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In this report, we examined the relationship between mother's breastfeeding history and her risk of breast cancer, in a case-control study in Tunisia between 2006 and 2009. About 400 breast cancer cases and 400 controls were included. Cases and controls were interviewed using a standardized structured questionnaire to obtain information on breastfeeding and other risk factors. Mean duration of breastfeeding per child was significantly associated with a reduced risk of breast cancer for women who breastfed for > 24 months per child. The OR was 0.46 (95% CI, 0.28-0.76) when compared those who breastfed for < 6 months. The test for trend was significant (p = 0.01). A significantly reduced risk of breast cancer was found for those whose lifetime duration of breastfeeding was 73-108 months (OR = 0.65, 95% CI, 0.36- 1.18) and for those who breastfed for > or = 109 months (OR = 0.42, 95% CI, 0.20-0.84). Stratification by menopausal status showed a reduced risk of breast cancer associated with a longer duration of breastfeeding for both pre- and postmenopausal women. The risk reduction was more consistent for lifetime duration of breastfeeding, the test for trend being significant for both pre- (p = 0.03) and postmenopausal (p = 0.01) women. These results support an inverse association between breastfeeding and breast cancer risk.

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The SLN identification and false-negative rates after NAC for IBC were unacceptably high and based on the current findings, SLNB without systematic axillary lymph node dissection is unsuitable in this patient population.

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Résumé Ce travail a pour objectif de préciser les aspects anatomo-cliniques et les paramètres pronostiques des cancers du sein dans la région du centre tunisien. Cette étude rétrospective porte sur 729 patientes atteintes de cancers mammaires prouvés à l’histologie et/ou à la cytologie, diagnostiqués et traités entre janvier 1990 et juin 1998 au CHU F Hached de Sousse (Tunisie). L’âge moyen était de 50 ans (extrêmes 22-91 ans). La taille clinique moyenne au diagnostic était de 49,1 mm ; 90 % étaient des carcinomes canalaires infiltrants avec un grade histopronostique SBR souvent élevé (grade II et III : 82,6 %). Le taux de survie globale de l’ensemble des patientes était de 50,5 % à 5 ans et de 50 % à 7 ans. En étude monofactorielle, les paramètres pronostiques étaient la taille tumorale, le statut ganglionnaire clinique, les métastases au diagnostic, le nombre de ganglions envahis, les ruptures capsulaires et les embols lymphatiques, le grade SBR et le délai de consultation. L’analyse multifactorielle (modèle de Cox) a isolé 2 paramètres pronostiques : la taille tumorale initiale (p = 0,001) et les métastases au diagnostic (p = 0,01). Le pronostic du cancer du sein demeure réservé en Tunisie du fait, notamment, du diagnostic tardif.

Meaningfully applied to our population, although AUC values had overlapping of 95% confidence intervals but combined our data suggest that the Stanford nomogram may be the most accurate. Before prospective trials validate these nomograms, CALND remains the standard for patients who have SN metastases.