Awareness, acceptance, and perspective of women for reconstruction post Mastectomy.

OBJECTIVE: To assess the level of awareness and acceptance among women for breast reconstruction surgery after mastectomy. METHODS: The observational cross-sectional study was conducted at King Khalid University Hospital, Riyadh, Saudi Arabia, from November 2014 to April 2015, and comprised women aged 19-65 years with breast masses and women with high risk for breast cancer who were offered therapeutic mastectomy. The subjects were interviewed using a structured and validated questionnaire. Data was analyzed using SPSS 21. RESULTS: Of the 224 individuals approached, 209(93.3%) participated. Of them, 106(50.7%) considered having reconstruction and 97(46.4%) had read or heard about it. The most influencing factor for reconstruction was improving their psychological status 84(40.2%) and the most common reason for refusal was old age 26(12.4%). Patients who were 40 years or younger were more willing to undergo reconstruction (p=0.001). CONCLUSIONS: Patients with knowledge about breast reconstruction were more willing to accept the procedure. Increasing the awareness will increase acceptance of breast reconstruction..

Clinicopathological concordance in the diagnosis of skin diseases: a retrospective analysis of 5000 histopathology reports.

BACKGROUND: The accuracy of clinical diagnoses of skin diseases has not been researched in Saudi Arabia. OBJECTIVES: Assess concordance between the histopathological and clinical diagnosis in skin diseases. DESIGN: Retrospective. SETTING: Academic tertiary care center. METHODS: Demographic, clinical and pathological data were collected from the medical record for the period 1997-2013. MAIN OUTCOME MEASURES: Concordance between the pathological and clinical diagnosis. SAMPLE SIZE: 4268 cases. RESULTS: Of 4268 biopsies, 2440 (58.1%) were females. The mean age (SD) of patients was 36.9 (17.8) years. The three most common locations from which skin biopsies were retrieved in descending order were the lower extremity (1123; 29.1%), head, neck, scalp and hair (1033; 26.7%) and trunk (853; 22.1%). Overall concordance was 75.9% (partial concordance 47.6%, full concordance 28.3%). Biopsies from the oral mucosa and lips had the lowest concordance (overall 58.5%, full 26.4%) at P=.004. Overall concordance was highest for the following three diagnoses: malignant neoplasms, 88%; vesiculobullous diseases 87%; urticarias, erythemas, and purpuras 87%. CONCLUSION: There is considerable variability in concordance among different histopathological diagnoses. The full concordance between the clinical diagnosis and the pathological diagnosis is low. This is a reflection of the fact that the biopsies were obtained only in cases where the clinical diagnosis was a dilemma. LIMITATIONS: Single center, retrospective, incomplete medical records, low percentage of biopsies were assessed by dermatopathologists. CONFLICT OF INTEREST: None.

Nonmelanoma skin cancer in Saudi Arabia: single center experience.

BACKGROUND: Skin cancer is the most common cancer worldwide; one in every three diagnosed malignancies is a skin cancer. However, skin cancer is rarely reported in Saudi Arabia so we conducted this study to highlight these underreported neoplasms. OBJECTIVES: Determine the prevalence and patterns of basal cell carcinoma (BCC) and primary squamous cell carcinoma (SCC), the most common types of nonmelanoma skin cancer (NMSC) with respect to age, sex, and anatomic location and to identify potentially associated risk factors. DESIGN: Retrospective, descriptive medical record review. SETTING: A tertiary care centre. PATIENTS AND METHODS: We did a retrospective chart review of all patients diagnosed with basal cell carcinoma and primary squamous cell carcinoma between 2003-2016. MAIN OUTCOME MEASURES: Prevalence and pattern of BCC and SCC with respect to age, sex, and anatomic location. RESULTS: Of 593 cases reviewed, 279 had NMSC. Most (95%) were diagnosed with BCC or SCC or both in a few cases. The mean age at diagnosis was 59 (19.5) years. Sixty-two percent of the patients were males. However, 24.3% (n=68) of skin cancers occurred in patients younger than 50 years. The frequency of BCC and SCC was 50.2% and 44.8%, respectively. The head and neck was the most common location (79.6%). In patients younger than 50 years, xeroderma pigmentosum and previously treated solid malignancies were the major factors. CONCLUSIONS: BCC and SCC are uncommon but not rare. However, skin cancers are underreported in our population. NMSC in individuals younger than 50 years of age requires more careful evaluation of possible risk factors. LIMITATIONS: Retrospective in a single tertiary care setting.