We interviewed 500 adult females without personal history of any type of cancer to assess their awareness and attitude toward various aspects of breast cancer. The mean age (SD) of participants was 31.6 (+/- 8.5) years with a range of 18 to 62 years. After control for level of education, age was not found to be a statistically significant factor that influenced participants' performance. Also not statistically significant was the history of having a relative who had cancer. Conversely, education was the only examined factor that correlated with interviewees' awareness and attitude. Individuals with university or higher education (level III) were more knowledgeable (statistically significant) than uneducated or those with only primary schooling (level I), or those participants who only had intermediate or high school education (level II). On the other hand, the responses of those individuals with education level I generally performed in a fashion similar to those at education level II. The general outcome of this exercise was that unacceptably high proportions of females at all education levels were either wrong or uncertain about some fundamental aspects of breast cancer etiology, risk factors, clinical features, detection methods, and management. Also shown was the relatively high percentages of those, particularly in education level I, who held misconceptions about unconventional management or the complications of conventional methods. We conclude that academic education alone is not enough to assure that recommended health behaviors will be adopted. For establishing cancer health education or cancer prevention and early detection programs, primary care physicians and community cancer centers should work jointly. Brief guidelines are proposed.

Data on 130 women with invasive breast cancer, seen at our institution between April 1981 and November 1990, were retrospectively reviewed to assess the influence of age and menstrual status on the pattern and prognosis of their disease. Patients were mostly young (median age 40 years) and in 21 patients (16%) the diagnosis was established at the age of 30 years or younger. Eighty-six patients (66%) were under 50 and 82 patients (63%) were pre-menopausal. Pre-menopausal patients were more numerous than expected in stage III and less numerous in stage II. On the other hand, the differences between observed and expected values for both stage I and stage IV in the 2 menopausal groups were not significant. Compared with post-menopausal patients, pre-menopausal patients with 1-3 or greater than 3 positive lymph nodes were more numerous than expected. Differences between pre-menopausal and post-menopausal patients have persisted after categorizing patients into 2 age-groups with a cut-off point at 50 years. Comparable initial assessment and therapeutic modalities were offered to the 2 menopausal groups. At the time of analysis (January, 1991) all patients had a complete follow-up. Over a median follow-up of 46 months, the overall median survival (+/- SE) was 85.7 (+/- 4.4) months with a survival probability (+/- SE) at 5 years of 62% (+/- 5%). The proportional hazard model of Cox has identified advanced stage (stages III and IV) and involvement of lymph nodes as the only independent adverse predictors of survival with estimated hazard rates of 2.9 and 2.8, respectively. Unadjusted analysis, adjusted analysis and stratified survival functions failed to reveal any survival difference based on age or menstrual status. We conclude that, in a low-risk population and despite apparent baseline differences in demographic and disease characteristics between pre-menopausal and post-menopausal breast cancer patients, neither age nor menopausal status had a significant influence on survival. Our results should guide future cancer-care programs in Saudi Arabia.

The study demonstrates the comparatively high frequency of gastric lymphoma in this population and confirms the intimate association of H-pylori infection to both gastric adenocarcinoma and MALT-lymphoma. Gastric lymphoma should always be considered in the differential diagnosis of gastric malignancy and the use of immunohistochemistry is essential for the differential diagnosis of some of these tumors.

No abstract

A total of 14 adults were diagnosed as having brucellosis by clinical means, serology and blood culture. The first patient to be treated failed to respond to 2 g/day intravenous ceftriaxone, therefore, subsequent patients were treated intravenously, twice daily with 2 g ceftriaxone. Immediate clinical response was seen in nine (69.2%) of the patients. Therapy was changed to tetracycline plus streptomycin in the remaining four (30.8%) patients because of lack of response after 5 days. It is concluded that ceftriaxone may be considered a second-line therapy for brucellosis in patients who cannot be given conventional therapy. Further evaluation of ceftriaxone, either alone or preferably in combination with streptomycin or rifampicin on a larger scale, is indicated.