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Ocular manifestations as the initial presentation of plasmablastic lymphoma: a diagnostic challenge and review of literature

Ali MatarAlzahrani¹, Eman Al Mussaed ², Waleed Al Bissi³, Mohamed RajebHabibullah³, Sultan Alotaibi⁴ and Ghaleb Elyamany^{3, 5} *

¹ Department of Oncology, Prince Sultan Military Medical City, Riyadh, Saudi Arabia

²Department of Basic Science, Hematopathology Division, Princess NourahBintAbdulrahman University, College of Medicine, Riyadh, Saudi Arabia

³ Department of Central Military Laboratory and Blood Bank, Prince Sultan Military Medical City, Riyadh, Saudi Arabia

⁴Department of Adult Clinical Hematology and Stem cell Therapy, Prince Sultan Military Medical City, Riyadh, Kingdom of Saudi Arabia

⁵Department of Hematology, Theodor Bilharz Research Institute, Giza, Egypt

ghalebelyamany@yahoo.com

Abstract: Plasmablastic lymphoma (PBL) is a rare aggressive mature B-cell neoplasms, frequently involving the jaw and oral mucosa in HIV-positive patients, however, a number of cases have been reported in extra-oral sites. HIV-negative PBL has not been extensively reported. Overall, the oral cavity represents the primary site of origin in 51% of the cases, while 20% of extra-oral PBL involve the lymph nodes. PBL remains a diagnostic challenge due to its peculiar morphology and an immunohistochemical profile similar to plasma cell myeloma. PBL is also a therapeutic challenge with a clinical course characterized by a high rate of relapse and death. There is no standard chemotherapy protocol for treatment of PBL; however, cyclophosphamide, doxorubicin, vincristine, and prednisone (CHOP), or CHOP-like regimens have been the back bone while more intensive regimens are possible options. Although PBL has been reported from countries across the world, including from Asian countries such as India and Thailand, few reported cases from Saudi Arabia in the English-language literature. Here, we report a rare case of PBL young male without immunodeficiency diseases, HIV negative presenting with Ocular manifestation as a first presenting feature.

[Ali Matar Alzahrani, Eman Al Mussaed, Waleed Al Bissi, Mohamed Rajeb Habibullah, Sultan Alotaibi and Ghaleb Elyamany. Ocular manifestations as the initial presentation of plasmablastic lymphoma: a diagnostic challenge and review of literature. Cancer Biology 2015;5(3):1-6]. (ISSN: 2150-1041). http://www.cancerbio.net. 1. doi:10.7537/marscbj070315.01

Key words: Plasmablastic lymphoma, eye, HIV, outcome

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Antimicrobial Activity of Extracts and Latex of Calotropis procera (Ait.) and Synergistic Effect with Reference Antimicrobials

Gomah E. Nenaah^{a *} and Essam M. Ahmed^b

^aDepartment of Zoology, Faculty of Science, Kafrelsheikh University, 33516, Kafr El sheikh, Egypt

* Corresponding author address: Department of Biology, College of Arts and Sciences, Najran University, 1988, Najran, Saudi Arabia. Email: gnenaah2000@yahoo.com

^bMicrobiology Department, Faculty of Medicine, Najran University, Saudi Arabia

Abstract: Aqueous and organic solvent extracts of the leaves, flowers and latex of Calotropis procera (Ait.) were tested for their antimicrobial activity using the disc diffusion bioassay. Results revealed a considerable antimicrobial activities of the tested extracts with the extraction solvent was a determinant factor for the extraction of antimicrobial agents. The leaf and latex methanolic extracts showed the strongest activities, where Escherichia coli, Staphylococcus epidermides, and Bacillus spp. were the most sensitive with inhibition zones reached 23.5 mm and minimal inhibitory concentrations (MIC) between 0.25-1.5 mg/ml. All extracts showed biocidal activities against all of the tested fungal strains with diameters of inhibition zones ranged between 9.0 and 26.5 mm. The latex methanolic was the most effective extract (inhibition zones ranged from 21.0-26.5 mm against Candida albicans, C. tropicalis, Penicillium chrysogenum and Saccharomyces cerevisiae). When the latex methanolic extract was added at concentrations equal ¹∕₂, ¹∕₄, ¹∕_8, ¹∕₁₆ and ¹∕₃₂ and 0 of the original MIC values, the MIC's of both Ciprofloxacin and Clotrimazole, the two antimicrobial standards, were lowered indicating a synergistic interaction between the botanical and the conventional drugs. Our findings confer the utility of extracts and/or latex of C. procera in developing a novel antimicrobial biorationals of plant origin.

[Gomah E. Nenaah and Essam M. Ahmed. Antimicrobial Activity of Extracts and Latex of Calotropis procera (Ait.) and Synergistic Effect with Reference Antimicrobials. Cancer Biology 2015;5(3):7-14]. (ISSN: 2150-1041). http://www.cancerbio.net. 2. doi:10.7537/marscbj070315.02

Keywords: Calotropis procera; Isolates; Antimicrobial activity; synergism.

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An investigation study on SNP frequency of rs1127354 and rs7270101 in ITPA gene of infertile patients

Fahime Mollaahmadi, Mehrdad Behmanesh, Ashraf Moini

Faculty of biological science, Tarbiat Modares University

FahimeMollaahmadi@chmail.ir

Abstract: Infertility is a relatively common problem that affects couples worldwide. It is estimated that approximately 1 in 6 couples will experience difficulties in reproducing, defined as a failure to conceive after two years of unprotected sexual intercourse. The molecular and genetic factors underlying the cause of infertility remain largely undiscovered. In human, ITPA, an inosine triphosphatase (ITPase), has been reported to hydrolyze (d) ITP and XTP to the corresponding nucleoside monophosphates and pyrophosphates. An understanding of the role of ITPA in human cells is important because in humans, some variants of ITPA are reported to be associated with decreased ITPase activity. The human genomic DNA of all patients was extracted from peripheral blood cells using salting out method in order to determine the single nucleotide polymorphism (SNP) of ITPA (rs1127354). SNP genotyping was performed by RFLP-PCR. This study sought to to investigate and clarify, for the first time, the understanding of this genetic association in a cohort of infertile patients. This study explored the association between inosine triphosphatase (ITPA) Functional variants; SNPs rs1127354 (missense variant in exon 2) and rs7270101 (splicing-altering SNP in second intron), and the development of infertility, and explored the relationship between ITPA variants and therapeutic response. It seems that rs1127354 / rs7270101 variants could be a genetic determinant for defective gametogenesis or decreased fertility.

[Fahime Mollaahmadi, Mehrdad Behmanesh, Ashraf Moini. An investigation study on SNP frequency of rs1127354 and rs7270101 in ITPA gene of infertile patients. Cancer Biology 2015;5(3):15-28]. (ISSN: 2150-1041). http://www.cancerbio.net. 3. doi:10.7537/marscbj070315.03

Keywords: ITPA, SNP, infertility

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Proximate And Essential Nutrient Compositions Of Momordica Charantia Plant

Egbon, E. E¹., Jimah, A². and Okojie. V. U³.

^1,3 Department of Chemistry, Faculty of Natural Sciences,Ambrose Alli, University, Ekpoma, Edo State, Nigeria.

² Department of Food Technology, Auchi Polytechnic, Auchi, Nigeria. Corresponding author:

e-mail: egheeemadgmail.com

Abstract: The need to study the potential of medicinal plants cannot be over-emphasized Momordica charantia (bitter melon) plant is often used for some medicinal purposes in traditional medicine but the food value was investigated. The nutritional compositions of momordica charantia leaf and fruit were investigated using standard analytical methods. The proximate compositions showed the percentage of moisture content (11.38 ±0.29 and 10.74 ± 0.02), ash (14.39 ±0.02 and 7.40 ± 0.1), crude fat (2.65 ±0.10 and 6.11 ± 0.05), crude fibre (16.11 ±0.04 and 13.61 ± 0.04), crude protein (21.19 ±0.52 and 27.92 ± 0.06), carbohydrate (33.94 ±0.25 and 34.22 ± 0.11) and the calorific value (244.37 and 303.55) of samples on dry weight basis while the fresh momordica charantia fruit contains 82.83 ±0.21% and 90.84 ± 0.17% moisture content on wet weight basis for the leaf and the fruit respectively. The mineral analysis showed the concentration in mg/kg of Ca (53900 ±0.30 and 7000 ±0.23), Mg (1900 ± 0.01and 1600 ±0.02), Na (400.4 ±0.04 and 45.47 ±0.02), K (6700 ±0.02 and 31900 ±0.03), P (8800 ±0.01 and 3600 ±0.01), Fe (98.00 ± 0.02 and 139.1 ±0.04), Zn (105.5 ±0.40 and 72.40±0.56) and Cu (96.51 ±0.20 and 51.00 ±0.06) of samples on dry weight basis for the leaf and fruit respectively. The study indicated the presence of nutritional components that are beneficial in addition to the purported numerous medicinal values of the plant.

[Egbon, E. E., Jimah, A. and Okojie. V. U. Proximate And Essential Nutrient Compositions Of Momordica Charantia Plant. Cancer Biology 2015;5(3):29-33]. (ISSN: 2150-1041). http://www.cancerbio.net. 4. doi:10.7537/marscbj070315.04

Keywords: momordica, medicinal plant, proximate composition, minerals, education.

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Phytochemical Evaluation Of Selected Nigerian Medicinal Plants

Egbon, E. E¹., Jimah, A².

^1. Department of Chemistry, Faculty of Natural Sciences, Ambrose Alli University, Ekpoma, Edo State, Nigeria.

^2. Department of Food Technology, Auchi Polytechnic, Auchi, Nigeria.

Corresponding author e-mail: egheeemadgmail.com

Abstract: Momordica charantia, carica papaya and palisota hirsuta leaves are often used for some medicinal purposes in traditional medicine in Nigeria. The chemical compositions of the leaves were investigated using standard analytical methods. Powdered samples of the leaves were extracted with water and ethanol respectively in order to isolate the required phytochemicals. Phytochemicals like alkaloids, tannins, flavonoids, saponins, steroids and cardiac glycosides were found present in all the leaves except saponins not present in the leaves of Palisota hirsuta. The study indicated the presence of chemical components that have medicinal values. Hence the results obtained in this study supported the use of momordica charantia, carica papaya and palisota hirsuta leaves in herbal medicine. Therefore the leaves can be further purified and used for herbal treatment of various diseases and as a potential source of useful elements for drugs formulation.

[Egbon, E. E., Jimah, A. Phytochemical Evaluation Of Selected Nigerian Medicinal Plants. Cancer Biology 2015;5(3):34-37]. (ISSN: 2150-1041). http://www.cancerbio.net. 5. doi:10.7537/marscbj070315.05

Keywords: Phytochemicals, palisota hirsuta, carica papaya, momordica charantia, herbs

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Cancer and Alcohol Research Literatures

Ma Hongbao ¹, Margaret Ma ², Yang Yan ¹

¹ Brookdale Hospital, Brooklyn, New York 11212, USA; ² Cambridge, MA 02138, USA

ma8080@gmail.com

Abstract: Cancer is the general name for a group of more than 100 diseases. Although there are many kinds of cancer, all cancers start because abnormal cells grow out of control. Untreated cancers can cause serious illness and death. The body is made up of trillions of living cells. Normal body cells grow, divide, and die in an orderly fashion. During the early years of a person’s life, normal cells divide faster to allow the person to grow. After the person becomes an adult, most cells divide only to replace worn-out or dying cells or to repair injuries. This article introduces recent research reports as references in the cancer and alcohol related studies.

[Ma H, Young M, Yang Y. Cancer and Alcohol Research Literatures. Cancer Biology 2015;5(3):38-65]. (ISSN: 2150-1041). http://www.cancerbio.net. 6. doi:10.7537/marscbj070315.06

Keywords: cancer; life; cell; medicine; biology; alcohol

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Cancer in Amrica Research Literatures

Ma Hongbao ¹, Margaret Ma ², Yang Yan ¹

¹ Brookdale Hospital, Brooklyn, New York 11212, USA; ² Cambridge, MA 02138, USA

ma8080@gmail.com

Abstract: Cancer is the general name for a group of more than 100 diseases. Although there are many kinds of cancer, all cancers start because abnormal cells grow out of control. Untreated cancers can cause serious illness and death. The body is made up of trillions of living cells. Normal body cells grow, divide, and die in an orderly fashion. During the early years of a person’s life, normal cells divide faster to allow the person to grow. After the person becomes an adult, most cells divide only to replace worn-out or dying cells or to repair injuries. This article introduces recent research reports as references in the cancer in America related studies.

[Ma H, Young M, Yang Y. Cancer in Amrica Research Literatures. Cancer Biology 2015;5(3):66-84]. (ISSN: 2150-1041). http://www.cancerbio.net. 7. doi:10.7537/marscbj070315.07

Keywords: cancer; life; cell; medicine; biology; America

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Cancer and Artemisinin Research Literatures

Ma Hongbao ¹, Margaret Ma ², Yang Yan ¹

¹ Brookdale Hospital, Brooklyn, New York 11212, USA; ² Cambridge, MA 02138, USA

ma8080@gmail.com

Abstract: Cancer is the general name for a group of more than 100 diseases. Although there are many kinds of cancer, all cancers start because abnormal cells grow out of control. Untreated cancers can cause serious illness and death. The body is made up of trillions of living cells. Normal body cells grow, divide, and die in an orderly fashion. During the early years of a person’s life, normal cells divide faster to allow the person to grow. After the person becomes an adult, most cells divide only to replace worn-out or dying cells or to repair injuries. This article introduces recent research reports as references in the cancer and artemisinin related studies.

[Ma H, Young M, Yang Y. Cancer and Artemisinin Research Literatures. Cancer Biology 2015;5(3):85-100]. (ISSN: 2150-1041). http://www.cancerbio.net. 8. doi:10.7537/marscbj070315.08

Keywords: cancer; life; cell; medicine; biology; artemisinin

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Benign Tumor Research Literatures

Ma Hongbao ¹, Margaret Ma ², Yang Yan ¹

¹ Brookdale Hospital, Brooklyn, New York 11212, USA; ² Cambridge, MA 02138, USA

ma8080@gmail.com

Abstract: Cancer is the general name for a group of more than 100 diseases. Although there are many kinds of cancer, all cancers start because abnormal cells grow out of control. Untreated cancers can cause serious illness and death. The body is made up of trillions of living cells. Normal body cells grow, divide, and die in an orderly fashion. During the early years of a person’s life, normal cells divide faster to allow the person to grow. After the person becomes an adult, most cells divide only to replace worn-out or dying cells or to repair injuries. This article introduces recent research reports as references in the benign tumor  related studies.

[Ma H, Young M, Yang Y. Benign Tumor Research Literatures. Cancer Biology 2015;5(3):101-117]. (ISSN: 2150-1041). http://www.cancerbio.net. 9. doi:10.7537/marscbj070315.09

Keywords: cancer; life; cell; medicine; biology; benign tumor

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Cancer and HIV/AIDS Research Literatures

Ma Hongbao ¹, Margaret Ma ², Yang Yan ¹

¹ Brookdale Hospital, Brooklyn, New York 11212, USA; ² Cambridge, MA 02138, USA

ma8080@gmail.com

Abstract: Cancer is the general name for a group of more than 100 diseases. Although there are many kinds of cancer, all cancers start because abnormal cells grow out of control. Untreated cancers can cause serious illness and death. The body is made up of trillions of living cells. Normal body cells grow, divide, and die in an orderly fashion. During the early years of a person’s life, normal cells divide faster to allow the person to grow. After the person becomes an adult, most cells divide only to replace worn-out or dying cells or to repair injuries. This article introduces recent research reports as references in the cancer and HIV/AIDS related studies.

[Ma H, Young M, Yang Y. Cancer and HIV/AIDS Research Literatures. Cancer Biology 2015;5(3):118-144]. (ISSN: 2150-1041). http://www.cancerbio.net. 10. doi:10.7537/marscbj070315.10

Keywords: cancer; life; cell; medicine; biology; HIV; AIDS

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Cancer and Immortal Research Literatures

Ma Hongbao ¹, Margaret Ma ², Yang Yan ¹

¹ Brookdale Hospital, Brooklyn, New York 11212, USA; ² Cambridge, MA 02138, USA

ma8080@gmail.com

Abstract: Cancer is the general name for a group of more than 100 diseases. Although there are many kinds of cancer, all cancers start because abnormal cells grow out of control. Untreated cancers can cause serious illness and death. The body is made up of trillions of living cells. Normal body cells grow, divide, and die in an orderly fashion. During the early years of a person’s life, normal cells divide faster to allow the person to grow. After the person becomes an adult, most cells divide only to replace worn-out or dying cells or to repair injuries. This article introduces recent research reports as references in the cancer and immortal related studies.

[Ma H, Young M, Yang Y. Cancer and Immortal Research Literatures. Cancer Biology 2015;5(3):145-148]. (ISSN: 2150-1041). http://www.cancerbio.net. 11. doi:10.7537/marscbj070315.11

Keywords: cancer; life; cell; medicine; biology; immortal

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Immunohistochemical B-cell markers as current prognostic factors in DLBCL patients

Fatma Z Hussein¹, Eiman A Hasby² and  Esam A abozina¹

Department of Clinical Oncology¹ and Department of Pathology², Faculty of Medicine, Tanta University

fatmaz_555@yahoo.com

Abstract: Objective: The aim of this study was to identify the prognostic and predictive relevance of CD10, BCL6 and MUM1/IRF4 rearrangements and protein expression in a sample of patients with diffuse large B-cell lymphomas (DLBCL). Methods: This retrospective study was conducted on 60 patients with DLBCL who were treated between January 2009 and September 2013 in Clinical Oncology Department of Tanta University Hospitals. All patients were evaluated by immunohistochemical (1HC) analysis for (CD10, BCL6 and MUM1/IRF4) protein expression. Based on the algorism of Hans et al 2004 patients were biologically subdivided into two groups: Germinal center B-cell (GCB) (n= 30, 50%) and non- GCB phenotypes (n=30, 50%) correlated with IP1score system using CH1-square test and survival (Failure – free and overall) (FFS & OS) using Kaplan- meier. Results: the median age of the present study population was 49.9 years. The median follow- up period was 35 months. Twenty-eight patients (28/60, 47%) were IHC staining positive for CD10, 30 patients (30/60, 50%) were IHC staining positive for BCL6 and 30 patients (30/60, 50%) were IHC staining positive for MUM1/IRF4. Both study groups were matched for age, sex, stage, and treatment protocols received. For response to treatment no significant difference in between both study groups; however, there was higher objective response rate (CR+PR) in GCB than non-GCB groups,( 74% versus 54%, P=0.309) respectively. Survival analysis based on IHC revealed that inferior outcomes in 3-year OS and FFS with non-GCB versus GCB groups (17% versus 67%, P=0.001) for OS and (44% versus 79%, P= 0.002) for FFS respectively. The statistical analysis at univariate level revealed that non- GCB subgroup did worse independent of IP1 score system. Great negative significant difference was found in the 3-year FFS of non-GCB patients with omission of target therapy (29% versus 75%. P=0.001). Conclusion: Biological markers (CD10, BCL6 and MUM1/IRF4) over protein expression were necessary for antigen receptors driven B-cell proliferation and associated with adverse prognosis and high predictive value independently of the IPI score in DLBCL patients. The number of ongoing clinical studies attests to the search for novel targeted agents tailored toward these specific molecules.
[Fatma Z Hussein, Eiman A Hasby and Esam A abozina. Immunohistochemical B-cell markers as current prognostic factors in DLBCL patients. Cancer Biology 2015;5(3):149-158]. (ISSN: 2150-1041). http://www.cancerbio.net. 12. doi:10.7537/marscbj050315.12.

Keywords: diffuse large B-cell lymphoma, Hans algorithm, germinal center B-cell like DLBCL, non-germinal center B-cell – like DLBCL, immunohisto- chemistry.

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10-Years Follow-Up of Early Breast Cancer: Experience of Zagazig University Hospital

Mostafa M. Toam, MD¹, Ahmed M. Yehia, MD² and Samah S. Sheta MD³

¹Department of Clinical Oncology and Nuclear medicine, Faculty of Medicine Zagazig University, Egypt.

²Department of Surgery, Faculty of Medicine Zagazig University, Egypt.

³Department of Industrial Medicine and Occupational Health, Faculty of Medicine Zagazig University, Egypt.

m_toam@yahoo.com

Abstract: Aim of the study: This is retrospective study was done to assess prognosis of early breast cancer and correlate this prognosis to prognostic factors. Patients and methods: This is retrospective study carried out at the clinical oncology department, Zagazig university on 351 early  breast cancer patients diagnosed and treated between 2005-2007. Results: The median follow-up was 65 months. Locoregional recurrence occured in 45 patients (12.8%) and distant metastasis occurred in 50 patients (14.2%). The DFS at 3, 5, 7, 10 years were 94.8%, 79.4%, 59.7%, 50.8% respectively. The OS at 3, 5, 7, 10 years were 95.1%, 79.5%, 60.6%, 52.4% respectively. Conclusions: The most important prognostic factor for overall survival and relapse free survival are positive LNs, tumor size, T3 and pathological grade.

[Mostafa M. Toam, Ahmed M. Yehia,. and Samah S. Sheta. 10-Years Follow-Up of Early Breast Cancer: Experience of Zagazig University Hospital. Cancer Biology 2015;5(3):159-166]. (ISSN: 2150-1041). http://www.cancerbio.net. 13. doi:10.7537/marscbj050315.13.

Key words: breast cancer, follow up

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The role of prophylactic cranial irradiation within a combined modality therapy for prevention of brain metastases in patients with stage III non-small cell lung cancer

Ahmed Z Alattar ¹, Ahmad Al-Hosainy¹, Nashwa Nawwar¹ and Inas M. Elfiki²

¹Clinical Oncology & Nuclear Medicine, Faculty of Medicine, Zagazig University Zagazig, Egypt

 ² Radiology Departments, Faculty of Medicine, Zagazig University Zagazig, Egypt

ahmedenbedo@hotmail.com

Abstract: Introduction: Prophylactic cranial irradiation (PCI) is not a standard practice in locally advanced non-small cell lung cancer (LAD-NSCLC) due to the lack of studies showing a survival benefit, and due to neurotoxicity of whole brain irradiation. The aim of PCI in LAD-NSCLC is to increase the freedom from relapse without severe toxicities. Relapse pattern and late toxicities in long term survivors were analyzed after the introduction of PCI following potentially curative treatment for LAD-NSCLC. Methods: Sixty-eight patients with stage III A/III B NSCLC were treated with induction chemotherapy (phase 1) and chemoradiotherapy (phase II). PCI was routinely offered during the second phase of the study accrual. Patients were randomized into two groups. Group A included 35 patients (who have received PCI at a total radiation dose of 30Gy (2Gy per daily fraction) over a 3 week period, starting one day after the last chemotherapy cycle, and group B included 33 patients who did not receive PCI. MRI was performed to long term survivors in both groups. Results: Introduction of PCI reduced the rate of brain metastases as first site of relapse from 38% (group B) to 10% (Group A) at 5 years (P = 0.005), and that of overall brain relapse from 58% (Group B) to 13% (Group A) (P < 0.001). The effect of PCI was also observed in the good-prognosis subgroup of patients who had a partial response or complete response to induction chemotherapy, with a reduction of overall brain relapse from 48% + 12% to 8% ± 8% at 5 years (P = 0.0005). Conclusion: PCI at a moderate radiation dose reduced brain metastases in LAD-NSCLC to a clinically significant extent, comparable to that in limited-disease small cell lung cancer.

[Ahmed Z Alattar, Ahmad Al-Hosainy, Nashwa Nawwar and Inas M. Elfiki. The role of prophylactic cranial irradiation within a combined modality therapy for prevention of brain metastasis in patients with stage III non-small cell lung cancer Cancer Biology 2015;5(3):167-177]. (ISSN: 2150-1041). http://www.cancerbio.net. 14.doi:10.7537/marscbj050315.14.

Key words: PCI, Locally advanced -NSCLC.

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Retention versus Removal of pectoralis minor in Axillary surgery for breast cancer

Ali Zedan, Haisam Atta², Adel gabr³ and Tareq Salah⁴

¹Department of Surgical Oncology, South Egypt Cancer Institute (SECI), Assiut University, Egypt.

²Department of Radiology/Oncoradiology, South Egypt Cancer Institute (SECI), Assiut University, Egypt.

³Department of Medical Oncology, South Egypt Cancer Institute (SECI), Assiut University, Egypt.

⁴Department of Clinical Oncology, Faculty of Medicine, Assiut University, Egypt.

Abstract: Background and Objectives: There has been a gradual shift away from radical surgery towards conservation treatment, for breast cancer. The pectoralis minor muscle is increasingly preserved in women undergoingaxillary clearance as part of either breast conservation or mastectomy. We compare Retention versus Removal of pectoralis minor Patients and methods: A retrospective study of 278 patients who underwent axillary clearance, 86 with (Removed Group) and 192 who had the muscle preserved (Retained Group,) operated in South Egypt Cancer Institute, Assuit University in the period from January 2005 to January 2010. Study was aiming at evaluation of operative blood loss, operative time, Immediate post operative complication, functional impairment, Atrophy and fibrosis of pectoralis major muscle, pain, neuralgia, paraesthesia, decreased range of motion of the arm or shoulder, wound infection, Seroma formation, lymphedema of the arm, 5-years relapse free survival (RFS), cancer specific survival (CSS), Recurrence rates. Results: Similar Tumour size and typein the two groups.operative time of axillary dissection (37 in Removed Group vs. 33 minutes in in Retained Group (P=.07). The mean operative blood loss was 220mL Removed Groupvs 140mL in Retained Group.breast-conserving surgery (63% Retained Group v 57% Removed Group. CSS, RFS, was 89.7% and 80.8%, respectively in Removed Group. Retained Group it was 84.5% and 78.7%., wound infection (3.48%) in Removed Group and (6.77%) in Retained Group. Incidences of seroma (5.8%) in Removed Group, and (5.2%) in Retained Group (p<0.02) the Retained Group, ROM of the shoulder (45.34%) in Removed Group and (44.27%) in Retained Group, paresthesia (33.72%) in Removed Group and (30.73%) in Retained Group, and lymphedema (4.65%) in Removed Group and (3.13%) in Retained Group, partial atrophy and fibrosis of the pectoralis major muscle in (8.14%)% of Removed Groupvs (4.27%) in Retained Group. locoregional recurrence (1.16%) in Removed Group and (1.04%) in Retained Group (P = 0.19). The mean total number of nodes 16in Removed Group and 15 in Retained Group. Conclusion For the majority of patients with operable breast cancer, retention of the pectoralis minormuscle is not associated with under staging or under treatment of the axilla.

[Ali Zedan, Haisam Atta, Adel gabr and Tareq Salah. Retention versus Removal of pectoralis minor in Axillary surgery for breast cancer. Cancer Biology 2015;5(3):178-184]. (ISSN: 2150-1041). http://www.cancerbio.net. 15. doi:10.7537/marscbj050315.15.

Keywords: Brest cancer, pectoralis minor, Axillary surgery

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The role of boost dose of radiation after whole breast irradiation in decreasing local recurrence in breast conserving therapy of early stage breast carcinoma

Ahmad M. Alhosainy¹ and Abd Elhafez M. Elshewael²

¹Clinical Oncology and Nuclear Medicine, and ²General Surgery Departments, Faculty of Medicine, Zagazyg University, Egypt.

ahosainy40@yahoo.com

Abstract: Background: Breast conserving therapy (BCT) was the recommended modality for treating early stage (I-IIB) breast carcinoma. So, decreasing late morbidity of both chemotherapy and radiation therapy becomes one of our targets for the sake of expected long survival with good quality of life. Aim of the study: The aim of this study is the evaluation of the effect of adding boost dose of radiation therapy to the tumor bed in breast conserving therapy (BCT), significantly affect local recurrence & disease free survival (DFS). Patients and methods: Thirty seven patients were included in this study (age range from 35 to 70 years, mean age 53 ± 3.84), all have an early stage breast carcinoma (stage I-II B) and treated surgically with breast conserving surgery (lumpectomy + axillary clearance level one and two lymphadenectomy), followed by adjuvant chemoradiotherapy without boost dose to tumor bed, using 3-D conformal radiation therapy this group (A) was, compared to a historical retrospective group (B), of 40 patients with the same criteria but with boost dose to tumor bed. Results: The 3-year disease free survival (DFS) was 78% in group A compared to 83% in group B (P> 0.05). On the other hand, boost dose of radiation decreases local recurrence as a cause of failure by about 5% (22% versus 17% in group A & B respectively) P > 0.05. In group A most patients who achieved local failure were below the age of 45 years (82.6%) compared to 76.2% in group B, (P > 0.05). In group B, breast fibrosis as a late effect of radiation was 11% compared to 8.73% in group A (P ³ 0.05) without statistically significant difference. Conclusion: In early stage breast cancer (I-IIB), giving a boost dose of radiation to tumor bed (12 Gy) insignificantly decreases local failure with improvement of 3-years disease free survival on the sake of increasing grade III breast fibrosis as a late radiation toxicity.

[Ahmad M. Alhosainy and Abd Elhafez M. Elshewael. The role of boost dose of radiation after whole breast irradiation in decreasing local recurrence in breast conserving therapy of early stage breast carcinoma. Cancer Biology 2015;5(3):185-190]. (ISSN: 2150-1041). http://www.cancerbio.net. 16. doi:10.7537/marscbj050315.16.

Keywords: BCT, boost radiation dose, local recurrence, DFS

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