The prevalence of breast cancer in recent years has prompted women to seek medical advice randomly with minimal breast symptoms, but only a small number of women are aware of the proper methods of conducting breast self-examination (BSE) or the importance of radiological screening for breast cancer. In the Middle East, the incidence of breast cancer is rising and affecting a younger population compared to the West. Breast cancer awareness programs (BCAP) are meant to help in the prevention and early detection of breast cancer. In the Arab world, there are very few such programs. In an attempt to develop a structured BCAP in our community and to trigger wide-scale programs, 300 women from the medical field were interviewed to be recruited as future health education providers. Subjects and MethodsThis study was carried out at King Fahd Hospital of the University, Al Khobar, in the Eastern Province of Saudi Arabia. The 300 subjects were women working in the medical field, and comprised final-year medical students, interns, nurses, technicians, pharmacists, residents and consultants. The subjects were informed about the increased incidence of breast cancer in Saudi Arabia, especially among the young female population, and were requested to fill out a questionnaire, which was designed to capture the following information: 1) demographic data, 2) family history of breast cancer, 3) performance of breast self-examination, 4) timing of breast self-examination, and 5) attitudes towards mammographic screening. ResultsThere was a 100% response rate, with all participants promptly filling in the questionnaires. The participants ranged in age from 21-58 years, with a mean age of 33.4 years. They were all aware of the gravity of breast cancer but had no background knowledge on the methods of conducting breast self-examination, or the need for mammographic screening.Of the 300 women, 78% had previously performed BSE, however, only 17.3% had performed the monthly examination at the proper time, and only 42.7% had agreed to a mammographic screening.Rating the level of knowledge about breast cancer detection methods among the subjects was also disappointing in the high-risk group. Thirty-five of the subjects (11.6%) gave a positive family history of breast cancer, yet only 10 of these (28.5%) performed the regular monthly BSE, while 20 (57%) had agreed to a mammographic screening. Such results obtained from a highly educated sector are very disturbing, especially from people working in the medical field. DiscussionBreast cancer is the most common malignancy among women internationally.2 Hormonal, environmental and genetic factors have been shown to play a role in the pathogenesis of breast cancer. It is known that the incidence of breast cancer varies in different ethnic groups, with high incidence rates being reported from North America and Europe, while figures from the Middle East have been significantly lower. However, breast cancer in this part of the world comprises the highest relative frequency rates of all cancer types, ...

The term tumefactive fibroinflammatory lesion is used to describe an unusual fibrosclerosing disorder that behaves in a malignant way clinically but is histologically benign. Lesions in the head and neck are believed to be part of the broader fibrosclerosing syndrome which include pseudotumour of the orbit, Reidel's thyroiditis, sclerosing cholangitis and mediastinal fibrosis. Clinical diagnosis is often difficult and relies heavily on histopathology. Steroid therapy is suggested as the first line of management, while surgery or radiation therapy is reserved for failures.

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Mastectomy remains the treatment of choice in many developing countries due factors influencing the early detection strategies. Post mastectomy pains is often masked by the feeling of inadequacy and shame of the mutilated body image. Phantom pain is the pain that represent the feeling of the pain of an amputated body part. With Phantom Breast Syndrome" (PBS) patients may suffer the sensation which varies from mild discomfort itching, tingling, pressure, burning, and throbbing at the target site. The timing of the symptoms is variable ranging from few months to years [1]. In addition to the mutilated body image, it is estimated that over 50% of women suffer chronic pain following treatment for breast cancer surgery. " [2] It can seriously affect quality of life through the combined impact of physical disability and emotional distress. [3] Some reports have shown that genetic variations in the catecholaminergic and serotonergic pathways may contribute to the development and severity of persistent breast pain [4]. The severity and impact of PBS varies among individuals, it may be affected by age, education, axillary dissection, reconstruction, and psychosocial stress [5]. In our communities, pain may not be the major concern, women present late due to the fear of mutilating mastectomy and the social stigma it accompanies. Another entity is Alexithymia, or the inability to express emotions maybe involved in mechanisms of comprehending pain chronicity [6]. Materials & MethodsThis study was conducted at the breast oncology clinics between Jan 2017-December 2018. Direct interview using a prepared pilot tested structured questionnaire directed towards patients who underwent mastectomy between the periods of January