Fibro-adenoma is the most common lesion of the breast, it occurs in25%of asymptomatic women (1,2 )
It is usually a disease of early reproductive life, the peak incidence is between the ages15 and 35 years.(3,4) It presents as firm highly mobile, non tender mass .(5)
Less than 5% of fibro-adenomas grow rapidly and display the clinical and histologic characteristics of giant fibro-adenoma which is defined as a-tumour either having a diameter greater than 5 cm. And /or amass weighing more than 500 grams, and are conventionally a benign tumor of breast.(6)
Giant fibro-adenomas appear as well-circumscribed but not encapsulated masses on mammography and solid and the texture is homogenous and hypoechoic with low level echoes on U/S. (6, 7)
It is hormone dependent that lactates during pregnancy and involutes along with the rest of the breast in perimenopause.(5)
Excessive estrogen stimulation and /or receptor sensitivity, or lack of estrogen antagonist havebeen implicated in the etiology. (2)
Giant fibro-adenoma is often confined to one breast as a solitary mass occupying part or the whole breast and in rare cases it may be multifocal and involve both breasts. (8)
Giant fibro-adenomas are benign and do not become malignant. (9)
Histological cut surfaces have a lobulated grey-white myxoid semitransparent to dens fibrous appearance, it consist of epithelial and fibrous components, the pericanalicular fibro-adenoma maintains round and oval dilated ductal spaces whereas in the intracanalicular type the ductal lumens are compressed by polypoid fibrous stroma creating slit –like irregular spaces , the ducts are lined by two layers of cells: epithelial and myoepithelial cells and under influence of hormones the ducts become hyper plastic with papillary formation and more than two layers of cells varies from myxoid and hypo cellular to fibrous and moderately cellular . (2)
Surgical treatment of giant fibroadenoma ranges from shelling the tumour out in case it occupies part of the breast, to simple mastectomy. (10)
Historic cities such as Old Najaf are challenged with balancing the preservation of their cultural and architectural heritage against the pressures of modern urban development. Being one of the major religious centers for Shia Islam, Old Najaf receives annual millions of pilgrims and tourists, pressuring its infrastructure and threatening its historic façade. The aim of this study was to explore the viability of integrated approaches that balance heritage conservation with sustainable urban development, and lessons learned from international best practices, as well as stakeholder perspectives on this issue in the face of these challenges. This prompted the study to identify the challenges and opportunities for the heritage preservation and
... Show MoreAchieving an accurate and optimal rate of penetration (ROP) is critical for a cost-effective and safe drilling operation. While different techniques have been used to achieve this goal, each approach has limitations, prompting researchers to seek solutions. This study’s objective is to conduct the strategy of combining the Bourgoyne and Young (BYM) ROP equations with Bagging Tree regression in a southern Iraqi field. Although BYM equations are commonly used and widespread to estimate drilling rates, they need more specific drilling parameters to capture different ROP complexities. The Bagging Tree algorithm, a random forest variant, addresses these limitations by blending domain kno
The research discusses the public relations services, registration, and academic advising at Petra University for the years 2013-2014. Using a field study and surveying Petra University students to be informed about the services and to cover the tiny details that have to do with public relations role in the university as a specialized department interested in serving public and gaining their trust in terms of what is legal and possible to build and enhance the university reputation. And gain mutual trust between the university and its publics.
The public relations is consi
The research aimed to achieve many objectives represented in two variables, which are the impacted factors and the aggregate planning alternatives of workforce in Educational Al- yarmouk Hospital , This research started from a problem focused on finding solutions to the demand’s fluctuation or the energy limitation while the study importance is emerged from diagnosis the suitable strategy and adopt the suitable alternatives due to their importance in meeting the demand for the health service submitted by the hospital .This study based on choosing assumptions of connection relationship and the impact among the mentioned variables in the(surgery and internal diseases) departments. The research is dependent on ch
... Show MoreThe negotiation phase is gaining great importance in investment loans due to the magnitude of the amounts awarded and the need to obtain adequate lending guarantees and the development of better conditions, and this requires that negotiating policy with fixed principles that balance between meeting the demands of customers and maintain market share and achieve profits and avoid defaults and losses the bank, and so I have touched Find the concept of investment loans and procedures for granting and the concept of the negotiation process for the granting of loans. The practical side to ensure the preparation of examination form consists of questions commensurate with the methodology developed by the researchers, were directed to the officia
... Show MoreThe permeability estimates for the uncored wells and a porosity function adopting a modified flow zone index-permeability crossplot are given in this work. The issues with implementing that approach were mostly crossplots, due to the influence of geological heterogeneity, did not show a clear connection (scatter data). Carbonate reservoir flow units may now be identified and characterized using a new approach, which has been formally confirmed. Due to the comparable distribution and flow of clastic and carbonate rock fluids, this zoning method is most effective for reservoirs with significant primary and secondary porosity. The equations and correlations here are more generalizable since they connect these variables by combining cor
... Show MoreThe purpose of this study is to examine the dimensions of strategic intent (SI; see Appendix 1) according to the Hamel and Prahalad model as a building for the future, relying on today’s knowledge-based and proactive strategic directions of management as long-term and deep-perspective creative directions, objective vision and rational analysis, integrative in work, survival structure and comprehensiveness in perception.
The quantitative approach was used based on research, detection and proof, as data were collected from leader
This research aims to identify and measure the role of TQM in the process of developing the financial performance of Diyala State Company and show the reality and obstacles, after applying the company's management to the requirements of ISO 9001: 2008 and compare it with its performance before applying this standard, The researcher measured the financial performance by conducting financial analysis of the financial statements and conducting a number of interviews at the company's headquarters, Diyala State Company (one of the Iraqi Ministry of Industry and Minerals formations) was sele
... Show MoreThe neutrophil/ lymphocyte ratio (NLR) and platelet/lymphocyte ratio (PLR) have the potential to be inflammatory markers that reflect the activity of many inflammatory diseases. The aim of this study was to evaluate the NLR and PLR as potential markers of disease activity in patients with ankylosing spondylitis.
The study involved 132 patients with ankylosing spondylitis and 81 healthy controls matched in terms of age and gender. Their sociodemographic data, disease activity scores using the Bath Ankylosing