الفهرس Only 14 pages are availabe for public view
 |  | from | 110 |  |  |
| | | from | 110 | | |
Abstract
Breast cancer represents one of the most common cancers among women residing in the United States and worldwide (Jemal et al., 2005).
In Egypt, breast cancer is the most common cancer among women, representing 18.9% of total cancer cases. It has been estimated to account for 35.1% in women and 2.2% in men among the Egypt National Cancer Institute (NCI) series of 10556 patients during the year 2001 (Elatar, 2001). It is one of the oldest known forms of cancer tumors. The oldest description of cancer (although the term cancer was not used) was discovered in Egypt and dates back to approximately 1600 BC. The Edwin Smith Papyrus describes 8 cases of tumors or ulcers of the breast that were treated by cauterization, with a tool called ”the fire drill.” The writing says about the disease, ”There is no treatment.” (American Cancer Society, 2006 ).
As a result of increased screening, the majority of patients now present with early-stage breast cancer. In 1995, 56.2% of all breast cancer cases were stage 0 or 1 compared with 42.5% in 1985 (Bland et al., 1998).
Prognostic factor is any measurement available at the time of surgery that correlates with disease-free or overall survival in the absence of systemic adjuvant therapy and, as a result, is able to correlate with the natural history of the disease. In contrast, a predictive factor is any measurement associated with response to a given therapy. (Cianfrocca and Goldstein, 2004).
On multivariate analysis, the tumor stage, the number of metastatic axillary lymph nodes and high nuclear grade were thought to be the most important prognostic factors. (Kyoung et al., 2005).
Estrogen receptor and progesterone receptor status in the primary tumor is a powerful factor for predicting endocrine responsiveness. Patients with receptor-positive cancer have a better prognosis than those whose cancer is receptor-negative. (DeVita et al., 2001).
Human epidermal growth factor receptor (HER2/neu) is a biologic tumor marker detected in 25% of breast cancer cases. Its over-expression correlates with more aggressive behavior of the tumor.