Rationale: Adherence to endocrine therapy provides substantial reduction in breast cancer (BC) relapses and improve survival. Hence, non-adherence remains an under reported issue mainly in developing countries. Aims and Objectives: The aim of this study is to evaluate the adherence to endocrine therapy (tamoxifen [TAM] and aromatase inhibitors [AIs]) among BC patients visiting an outpatient clinic (2015-2016) in Khartoum Oncology Hospital, Sudan. Methods: Adherence was assessed using pills count and self-reporting methods. A total of 172 patients were interviewed. Also, records were reviewed for demographic and other cancer characteristics. Results: The patients' mean age at diagnosis was 53 years, with the highest frequency at (41-60) years. Invasive ductal carcinoma 69.2% formed the main pathological diagnosis. T2 tumour size (51.2%) and lymph node involvement (N1) (31.4%) were most evident. Also, the majority of patients were stage III (45.9%) and grade II (48%). The studied women were postmenopausal (49.4%) and premenopausal (47.7%). Regarding hormonal receptors, about 68% were oestrogen (ER)+/progesterone (PR)+ and 23.3% were ER+/PR−. Studying adherence, almost (93%) of the studied group were ≥80% adherent to TAM and AIs. The hormonal therapy persistence mean was 27.2 ± 22.5 months (40-96). While adherence percentage mean was 93.7 ± 13.6% (0%-100%). Also disease-free survival (DFS) mean was 36.3 ± 32.7 months (4-312).
Primary breast lymphoma (PBL) represents 0.04-0.5% of all malignant breast tumors, <1% of all patients with non-Hodgkin’s lymphomas and 1.7-2.2% of all patients with extra nodal lymphomas. Despite the high prevalence of breast cancer, primary breast lymphoma is very rare. We report a rare case of PBL, successfully treated with surgery, chemotherapy and radiotherapy. This is the first case of PBL to be reported from Sudan to our knowledge.
Metastatic deposits to the oral cavity are exceptionally rare. The commonest tumor types metastasizing to the oral cavity include lung and breast carcinoma. Renal cell carcinoma is believed to be the third most common infra clavicular tumor to metastasize to the head and neck. We report a case where an oral cavity deposit was the initial presentation for an occult clear cell renal carcinoma. Additional therapeutic options, including immunotherapy, tyrosine kinase inhibitors, and participation in a clinical trial, should be discussed with the patient despite the poor overall prognosis.
Introduction: Cervical cancer is the second most prevalent cancer in Sudanese Women; breast cancer forms between 29 - 35% of female cancers while Ca Cervix forms 12 - 16%. There are limited screening activities in the country using VIA, and Pap smears in Obs. and Gyn. clinics. With the main emphasis on health education programs, teaching women the early symptoms of ca cervix and early detection. Due to lack of awareness the majority of women don’t know anything about screening, so there is limited demand. Method: This is a retrospective study of 405 Cases of Ca Cervix treated during the period between 2000—2013 at the Radiation and Isotopes Center of Khartoum, RICK. Data was collected from patients records. Results: Age distribution showed,<40 years =8 = 2 %,41 -50 = 94 =23.2%,51—60 = 187 = 46.2%,61—70 = 102 = 25.2%,>70 14= =3.5%. Age range =28—79,mean age =47 years. Residence distribution was as follows, western Sudan = 48 %,central Sudan = 41.%,North = 7%,East = 4%. Length of duration of symptoms, range between 1—10 months, mean of 5 months. FIGO Stage distribution: Stage 1= 6%, Stage 2 A =13%.Stage 2 B =23%,Stage 3 A=18%,Stage 3B =34%,Stage 4 A,B =7%,. Pathology: poorly dif. Squamous ca 38%, moderately dif. Squamous 26%,well dif 25%,Adenocarcinoma 9%,others 2%. Treatment: external Radiotherapy,45-50 Gy in 20—25 fractions, by 2 or 4 fields, using Co 60 or lineacs 6,9 Mv, concurrent chemo radiotherapy was given to patients with stage 2B, 3A, 3B, and 4A. Using weekly Cisplatinum, this was given to 32% of patients. 60 %% of the patients had Brach therapy, 34% with Low Dose Rate, LDR, Manual Brachy therapy, 35Gy to point A,and 66% had High Dose Rate Brachy, HDR, 9 Gy x 2 sessions, using a cobalt source. Results: 175 patients (43.3%) survived for 5 years and more, mostly patients with stage one and two 158 = 39% survived for 3-4 years after treatment,39 patents = 9.6 %, mostly patients with stage four, died during follow up due to the disease and 33 patients = 8.2% disappeared after treatment. The poor outcome is attributed to the advanced stages at presentation, lack of screening and awareness about cervical cancer, poverty, illiteracy, the large size of the country and the poor distribution of the limited medical resources. The patients treated with LDR or HDR have equal outcome and morbidity. Conclusion: Most of Ca Cervix Patients present with advanced disease, hence the poor prognosis, due to lack of awareness and screening, illiteracy and poverty, the majority are poorly differentiated squamous cancers. There is a need for increasing public awareness about ca cervix and its early symptoms, and provision of a pap smear and VIA services in the primary health care facilities. Citation Format: Kamal Eldein H. Mohamed, Dr Ammar Ashmeig Ahmed Ashmeig. Cervical cancer: Our experience in Sudan [abstract]. In: Proceedings of the American Association for Cancer Research Annual Meeting 2017; 2017 Apr 1-5; Washington, DC. Philadelphia (PA): AACR; Cancer Res 2017;77(13 Suppl):Abstract nr 771. doi:10.1158/1538-7445.AM2017-771
We report a rare case of primary hepatic lymphoma (PHL) in a hepatitis B virus- (HBV-) infected young female patient who presented with right upper abdominal pain, nausea, and vomiting for a few days. The preoperative diagnosis was difficult due to the rarity of the disease and the presence of a solitary hypodense mass in the left lobe of the liver on contrast-enhanced computed tomography (CT) scan with a normal alpha-fetoprotein (AFP) and negative cytology. She underwent an uneventful extended left hemihepatectomy, and the surgical biopsy revealed a PHL—of diffuse large B-cell lymphoma (DLBCL) type—with negative resection margins. She received adjuvant combination chemotherapy and remained disease-free with normal serial radiology over a 2-year follow-up period.
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