Background: Breast cancer is the most common cancer in Iraq and the United Kingdom. While the disease is frequently diagnosed among middleaged Iraqi women at advanced stages accounting for the second cause of cancer-related deaths, breast cancer often affects elderly British women yielding the highest survival of all registered malignancies in the UK. Objective: To compare the clinical and pathological profiles of breast cancer among Iraqi and British women; correlating age at diagnosis with the tumor characteristics, receptor-defined biomarkers and phenotype patterns. Methods: This comparative retrospective study included the clinical and pathological characteristics of (1,940) consecutive female patients who were diagnosed with invasive breast cancer from 2014 to 2016 in Iraq (Medical City Teaching Hospital, Baghdad: 635 cases) and UK (John Radcliffe, Oxford and Queen's, BHR University Hospitals: 1,305 cases). The studied parameters in both groups comprised the age of the patient at the time of diagnosis, breast cancer histologic type, grade, tumor size, lymph node status, clinical stage at presentation, Estrogen Receptor (ER), Progesterone Receptor (PR) and HER2 positive tumor contents and the receptor defined breast cancer surrogate subtypes. Results: The Iraqi patients were significantly younger than their British counterparts and exhibited higher trend to present at advanced stages; reflected by larger size tumors and frequent lymph node involvement compared to the British (p<0.00001). They also had worse receptor-defined breast cancer subtypes manifested by higher rates of hormone receptor (ER/PR) negative, HER2 positive tumor contents, Triple Positive and Triple Negative phenotypes (p<0.00001). Excluding HER2 status, the significant differences in the clinical and tumor characteristics between the two populations persisted after adjusting for age among patients younger than 50 years. Conclusion: The remarkable differences in the clinical and tumor characteristics of breast cancer between the Iraqi and British patients suggest heterogeneity in the underlying biology of the tumor which is exacerbated in Iraq by the dilemma of delayed diagnosis. The significant ethnic disparities in breast cancer profiles recommend the prompt strengthening of the national cancer control plan in Iraq as a principal approach to the management of the disease.
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 MoreAbstract
The research aimed to test the relationship between the size of investment allocations in the agricultural sector in Iraq and their determinants using the Ordinary Least Squares (OLS) method compared to the Error Correction Model (ECM) approach. The time series data for the period from 1990 to 2021 was utilized. The analysis showed that the estimates obtained using the ECM were more accurate and significant than those obtained using the OLS method. Johansen's test indicated the presence of a long-term equilibrium relationship between the size of investment allocations and their determinants. The results of th
... Show MoreTo achieve the goals, the researcher followed the design of equal and independent groups of partial control and post-test . The research has chosen the Institute of Fine Arts in the area Almansour area as deliberate sample where three sections of students have been chosen and the number of students is (69) students. The researcher conducted equivalence in the variables (age, and IQ , and the overall rate for grade III). in diagnostic phase, (21) concepts of alternative image out of (46) concepts have been identified in addition to the goals of formulation of acquisition concepts according to the three processes (definition, discrimination and application). Achievement test has been
... Show MoreThis research dealt with the subject of negotiation skills of employees in public relations departments which is one of many skills supposed to be available to these employees. These skills combined help in the success of the job of public relations departments; and give them an important and vital role within the roles distributed in the departments of any government institution wither is governmental or non-governmental.
Negotiation is a skill that requires intelligence, tact, culture, information, intuition, and knowing to use the means of communication to access the information that is useful in reaching satisfactory results
... Show MoreThe research aimed to study the financial markets liquidity and returns of common stocks , Take the research the theoretical concepts associated with each of the liquidity of financial markets and returns of common stocks , As well as the use of mathematical methods in the practical side to measure market liquidity and Stocks Return, the community of research in listed companies in Iraqi stock exchange that have been trading on its stock and number 85 joint-stock company, The research was based to one premise, there is a statistically significant effect for the liquidity of the Iraqi stock exchange on returns of common stocks to traded companies in which , Using th
... Show MoreComparison is the most common and effective technique for human thinking: the human mind always judges something new based on its comparison with similar things that are already known. Therefore, literary comparisons are always clear and convincing. In our daily lives, we are constantly forced to compare different things in terms of quantity, quality, or other aspects. It is known that comparisons are used in literature in order for speech to be clear and effective, but when these comparisons are used in everyday speech, it is in order to convey the meaning directly and quickly, because many of these expressions used daily are comparisons. In our research, we discussed this comparison as a means of metaphor and expression in Russia
... Show MoreThe study of history has begun to become increasingly important for those interested in the field of education in general, and physical education and sports sciences in particular. It is a recent study of the past and relying on it. Therefore, studying the history of sports for people with disabilities and their development is of great importance, as it is one of the means to measure the extent of development of societies and their culture in this field. Weightlifting is a sport for people with motor disabilities, and the way to play is for the contestant to lie on the bench (ping bar) and most often the legs are tied to the bench to ensure that the hip and legs do not contribute to the lifting process with the arms, when the player grabs t
... Show More