Association between body mass index and risk of breast cancer in Tunisian women.

BACKGROUND AND OBJECTIVES: The number of breast cancer in women has increased dramatically in Tunisia. The cause is perceived to stem from adaptation to a westernized life style which increases body mass index (BMI). This study aimed to investigate the association between BMI and breast cancer among Tunisian women. DESIGN AND SETTING: Hospital-based case control study of breast cancer patients seen between November 2006 and April 2009 at the University College Hospital Farhat Hached in Sousse, Tunisia. PATIENTS AND METHODS: Standardized questionnaires concerning BMI and other anthropometric data were completed on 400 breast cancer cases and 400 controls. The controls were frequency-matched to the cases by age. RESULTS: BMI at diagnosis was positively correlated with the risk of breast cancer among postmenopausal women (P<.001 for trend). When compared with women with a low BMI (<19), women with a BMI of 23-27 and 27-31 had a 1.7-fold (95% CI, 1.1-2.9) and 2.1-fold (95% CI, 1.1-3.9) increased risk of breast cancer, respectively, after adjustment for non-anthropometric risk factors. BMI at diagnosis was not related to the risk of breast cancer among premenopausal women. The odds ratios for premenopausal women with a BMI of 23-27 and 27-31 were 1.5 (95% CI, 0.8-2.8) and 1.3 (95% CI, 0.4-4.5), respectively. Furthermore, present BMI was not associated with breast cancer risk in either pre- and postmenopausal women. CONCLUSIONS: Weight control in obese women may be an effective measure of breast cancer prevention in postmenopausal women.

Physical activity reduces breast cancer risk: a case-control study in Tunisia.

PURPOSE: This study examined the relationship between lifetime history of physical activity and breast cancer risk. METHODS: The case-control study was conducted on 400 women with histological confirmed breast cancer operated during the 2006-2009 period at Farhat Hached University Hospital, Sousse, Tunisia, and 400 cancer-free controls, aged 25-75 years. The physical activity was assessed using a structured questionnaire on each activity: type, duration, frequency, and intensity. Odds ratios (ORs), 95% confidence intervals (CI) and a full confounding assessment, included in this analysis, were derived using logistic regression. RESULTS: These cases had lower lifetime averages for total physical activity for both forms of activity measurements (hours/week/year and MET-hours/week/year) and (P(trend)<0.001 and P(trend)=0.002, respectively). Significant risk reductions were found in total physical activity for both forms of activity measurements (OR=0.27, 95% CI: 0.18-0.52, OR=0.42, 95% CI: 0.26-0.73, respectively) for the highest versus the lowest level of activity (P(trend)=0.001 and 0.004, respectively). The stratification by menopausal status showed a significant 56% reduction in breast cancer risk for post-menopausal women (P(trend)=0.001, adjusted for age). The risk was further reduced to 68% (P(trend)=0.002, multivariate adjusted). Among pre-menopausal women, the total physical activity was not significantly associated with reduced risk, ORs were 0.88 (95% CI: 0.40-1.99, age adjusted) and 0.43 (95% CI: 0.12-1.38, multivariate adjusted). CONCLUSION: These data are in concordance with the majority of previous reports which involved physical inactivity as an important risk factor for breast cancer.

WITHDRAWN: Physical activity reduces the risk of breast cancer: a case-control study in Tunisian population.

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Breastfeeding reduces breast cancer risk: a case-control study in Tunisia.

In this report, we examined the relationship between mother's breastfeeding history and her risk of breast cancer, in a case-control study in Tunisia between 2006 and 2009. About 400 breast cancer cases and 400 controls were included. Cases and controls were interviewed using a standardized structured questionnaire to obtain information on breastfeeding and other risk factors. Mean duration of breastfeeding per child was significantly associated with a reduced risk of breast cancer for women who breastfed for > 24 months per child. The OR was 0.46 (95% CI, 0.28-0.76) when compared those who breastfed for < 6 months. The test for trend was significant (p = 0.01). A significantly reduced risk of breast cancer was found for those whose lifetime duration of breastfeeding was 73-108 months (OR = 0.65, 95% CI, 0.36- 1.18) and for those who breastfed for > or = 109 months (OR = 0.42, 95% CI, 0.20-0.84). Stratification by menopausal status showed a reduced risk of breast cancer associated with a longer duration of breastfeeding for both pre- and postmenopausal women. The risk reduction was more consistent for lifetime duration of breastfeeding, the test for trend being significant for both pre- (p = 0.03) and postmenopausal (p = 0.01) women. These results support an inverse association between breastfeeding and breast cancer risk.

Clinical and Pathological Response to Neoadjuvant Anthracycline Based Chemotherapy in women with breast cancer.

BACKGROUND: Neoadjuvant chemotherapy has been used as a primary treatment for locally advanced or inflammatory breast cancer, and recently extended to operable breast cancer. The aim of this study was to evaluate the predictive value of different histologic factors in breast cancer treated with neoadjuvant anthracycline chemotherapy in Tunisian women. METHODS: A total of 109 stage II and III breast cancer patients who received neoadjuvant anthracycline chemotherapy were enrolled in this study. Using pretreatment biopsy materials, histologic grade was recorded and immunohistochemical studies were performed for estrogen receptor, progesterone receptor and Her2neu. We analyzed the associations among this histologic factors and clinical and pathological complete response. Statistical analysis used is SEM logiciel. RESULTS: The overall clinical response was 63% (clinical partial response in 49% of cases and clinical complete response in 14% of cases). The pCR was 7%; in univariate analysis, clinical response rate by each factors were as follows: 63% in ER-positive tumors, 84% in ER-negative (P = 0.2), 59% in PgR-positive, 62% in PgR-negative (P = 0.3), 64% in HER2-positive, 62% in HER2-negative (P = 0.6), 60% in tumors of low nuclear grade and 63% in ones of high nuclear grade (P = 0.9). CONCLUSIONS: Biological markers that reliably predict clinical and pathological response to primary systemic therapy may have considerable clinical potential. The future of neoadjuvant therapy lies in tailoring treatment to individual patients by identifying response predictors.

Metastatic hidradenocarcinoma: Surgery and chemotherapy.

CONTEXT: Hidradenocarcinoma is a rare carcinoma of high malignant potential. It most metastasizes to regional lymph nodes and distant viscera. CASE REPORT: We report a case of 52-year-old woman who presented with an invasive hidradenocarcinoma of the finger, treated with surgical excision. The patient presented with skin and lymph node metastases four years after, treated by chemotherapy. CONCLUSION: Hidradenocarcinoma is an aggressive tumor. It seems important to use adjuvant therapies particularly for recurrent and metastatic forms.