This cross-sectional, questionnaire-based study evaluated the knowledge, attitude and practice towards breast cancer and breast self-examination (BSE) among 387 (302 females and 85 males) educated Iraqis affiliated to 2 Iraqi universities. The participants were categorized into 3 occupations: student (71.3%), teaching staff (10.3%) and administrative staff (18.3%). About half of the participants had a low knowledge score (< 50%); only 14.3% were graded as "Good" and above. Almost 75% of the participants believed that the best way to control breast cancer was through early detection and other possible preventive measures. Most participants (90.9%) had heard of BSE, the main source of information being television. However, only 48.3% practised BSE; the most common reason for not doing so was lack of knowledge of how to perform the technique correctly. Almost 84% of the female participants were willing to instruct others in the technique of BSE. Unit, Baghdad Medical College, Baghdad, Iraq (Correspondence to N.A.S. Alwan: nadalwan@yahoo.com). Les résultats de près de la moitié des participants étaient faibles en termes de connaissances (< 50 %) : seuls 14,3 % ont obtenu des résultats « satisfaisants » ou supérieurs. Près de 75 % des participants pensaient que la meilleure méthode pour lutter contre le cancer du sein était une détection précoce et l'adoption d'autres mesures préventives. La majorité des participants (90,9 %) avaient entendu parler de l'autoexamen des seins, la télévision étant leur principale source d'information. Toutefois, seules 48,3 % des femmes pratiquaient l'auto-examen des seins ; la raison invoquée le plus fréquemment était l'absence de connaissances permettant d'utiliser la technique correctement. Près de 84 % des participantes étaient volontaires pour former les autres à la technique de l'auto-examen des seins. Breast Cancer Research

Breast cancer is the commonest type of malignancy in Iraq. The study was carried out on 721 out of a total of 5044 patients (14.3%) presenting with palpable breast lumps that were diagnosed as cancer. Approximately one third of the breast cancer patients were diagnosed at age 40-49 years; 71.9% came from urban areas; and 75% were married. History of lactation was reported in 63.1% and hormonal therapy in 29%. Positive family history was recorded in 16.2%. Although the lump was detected by the patient herself in 90.6% of cases, only 32% sought medical advice within the first month. Accordingly, 47% of these patients presented in advanced stages (III and IV). The main histological type was invasive ductal carcinoma, in which pathological changes of grade II and III were observed in 56.6% and 39.9% respectively. DNA analysis showed that 80.3% of the carcinomas were aneuploid. The findings of this study justify increasing efforts for establishing comprehensive breast cancer control programmes in Iraq.

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Background: Breast cancer is the most frequently diagnosed malignancy and the second leading cause of mortality among women in Iraq forming 23% of cancer related deaths. The low survival from the disease is a direct consequence to the advanced stages at diagnoses.

Background:Breast cancer is the most common cancer in Iraq and the United Kingdom. While the disease is frequently diagnosed among middleaged Iraqi women at advanced stages accounting for the second cause of cancer-related deaths, breast cancer often affects elderly British women yielding the highest survival of all registered malignancies in the UK. Objective:To compare the clinical and pathological profiles of breast cancer among Iraqi and British women; correlating age at diagnosis with the tumor characteristics, receptor-defined biomarkers and phenotype patterns. Methods:This comparative retrospective study included the clinical and pathological characteristics of (1,940) consecutive female patients who were diagnosed with invasive breast cancer from 2014 to 2016 in Iraq (Medical City Teaching Hospital, Baghdad: 635 cases) and UK (John Radcliffe, Oxford and Queen's, BHR University Hospitals: 1,305 cases). The studied parameters in both groups comprised the age of the patient at the time of diagnosis, breast cancer histologic type, grade, tumor size, lymph node status, clinical stage at presentation, Estrogen Receptor (ER), Progesterone Receptor (PR) and HER2 positive tumor contents and the receptordefined breast cancer surrogate subtypes. Results:The Iraqi patients were significantly younger than their British counterparts and exhibited higher trend to present at advanced stages; reflected by larger size tumors and frequent lymph node involvement compared to the British (p<0.00001). They also had worse receptor-defined breast cancer subtypes manifested by higher rates of hormone receptor (ER/PR) negative, HER2 positive tumor contents, Triple Positive and Triple Negative phenotypes (p<0.00001). Excluding HER2 status, the significant differences in the clinical and tumor characteristics between the two populations persisted after adjusting for age among patients younger than 50 years. Conclusion:The remarkable differences in the clinical and tumor characteristics of breast cancer between the Iraqi and British patients suggest heterogeneity in the underlying biology of the tumor which is exacerbated in Iraq by the dilemma of delayed diagnosis. The significant ethnic disparities in breast cancer profiles recommend the prompt strengthening of the national cancer control plan in Iraq as a principal approach to the management of the disease. This comparative retrospective descriptive study included the clinical and pathological characteristics of (1,940) female patients diagnosed with invasive breast cancer in two countries; Iraq (635 cases) and UK (1,305 cases). The Iraqi GroupThis group enrolled 635 consecutive female patients who were diagnosed with breast cancer at the Referral Training Center for Early Detection of Breast Tumors, Medical City Teaching Hospital in Baghdad over a three-year period from 2014 to 2016. Data was extracted from an established information system database developed by the principal investigator under the direct supervision of the International Agency for Research on Cancer (IARC); utili...

Objective To highlight the main demographic characteristics and clinical profiles of female patients registered with breast cancer in Iraq; focusing on the impact of age.Methods This retrospective study enrolled 1172 female patients who were diagnosed with breast cancer at the Main Center for Early Detection of Breast Cancer/Medical City Teaching Hospital in Baghdad. Data were extracted from an established information system, developed by the principal author under supervision of WHO, that was based on valid clinical records of Iraqi patients affected by breast cancer. The recorded information regarding clinical examination comprised positive palpable lumps, bloody nipple discharge, skin changes, bilateral breast involvement, tumor size, lymph node status, and the stage of the disease.Results The mean age at the presentation was 51 years; patients under the age of 50 constituted 46.8%. Overall 9.8% were not married, 22.4% were illiterate whereas 19.2% graduated from universities. About 72% of the patients had more than two children, merely 7.5% delivered their first child after the age of 35 years and only 11% were nulliparous. History of lactation and hormonal therapy was recorded in 57.6% and 19.4% respectively. Family history of cancer was positive in 28.8% and breast cancer specifically in 18.7%. Clinically, the most common presenting symptom was breast lumps (95%) followed by skin changes/ulcerations (6.7%) and bloody nipple discharge (4.3%).Bilateral breast involvement was encountered in 4.7%. More than two-thirds of the patients (68.2%) had palpable axillary lymph nodes; classifying 40.5% into advanced stages III and IV. In general stages I–IV comprised 12%, 47.5%, 31.9%, and 8.6% respectively. Upon stratifying the studied sample with respect to age at diagnosis, it was observed that the frequency of unmarried patients was significantly higher among younger women under the age of 50 years, whereas illiteracy and nulliparity features were statistically lower (p < 0.05).Conclusion A considerable proportion of breast cancer patients in Iraq still present with locally advanced disease at the time of diagnosis. That justifies the necessity to promote public awareness educational campaigns to strengthen our national early detection program. Excluding the marital status, level of education and number of parity, there was no statistical difference regarding the impact of age on the demographic and clinical profiles of breast cancer among premenopausal versus postmenopausal Iraqi patients.