Brain Metastasis from Breast Cancer: risk factors and radiotherapy perspective from a tertiary Middle Eastern facility.

BACKGROUNDS: Breast cancer represents the second most frequent cause of brain metastases after lung cancer. Previous studies have identified the subgroups of patients with triple-negative and HER2-positive as having an increased risk for the development of brain metastases. We are not aware in Kurdistan - Iraq of any national studies that are in parallel with these findings. PATIENTS AND METHODS: A cross-sectional descriptive study conducted on 57 patients who were known cases of breast cancer with brain metastasis, managed with whole brain radiotherapy at a tertiary radiotherapy institute in two years (January 2015 to December 2016), as a convenient sample. Data were collected from patients' archives and phone calls and then analyzed using SPSS version 23. RESULTS: Younger age at diagnosis and cancers with HER2-positive receptor phenotype are risk factors for brain metastasis. Median survival post-brain metastasis is significantly affected by receptor phenotypes (2 months in triple negative versus 7 months in hormone receptor positive) and performance status (18 months if performance score of 70% and above versus 1.5 months if it is 60% and less). CONCLUSION: Primary breast cancer patients have more risk to develop brain metastases if they are at younger age and HER2-positive and the survival post-brain metastases is dramatically affected by both triple negative receptor phenotype and lower performance score.

Mode of Presentation of Laryngeal Cancer: A Single Radiotherapy Institute Experience in Iraq.

PURPOSE: Laryngeal cancer is relatively common and usually presents with hoarseness due to a lesion in the glottis. We noticed that many of our patients had presented with supraglottic lesions and we could not find local literature in support of this observation. Mode of presentation and site of the lesion of these patients will be addressed in this review. MATERIALS AND METHODS: A retrospective cross-sectional descriptive study for laryngeal cancer patients who received radiotherapy at a tertiary radiotherapy center in Iraq, from January 2010 to December 2015, and who are residents in the Sulaimani governorate. RESULTS: In 6 years, laryngeal cancer patients from Sulaimani were 83 (out of 123 in total), which constituted the most common, 40.8%, head and neck cancers. 86.7% were males and the median age was 68.3 year. Most common presentation was hoarseness, 79.5%, and the least was dysphagia and stridor, 28.9%. Pain and neck swelling were found in 51.8%, 34.9%, respectively. Site of the cancer lesions were in supraglottis in 53%, glottis in 32.5%, transglottis in 8.4%, and subglottis in 6%. Commonest stage was IVA in 54.2% while the least was IVB 2.4%. Squamous cell carcinoma was the pathological type in all of our patients. CONCLUSION: Laryngeal cancer is the most common head and neck cancer in our institutional registry. While all the pathologies were of squamous cell carcinoma, hoarseness was the most common presentation and supraglottis was the most common site of involvement.