Background: Breast cancer is the most common malignancy affecting the Iraqi population and the leading cause of cancer related mortality among Iraqi women. It has been well documented that prognosis of patients depends largely upon the hormone receptor contents and HER-2 over expression of their neoplasm. Recent studies suggest that Triple Positive (TP) tumors, bearing the three markers, tend to exhibit a relatively favorable clinical behavior in which overtreatment is not recommended. Aim: To document the different frequencies of ER/PR/HER2 breast cancer molecular subtypes focusing on the Triple Positive pattern; correlating those with the corresponding clinico-pathological characteristics among a sample of Iraqi patients diagnosed with the disease. Patients and Methods: This retrospective study involved 570 female patients diagnosed with breast cancer who visited the Main Referral Center for Early Detection of Breast Cancer and the National Cancer Research Center. The requested data was mainly extracted from an established information system database, developed by the principal author over a 4-years period from 2012 to 2016. The registered information comprised data related to clinical presentation, diagnostic and pathologic findings. ER, PR and HER2 status were analyzed immunohistochemically and the detected profiles were correlated with the corresponding clinico-pathological characteristics. Results: The rates of ER (+), PR (+) and HER-2 (+) tumors were 66.8%, 64% and 29.3% respectively. The tumor marker expression status was documented in eight subtypes; 83 cases (14.6%) of the examined breast carcinomas were categorized as ER+/PR+/HER2+ (Triple Positive/Luminal B), 89 cases (15.6%) were ER-/PR-/HER2- (Triple Negative), 241 (42.2%) were ER+/PR-/HER2- (Luminal A) while 67 (11.8%) showed ER-/PR-/HER2+ expression (HER-2 variant). No significant variations were noted when comparing age, menopausal status and tumor grade of Luminal B pattern to Luminal A and the rest of the studied subtypes. Although our data revealed a statistical difference with respect to the distribution of tumor types; where infiltrative ductal carcinoma constituted the major histology among patients with Triple Positive/Luminal B subtype (86.7% as compared to 67.6% in Luminal A), nevertheless, more than two third of those patients (67.4%) were diagnosed at earlier stages (I and II) compared to 55.2% of those in the remaining groups. Conclusions and Recommendations: Our findings support the hypothesis that the Triple Positive subtype might be driven primarily by the hormone receptor status. Further comprehensive surveys are recommended to focus on the intrinsic interactions and tumor cell heterogeneity of that pattern to avoid overtreatment and predict accurate response to therapy.
Abstract
The current research problem includes a variety of research motivations to serve the private health sector, which is witnessing a great competition from internal and external environments. In this regard, private medical clinics are increasingly seeking to attract and retain customers through the quality of their service offerings represented by health services. Innovative and effective marketing methods to improve performance and stay in competition, by relying on the physical evidence of the product as a component of the marketing mix of services and its role in particular in packaging and supporting the health service with concrete evidence that affects the customer an
... Show MoreThis research aims to clarify the role of Information Technology Competency (ITC) with dimensions' (IT Usage, IT Knowledge, and IT Operations) as an independent variable in the activation of Human Resources Management Practices (HRM Practices) as a dependent variable with dimensions' (Training and Development, Recruitment, Job Design, and Performance appraisal). Based on this, the correlation and effect relationships between the independent and dependent variables are determined by formulating two main hypotheses. There are a significant relationship and effect of IT competency with HRM practices within the dimensions. Furthermore, the scope and population of this research are the Informatics and Communications P
... Show More
Objectives: The study aimed to clarify the role of Al-Sayyid Al-Ajall and his family in the service of the Mongol Empire. They worked to develop its administrative and military institutions, benefiting from their extensive experience in administration, politics, economics, and urban affairs. Due to their capabilities, they received the patronage of Genghis Khan and subsequent generations, earning the confidence of the ruling Mongol authority. As a result, they were granted significant powers within the state. Methods: The study relied on the analytical method to analyze historical texts, compare them with others, and discuss them accurately. Results: The study yielded several results, including the minister's keen interes
... Show MoreIn this study, the Halder-Wagner method was used for an analysisX-ray lines of Tio2 nanoparticles. Where the software was used to calculate the FWHM and integral breath (β) to calculate the area under the curve for each of the lines of diffraction. After that, the general equation of the halder- Wagner method is applied to calculate the volume (D), strain (ε), stress (σ), and energy per unit(u). Volume (β). Where the value of the crystal volume was equal to (0.16149870 nm) and the strain was equal to (1.044126), stress (181.678 N / m2), and energy per unit volume (94.8474 J m-3).The results obtained from these methods were then compared with those obtained from each of the new paradigm of the HalderWagner method, the Shearer developm
... Show MoreThe properties of capturing of peristaltic flow to a chemically reacting couple stress fluid through an inclined asymmetric channel with variable viscosity and various boundaries are investigated. we have addressed the impacts of variable viscosity, different wave forms, porous medium, heat and mass transfer for peristaltic transport of hydro magnetic couple stress liquid in inclined asymmetric channel with different boundaries. Moreover, The Fluid viscosity assumed to vary as an exponential function of temperature. Effects of almost flow parameters are studied analytically and computed. An rising in the temperature and concentration profiles return to heat and mass transfer Biot numbers. Noteworthy, the Soret and Dufour number effect resul
... Show MoreA new ligand [ 2-chloro-N- (1,5-dimethyl-3-oxo-2-phenyl-2,3-dihydro -1H-pyrazol- 4- ylcarbamothioyl)acetamide](L) was synthesized by reacting the Chloro acetyl isothiocyanate with 4-aminoantipyrine,The ligand was characterized by(C HNS) elemental microanalysis and the spectral measurements including Uv-Vis ,IR ,1H and13C NMR spectra, some transition metals complex of this ligand were prepared and characterized by Uv-Vis, FT-IR spectra, conductivity measurements, magnetic susceptibility and atomic absorption. From the obtained results the molecular formula of all prepared complexes were [M(L)2(H2O)2]Cl2 (M+2 =Mn, Co, Ni, Cu, Zn, Cd and Hg),the proposed geometrical structure for all complexes were octahedra
This research aims at the possibility of rationalizing business organizations according to the strategic planning directions which have been developed to deal with many problems faced by business organizations, including the General Company for Automobile and Machinery Trade which was chosen as a research society, and several research problems were diagnosed, including an increase in the numbers of employees who constitute hidden unemployment, lack of work in the system of job specialization, and the organizational structure which is the non-application of the company to a modern administrative model. The importance of the research is that the company being investigated is a pioneer in its field of work and seeks to achieve custo
... Show MoreBackground: The anterior loop of mental nerve is commonly described as that part of the neurovascular bundle that transverses anterior and inferior to the mental foramen only to loop back to exit the mental foramen. The aim of the study is to evaluate the incidence and extension of anterior loop of mental nerve by using digital panoramic imaging system to avoid nerve damage during different surgical procedures in dentistry. Materials and Method: Panoramic image was taken for all 400 patients and stored in the computer. Then Horizontal and Vertical for the anterior loop extension when exist was measured and recorded in a special case sheet prepared for each subject. Results: Results indicated that out of 400 patients there were only 25 pat
... Show More