Breast Carcinoma in Younger Algerian Eastern Women: Epidemiological Profile in Series of 135 Cases

Abstract: Background: Actually, Breast cancer constitutes one of the most health problems in Algeria, and the leading cause of death among Algerian women. Breast cancer in young women is a rare form, but it has an aggressive behavior associated with a poor prognosis. Aims: this study focuses to report breast cancers phenotype in Algerian younger women. Material and methods: In order to better understand the determinants and tumor biology may explain earlier onset and aggressive breast cancers characteristics in Algeria from December 2011 to July 2014, 135 patients aged 40 years and under diagnosed with breast cancer were included in the study. Results: One hundred thirty-five women recorded, 65.9% patients were aged between 36-40 years. The mean age was 36.29 years. A significantly higher proportion of women were overweight or obese (62.9%). 75.6% patientshad full-term pregnancy. 29.6% breast cancers were diagnosed during pregnancy or after childbirth. 34.1% patients had a family history. In 87.4% of cases the revealing sign was nodule self-examination. Stage II and III associated with nodal extension, higher pathological grade, HR positive, were predominant. Neo-adjuvant was administered to 17.8%. 74.1%patients underwent radical mastectomy using Patey technique with complete axillary dissection.40.7% patients had distal metastases after diagnosis. The mean clinical tumor size was 4.88 cm.71.1% of tumors were invasive ductal carcinoma.69.9% patients had no family history. Conclusion: Breast tumors among Algerian young women are advanced with poor prognosis

Contribution of BRCA1 and BRCA2 Germline Mutations to Early Algerian Breast Cancer

International audienceBreast cancer is the most common female malignancy and the leading cancer mortality cause among Algerian women. Germline mutations in the BRCA1 and BRCA2 genes in patients with early-onset breast cancer have not been clearly identified within the Algerian population. It is necessary to study the BRCA1/2 genes involvement in the Algerian breast cancer occurrence. We performed this study to define germline mutations in BRCA1/2 and their implication in breast cancer among young women from eastern Algeria diagnosed or treated with primary invasive breast cancer at the age of 40 or less who were referred to Anti-Cancer Center of Setif, Algeria. Case series were unselected for family history. Eight distinct pathogenic mutations were identified in eight unrelated families. Three deleterious mutations and one large genomic rearrangement involving deletion of exon 2 were found in BRCA1 gene. In addition, four mutations within the BRCA2 gene and one large genomic rearrangement were identified. Novel mutation was found among Algerian population. Moreover, five variants of uncertain clinical significance and favor polymorphisms were identified. Our data suggest that BRCA1/2 mutations are responsible for a significant proportion of breast cancer in Algerian young women

Early onset breast cancer: differences in risk factors, tumor phenotype, and genotype between North African and South European women

International audiencePURPOSE: This report compares the risk factors, the tumor phenotypes, and the BRCA1/BRCA2 genotype of early onset breast cancer (EOBC) patients between Southern Europe and North Africa. METHODS: Four hundred and fifty six women with invasive EOBC (<=40~years) were prospectively included from four centers in France (n~=~270) and four centers in North Africa (Algeria, Egypt, Morocco, Tunisia; n~=~186). Life style, tumor phenotype, familial history, BRCA1/BRCA2 genotype were compared between the two populations. RESULTS: We found an older age at menarche, a higher number of childbearing, a more frequent breastfeeding, a higher body mass index, a lower use of oral contraceptives in North African women compared to French women. TNM stage at diagnosis was higher in North African women than in French women. North African women had a lower incidence of triple negative and proliferative (Ki 67 index~\textgreater~20%) tumors. There was a lower rate of BRCA1 mutation in North Africa (7 vs. 15%, P~=~0.02). Three putative BRCA1/2 founder mutations were identified in North Africa. CONCLUSIONS: In EOBC, we found~significant differences in risk factors, phenotype and a higher incidence of BRCA1 mutations in Southern Europe as compared to North Africa. The worst prognosis previously reported for EOBC in North Africa is more likely due to a higher stage at diagnosis than to a more aggressive phenotype, since triple negative tumors are more common in Southern Europe and advanced tumors in North Africa

Low incidence of SARS-CoV-2, risk factors of mortality and the course of illness in the French national cohort of dialysis patients

International audienceThe aim of this study was to estimate the incidence of COVID-19 disease in the French national population of dialysis patients, their course of illness and to identify the risk factors associated with mortality. Our study included all patients on dialysis recorded in the French REIN Registry in April 2020. Clinical characteristics at last follow-up and the evolution of COVID-19 illness severity over time were recorded for diagnosed cases (either suspicious clinical symptoms, characteristic signs on the chest scan or a positive reverse transcription polymerase chain reaction) for SARS-CoV-2. A total of 1,621 infected patients were reported on the REIN registry from March 16th, 2020 to May 4th, 2020. Of these, 344 died. The prevalence of COVID-19 patients varied from less than 1% to 10% between regions. The probability of being a case was higher in males, patients with diabetes, those in need of assistance for transfer or treated at a self-care unit. Dialysis at home was associated with a lower probability of being infected as was being a smoker, a former smoker, having an active malignancy, or peripheral vascular disease. Mortality in diagnosed cases (21%) was associated with the same causes as in the general population. Higher age, hypoalbuminemia and the presence of an ischemic heart disease were statistically independently associated with a higher risk of death. Being treated at a selfcare unit was associated with a lower risk. Thus, our study showed a relatively low frequency of COVID-19 among dialysis patients contrary to what might have been assumed