الفهرس 
INTRODUCTIONOnly 14 pages are availabe for public view
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Abstract
from January 2000 to December 2009 (10 years) ACOD participated in the treatment of 25508 cancer patients. The total number of breast cancer patients was 4316 which accounted for 17% of total number of malignancies. the total number of patients that were classified as early breast cancer was 619 which accounted for 14.3% of total number of breast cancer patients.
The aim of this retrospective study was to review the files of all patients with early stage breast cancer presented to Clinical Oncology and Nuclear Medicine Department, Alexandria Main University Hospitals during the same period to study their demographic data and clinicopathological features as well as the treatment lines received by these patients (local and systemic lines of treatment) and assess the treatment results (diseases free survival, overall survival).
In the current study, Patients age ranged from 23 to 80 years, with a mean age 50.2years .The age group 46-55 was the most common age group at presentation (38.6%), 48 % of patients were postmenopausal while premenopausal and perimenopausal patients were 36.5% and 3.9% respectively,64.6% were parous women and only 5% were nulliparous. Negative family history was recorded in 28.1% of patients, while positive family history for breast cancer was recorded in 7.8% and for other cancers in 1.1 %.
The most common clinical presentation in the study population was breast mass in 93.5% of patients, accidental discovery was reported by 2.7%, both breast mass and regional lymph nodes were reported by 2.6%, while regional lymph node only was reported by only 1.1%.
As regarding pathological data, IDC was seen in 93.4% of the patients, while ILC was seen in 12.4%, mixed IDC and ILC was seen in 2.3%, while rare types were seen in the rest of the study population. Grade I/II tumors were the most common grade representing 71.1%, grade III represented 14.1%, while unknown grade represented 14.9% of the patients. Tumor size 2-5 cm (T2) accounted for 69.8%,while tumor size ≤ 2 cm (T1) and > 5 cm (T3) accounted for 26.3% and 3.9% patients respectively. Patients with 1-3 lymph nodes (N1) were more than patients with negative lymph nodes and were 52.2% and 47.8% respectively. Most of the patients were stage II disease (86.3 %) while stage I disease represented only 13.7 % of cases.
As for estrogen receptors, 66.4 % of the cases were estrogen receptors positive, while 15.2 % were estrogen receptors negative, the other 18.4 % were of unknown estrogen receptors status. While for progesterone receptors, 62% of the patients were progesterone receptors positive, 18% were negative and the remaining 20 % were unknown. Patients were further classified into endocrine responsive (ER &/or PR positive) which accounted for 68 % of cases, endocrine unresponsive (ER and PR negative which accounted for13.9% of cases, and endocrine response unknown (18.1%of cases). Data about the HER-2 status of most of the patients is not sufficient, with 91.6% of them unknown HER-2 status.
In this study ,90.5% of patients underwent mastectomy, conservative surgery was the surgical treatment of choice in only 8% of patients, and only 1.5% of patients had excision biopsy. Chemotherapy was received in 75.9 % of patients, 98.7 % of them in the adjuvant setting while only 1.3 % in the neoadjuvant setting. Most of the patients (73.8%) received FAC regimen. Hormonal treatment was received in 54.6%of patients, while 45.4% did not received any hormonal treatment. Tamoxifen was the most common drug as 91.7 % of patients received it. 71.9% of the study population received radiotherapy while 28.1 % didn’t receive any radiotherapy. The most frequent schedule was 45 GY/ 22 fractions which accounted for 67 % of patients.