Inflammatory Breast Cancer in Tunisia from 2005 to 2010: Epidemiologic and Anatomoclinical Transitions from Published Data

Aim: To report epidemiologic and anatomoclinical transitions of inflammatory breast cancer (IBC) in Tunisia.Materials and
Methods: Data including clinico-pathological data for208 cases of T4d or PEV 3 non-metastaticbreast cancer diagnosed between 2005 and 2010 were collected from patient records. Chi2 and Z tests were usedto compare variables with two Tunisian historical series and a series about Arab-American patients.
Results:Thirty three percent of our patients had their first child before 23 years of age and 56% had their menarchebefore 12 years, 75% never receiving oral contraception. Obesity was observed in 42% of women and IBCoccurred during pregnancy in 13% of cases. Tumor grade was II-III in 90% of cases, HR was negative in 52%,HER2 was over expressed in 31% and invasion of more than 3 axillary nodes occurred in 18% of patients.We observed a pCR rate of 19% after neoadjuvant treatment (anthracyline-taxane used in 79%, trastuzumabin 27% ). Compared to historical Tunisian series (since 1996), IBC epidemiology remained stable in terms ofmedian age, menopausal status and obesity. However we observed a significant decrease in median clinical tumorsize and number of positive axillary lymph nodes. Comparison to IBC in Arab-Americans showed a significantdifference in terms of median age, menopausal status, positivity of hormonal receptors and educational level.
Conclusions: Our assessment of epidemiologic transition showed a reduction of clinco-pathological stage of IBC,keeping the same characteristics as compared to Tunisian historical series over a period of 14 years. Featuresseem to be different in Arab-American patients, probably related to migration, “occidentalization” of life styleand improvement in socio-economic level