Mejri N, Boussen H, Labidi S, Bouzaiene H, Afrit M, Benna F, Rahal K
Department of Medical Oncology, University Hospital A Mami, Ariana, Tunis, Tunisia E-mail :
Asian Pac J Cancer Prev. 2015;16(3):1277-80. doi: 10.7314/apjcp.2015.16.3.1277.
To report epidemiologic and anatomoclinical transitions of inflammatory breast cancer (IBC) in Tunisia.
Data including clinico-pathological data for208 cases of T4d or PEV 3 non-metastatic breast cancer diagnosed between 2005 and 2010 were collected from patient records. Chi2 and Z tests were used to compare variables with two Tunisian historical series and a series about Arab-American patients.
Thirty three percent of our patients had their first child before 23 years of age and 56% had their menarche before 12 years, 75% never receiving oral contraception. Obesity was observed in 42% of women and IBC occurred during pregnancy in 13% of cases. Tumor grade was II-III in 90% of cases, HR was negative in 52%, HER2 was over expressed in 31% and invasion of more than 3 axillary nodes occurred in 18% of patients. We observed a pCR rate of 19% after neoadjuvant treatment (anthracyline-taxane used in 79%, trastuzumab in 27% ). Compared to historical Tunisian series (since 1996), IBC epidemiology remained stable in terms of median age, menopausal status and obesity. However we observed a significant decrease in median clinical tumor size and number of positive axillary lymph nodes. Comparison to IBC in Arab-Americans showed a significant difference in terms of median age, menopausal status, positivity of hormonal receptors and educational level.
Our assessment of epidemiologic transition showed a reduction of clinco-pathological stage of IBC, keeping the same characteristics as compared to Tunisian historical series over a period of 14 years. Features seem to be different in Arab-American patients, probably related to migration, "occidentalization" of life style and improvement in socio-economic level.
报告突尼斯炎性乳腺癌（IBC）的流行病学及解剖临床转变情况。
从患者病历中收集2005年至2010年间诊断为T4d或PEV 3期非转移性乳腺癌的208例患者的临床病理数据。采用卡方检验和Z检验，将变量与两个突尼斯历史系列以及一个关于阿拉伯裔美国患者的系列进行比较。
我们的患者中，33%在23岁之前生育第一胎，56%在12岁之前月经初潮，75%从未使用过口服避孕药。42%的女性存在肥胖情况，13%的病例在孕期发生IBC。90%的病例肿瘤分级为II - III级，52%的病例激素受体为阴性，31%的病例HER2过表达，18%的患者腋窝淋巴结转移超过3个。新辅助治疗后（79%使用蒽环类 - 紫杉烷，27%使用曲妥珠单抗），我们观察到病理完全缓解（pCR）率为19%。与突尼斯历史系列（自1996年起）相比，IBC的流行病学在中位年龄、绝经状态和肥胖方面保持稳定。然而，我们观察到临床肿瘤中位大小和腋窝阳性淋巴结数量显著减少。与阿拉伯裔美国患者的IBC相比，在中位年龄、绝经状态、激素受体阳性率和教育水平方面存在显著差异。
我们对流行病学转变的评估显示IBC的临床病理分期有所降低，在14年的时间里与突尼斯历史系列相比保持相同特征。阿拉伯裔美国患者的特征似乎有所不同，这可能与移民、生活方式的“西方化”以及社会经济水平的提高有关。
