Twenty years of breast cancer in Iran: downstaging without a formal screening program.

BACKGROUND: breast cancer (BC) is the most common malignancy among Iranian women. Although the relative incidence of BC is low, the cause-specific mortality is much higher than developed countries. The present study surveyed the overall trend of BC in Tehran. PATIENTS AND METHODS: all breast pathologic records were studied in five major hospitals in Tehran during three phases (1: 1985-1995; 2: 1996-2000; and 3: 2001-2005). Malignant cases were classified according to the tumor-node-metastasis classification. Data were compared across the study. RESULTS: Of 9050 medical records from male and female patients with 'breast disease', 2946 females with BC were included. A significant increase in the diagnosis of palpable early BCs (stage II increased, stage III decreased) was observed between phases 1 and 2. A relative increases in stages 0 and I were noted between phases 3 and 2. Nevertheless, 76.8% of cases were T2 or higher and 65.3% had positive lymph nodes in the last phase. The proportion of patients with stage IIIb was increased in phase 3, despite the reduction in phase 2. CONCLUSIONS: despite the relative improvement in the status of BC patients, the vast majority are diagnosed in advanced stages. Specific screening measures should be implemented in Iran.

Focal pancreatitis mimicking pancreatic mass: magnetic resonance imaging (MRI)/magnetic resonance cholangiopancreatography (MRCP) findings including diffusion-weighted MRI.

BACKGROUND: Focal pancreatitis (FP) is a confined inflammation that mimics a pancreatic mass. Its imaging diagnosis is important to avoid unnecessary procedures. PURPOSE: To describe the spectrum of magnetic resonance imaging (MRI)/magnetic resonance cholangiopancreatography (MRCP) and diffusion-weighted MRI (DWI) findings of focal pancreatitis mimicking pancreatic masses. MATERIAL AND METHODS: Findings of MRI/MRCP including DWI with a b value of 0 and 600 s/mm(2) in 14 patients with pancreatic masses on MRI were retrospectively reviewed and compared to normal pancreas in 14 patients as a control group. RESULTS: FP revealed hypointense signal intensity (SI) (3/14), hypo- to isointense SI (7/14), or isointense SI (4/14) on T1-weighted images, and hypointense SI (1/14), isointense SI (5/14), iso- to hyperintense SI (7/14), or hyperintense SI (1/14) on T2-weighted images compared to remaining pancreas (RP). MRCP images revealed dilatation of the common bile duct (CBD) and main pancreatic duct (MPD) (5/14), dilatation of the MPD only (3/14), dilatation of the CBD only (3/14), and normal MPD and CBD (3/14). Both FP and RP revealed three types of time-signal intensity curves: 1) rapid rise to a peak, with a rapid decline (FP=2, RP=4), 2) slow rise to a peak, followed by a slow decline (FP=5, RP=4), and 3) slower rise to a peak, with a slow decline or plateau (FP=7, RP=6). Mean apparent diffusion coefficient (ADC) values for FP and RP were 2.09+/-0.18 and 2.03+/-0.2 x 10(-3) mm(2)/s, respectively. ADC values of FP and RP revealed no significant difference. CONCLUSION: The spectrum of imaging findings of focal pancreatitis on MRI/MRCP including DWI was described. Findings of FP were not distinctive as compared to the remaining pancreas.