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 a common malignancy in Iraq, accounting for one-third of female cancers in the Iraqi Cancer Registry. Radiotherapy confers benefits for local control and progression free survival (PFS) in patients with breast cancer. This study aimed to assess PFS in patients treated by hypofractionated three-dimensional conformal radiotherapy (3DCRT) and correlate PFS with patients' clinical and pathological profiles. Methods: We retrospectively reviewed 299 women with breast cancer treated at Baghdad Radiation Oncology Center between October 2017 and May 2018. Regarding radiotherapy, 4005 cGy in 15 fractions over 3 weeks was adopted as standard practice for patients undergoing mastectomy and 4005 cG in 15 fractions + 1000 cG in 5 fractions as a booster dose for women undergoing breast-conserving surgery. Results: Age ranged from 25 to 75 years, and the mean age was 49.9±10.99 years. The most common stage was T2 (156, 53.9%), which mostly comprised luminal A (105, 36.3%). The results showed a high frequency of N1 (109, 37.2%), with luminal A (69, 23.4%). Relapse occurred in 35/299 (11.7%) patients, and the chest wall was a common relapse site in 9 of these patients (25.9%). Conclusions: We conclude that adjuvant radiotherapy reduces locoregional recurrence, distant metastasis and mortality rate.

Tamoxifen (TMX) is regarded as standard treatment for Background: breast cancer (BC) patients . In recent years, several studies have reported gynecological side effects and due to TMX's estrogenic effects. Here, we evaluate the side effects of TMX on the endometrium and ovaries of female BC patients.This was an ultrasound-based cohort study conducted in three Methods: oncology centers in Baghdad, Iraq. A total of 255 female patients were included, 140 premenopausal (PreM) and 115 postmenopausal (PostM), with estrogen receptor (ER)-positive BC using TMX adjuvant hormonal treatment for at least three months after surgery and adjuvant chemo/radiotherapy. Ultrasound (US) on the endometrium and ovaries of the women following BC surgery/chemotherapy (baseline) and at 3, 6, 12, and 24 months following was performed . Data collected included age, menopausal status, co-morbid chronic illness and medications, including duration of TMX treatment.Presence of ovarian cyst was significantly higher in the PreM Results: compared to PostM women, while there were no significant differences for other gynecological findings. At baseline, endometrial thickness (ET) was significantly higher in the PreM compared to the PostM women. In both groups, women with increased ET became more frequent from baseline to 3 months, from 3 to 6 months, from 6 to 12 months, and from 12 to 24 months. At all time periods, women with increased ET was significantly higher in the PostM compared PreM women, resulting in a risk of ET increase by 6 folds (ranging from 3 -11 folds) in PostM compared to PreM women.Longer duration of TMX is associated with increased ET. Conclusions:Duration of TMX did not appear to increase the risk of various gynecological outcomes, for example endometrial cancer rate was low. Finally, there was an increase in ET, which appeared to be six-folds higher in PostM compared to PreM women. Keywords