological Review of Mastectomy Specimens Belonging to Iraqi Patients. World Journal of Breast Cancer Research, 2018; 1 (1): 1-3.
Alwan NAS, Kerr D. Cancer Control in War-Torn Iraq, The Lancet Oncology, 2018; 19 (3): 291-292
Alwan NAS, Tawfeeq FN. Comparison of Clinico-Pathological Presentations of Triple-Negative versus Triple-Positive and HER2 Iraqi Breast Cancer Patients. Open access Macedonian Journal of Medical Sciences, 2019; 7(21):3534-3539.
Weigelt B, Baehner FL, Reis-Filho JS. The contribution of gene expression profiling to breast cancer classification, prognostication and prediction: a retrospective of the last decade. J Pathol. 2010; 220:263–280.
World Health Organization. Strategy for cancer prevention and control in the Eastern Mediterranean Region 2009—2013; World Health Organization. Regional Office for the Eastern Mediterranean, 2010.
Alwan N. Iraqi Initiative of a Regional Comparative Breast Cancer Research Project in the Middle East, Journal of Cancer Biology & Research, 2014; 2 (1): 1016 – 1020.
Alwan NAS, Al-Attar WM, Al Mallah N. Barriers to Baseline Needs for Early Detection of Breast Cancer among Iraqi Female Patients. Iraqi National Journal of Nursing Specialties, 2016; 29 (2): 1-11.
Alwan N, al-Attar W, Eliessa R, Al-Midfaei Z & Nidhal F:” Knowledge, Attitude and Practice regarding Breast Cancer and Breast Self-Examination among a Sample of the Educated Population in Iraq”. EMHJ, WHO, EMRO, 2012; 18 (4): 337-345
Al Alwan NAS and Mualla FHM: Promoting Clinical Breast Examination as a Screening Tool for Breast Cancer in Iraq. Iraqi National Journal for Nursing Specialties, 2014; 27 (1): 76-82.
Al Alwan N: Establishing Guidelines for Early Detection of Breast Cancer in Iraq. Int. J. of Advanced Research. 2015. 3 (12): 539-555
Alwan N, Al-Diwan J, Al-Attar W & Eliessa R: “Knowledge, Attitudes and Practice towards Breast Cancer and BSE in Kirkuk University, Iraq”. Asian Pacific Journal of Reproduction, Elsevier, 2012; 1 (4): 308-311.
Alwan NAS and Al-Attar: Evaluating the Effect of an Educational Teaching Model on the Knowledge about Breast Cancer among Female University Students in Iraq., JJ Cancer Sci. Res. 2016, 2 (1): 026
Alwan NAS, Alattar W, Mallah N, Hassoun T: Baseline Needs Assessment for Breast Cancer Awareness and Management among Paramedical Health Care Providers in Iraq. International Journal of Science and Research (IJSR), 2017; 6 (7):1515-1520.
Alwan NAS, Tawfeeq FN, Abdulsattar SY, Yihya F. Assessing the period between diagnosis of breast cancer and surgical treatment among mastectomized female patients. International Journal of Medical Research & Health Sciences, 2019; 8 (1), 2019.
Von Karsa L, Qiao Y, Ramadas K et al. Prevention/Screening Implementation, in Stewart BW and Wild CP (eds): World Cancer Report 2014. Lyon, France, World Health Organization International Agency for Research on Cancer, 2014
Sankar R, Alwan N, Denny L. How Can We Improve Survival from Breast Cancer in Developing Countries?. Future Medicine, Breast Cancer Management, 2013, 2 (3): 179-183.
El Saghir N, Khalil MK, Eid T, et al. Trends in epidemiology and management of breast cancer in developing Arab countries: A literature and registry analysis. International Journal of Surgery, 2007; 226-233.
Shulman LN, Willett W, Sievers A et al. Breast Cancer in Developing Countries: Opportunities for Improved Survival, Journal of Oncology, 2010; 1-6.
Baccach J, Mansouri M, Derkaoui T et al. Clinicopathologic and prognostic features of breast cancer in young women: a seriesfrom North of Morocco. BMC Women's Health, 2017; 17:106
Lakhani SR, Ellis IO, Schnitt SJ et al. WHO Classification of Tumours of the Breast. Fourth Edition, WHO Classification of Tumours, Volume 4, IARC, 2012.
Elston CW, Ellis IO: Pathological prognostic factors in breast cancer. The value of histological grade in breast cancer: Experience from a large study with long-term follow-up. Histopathology, 2002; 41:154- 161.
Sobin LH, Gospodarowicz MK, Wittekind C. TNM Classification of Malignant Tumours. New York, NY, John Wiley & Sons 2011.
Alwan NAS: Family History among Iraqi Patents Diagnosed with Breast Cancer, IJSR, 2017; 6 (2): 868-872
Chia KS, Reilly M, Tan CS, et al. Profound changes in breast cancer incidence may reflect changes into a Westernized lifestyle: a comparative population-based study in Singapore and Sweden, Int J Cancer, 2005; 113 (2): 302-306)
Eleni L, Demetri Ss, Bernard A.et al. Effects of Reproductive and Demographic Changes on Breast Cancer Incidence in China: A Modeling Analysis, JNCI: Journal of the National Cancer Institute, 2008; 100 (19):1352–1360.
Momenimovahed Z, Salehiniya H. Epidemiological characteristics of and risk factors for breast cancer in the world. Breast Cancer, 2019; 11:151–164.
Erica T. Warner, Rulla M. Tamimi, Melissa E et al. Racial and Ethnic Differences in Breast Cancer Survival: Mediating Effect of Tumor Characteristics and Sociodemographic and Treatment Factors. Journal of Clinical Oncology, 2015; 33 (20): 2254-2261
Min Yi, Peijun Liu, Xu Li et al. Comparative Analysis of Clinicopathologic Features, Treatment, and Survival of Asian Women with a Breast Cancer Diagnosis Residing in the United States. Cancer, 2012: 1: 4117-4125.
Alwan NAS: Clinical and Pathological Characteristics of Familial Breast Cancer in Iraq, Chronicle Journal of Cancer Science, 2017; 1 (1): 002
Alwan NAS, Mualla F, Naqash M et al: Clinical and Pathological Characteristics of Triple Positive Breast Cancer among Iraqi Patients, Gulf Journal of Oncology, 2017; 25: 6-15.
Alwan NAS, Tawfeeq FN, Muallah FH. Breast Cancer Subtypes among Iraqi Patients: Identified by Their ER, PR and HER2 Status. J Fac Med Baghdad, 2017; 59 (4): 304-307.
Espina C, McKenzie F, Siva I. Delayed presentation and diagnosis of breast cancer in African women: a systematic review. Annals of Epidemiology, 2017; 27: 659-671.
Talpur AA, Surahio AR, Ansari A. Late presentation of breast cancer: A Dilemma. J. Pak Med Assoc. 2011; 61 (7): 661-666.
Echavarria MI, Anderson BO, Duggan C, Thompson B. Global uptake of BHGI guidelines for breast cancer. The Lancet Oncology, 2014; 15 (13): 1421-1423.
