Cervical cancer remains a major public health problem in Africa, particularly in Mali. The goal of this work was to investigate the epidemiological and clinical aspects of cervix cancer seen at the radiation therapy center. This was a descriptive study on the retrospective collection of data on patients found in the Radiation Therapy Centre of Bamako, for invasive cervical cancer between April 2014 and April 2017. The average age of our population was 52 ± 12.5 years with extremes ranges from 18 to 95 years. The most represented age group was [50-65 years] with 44.2%. The predominant histological type was squamous carcinoma (CE) with 94.2%. Bleeding were found in almost all patients, most often associated with foul smelling hydrorrhea; 80.3% of our patients were stage III and 12.9% of stage IV according to the IFGO classification. Cervix cancer remains a major public health problem in Mali. The diagnosis is often late, therefore, resulting in late care and unfavorable prognosis. Sensitization, vulgarization of vaccination and systematization of screening could be helpful in the fight against this cancer.

The purpose of this study was to update the management of invasive cervical cancers diagnosed during pregnancy. Patients and methods: This study was performed retrospectively at radiotherapy department of National Institute of Oncology Rabat Morocco. From 01/04/2005 to 31/05/2010, ten patients with invasive cervical cancer during pregnancy were included. Results: Ten patients were included in the study. The staging was as follow: stage IIIB (n = 4); stage IIB (n = 2) and stage IB2 (n = 4). The radical abdominal hysterectomy with pelvic lymphadenectomy was performed in five patients; a therapeutic interruption of pregnancy was performed in four patients. One pregnancy has resulted in the birth of a living child (by cesarean section). Adjuvant treatment was concomitant chemoradiotherapy followed by low dose rate (LDR) brachytherapy in three patients; adjuvant concomitant chemoradiotherapy followed by high dose rate (HDR) brachytherapy was performed in four patients; a HDR brachytherapy was done in one patient. Two patients have received an exclusive external radiotherapy. After a median follow-up of 4 years (2 -7 years), there were bone and lung metastases in one patient. Nine patients are alive after completed treatment. Conclusion: Our series focused on ten patients with invasive cervical cancer during pregnancy. Management is complex and requires discussion in a multidisciplinary meeting. Routine screening of cervical cancer and awareness are the key point to improve the treatment and survival rate of patients. The management of all cases is according to international recommendations.

Breast cancer is a major public health problem because of its incidence and mortality. Purpose: To establish the epidemiological and clinical characteristics of breast cancer seen at the radiotherapy center at the Mali Hospital of Bamako. Patients and methods: It was a retrospective, descriptive study of data from patients seen for breast cancer at the Center of Radiotherapy of Mali Hospital between April 2014 and December 2016. The parameters studied were: age, sex, family history of breast cancer, menopausal status, parity, breast tumor location, histological type, histological grade, cancer classification stage. Results: 134 cases of breast cancer were collected, with a frequency of 15%. The sex ratio (H/F) of 0.007. The patient's mean age was 47 ± 11 years old. The most represented age groups were 33-47 years old with 45.5% and 48-62 years old with 39%. Three percent (3%) of patients had a family history of breast cancer. Fifty (50%) of the patients were menopausal. The main clinical signs found were : mammary nodules (98%), mastodynia (65%), nodes (67%). Invasive ductal carcinomas were found in 94% of patients, followed by infiltrating lobular carcinomas with 3.7% and metaplastic carcinomas with 1.7%. SBR Grades II and III were mostly found with 37% and 23%. The average tumor size was 87 mm ± 43. Stage III was predominantly represented with 72%, followed by Stage II with 24% and Stages I and IV with 2% each. Conclusion: Breast cancer is common and reaches both before and after 50 years; the diagnosis is usually late; hence it is the importance of raising awareness and screening before the age of 50 and popularizing some complementary tests to better understand the prognosis of this disease and promote more targeted and conservative treatments that will improve survival.

Hypofractionated radiation therapy has proven effective on locoregional control and tolerance in the adjuvant treatment of breast cancer. The aim of this study is to compare the results of hypofractionated radiation therapy versus conventional radiation therapy in terms of local control and tolerance. It was a retrospective study of patients observations collected from January 2007 to December 2008 in Department of Radiation Therapy in Institut National d'Oncologie de Rabat. The treatment results were evaluated by the rate of locoregional recurrence, distant recurrence and research of late toxicities. Radiotherapy was delivered using the same technique in both groups, by gamma photons of cobalt 60 with an energy of 1.25 MeV. They were 2 groups: the first group treated with standard dose rate and the second group treated by hypofractionated radiation therapy. The mean age of the patients was 42.8 ± 6.9 years old in the standard group and 43.22 ± 7.2 years old in the hypofractionation group. We noted a predominance of infiltrating ductal carcinoma. The majority of patients were pT 2 , pN 0 and pN 1. The majority of patients had radical surgery and chemotherapy with anthracyclines in both groups. We noted a statistically significant difference in the irradiation of chest wall between the standard (89.2%) and hypofractionated group (70.3%), with p = 0.043. The median duration of radiation therapy was statistically different in both groups: 39 days in the standard and 23 days in the hypofractionated group (p < 0.001). The local recurrences were statistically identical to 12 and 24 months (p = 0.999). Concerning toxicities, the frequency of adverse event was similar in both groups. Hypofractionated radiation therapy with a total dose of 42 Gy at 2.8 Gy per fraction in 5 fractions weekly is comparable to standard radiotherapy in terms of local control and tolerance and is therefore a very good alternative to standard treatment.

Objective: To describe the screening for uterine cancer by visual methods. Method: We conducted a prospective and descriptive study over a period of 12 months from January to December 2020. Direct observation of providers and interview of patients were performed for data collection. Results: Out of 3400 patients, 1024 were enrolled for the study, or 30.11%. The average age of the patients was 41 years with the extremes of 17 to 87 years. Women aged 40 to 45 were the most represented with 58.78%, (n = 602). Housewives 85.83% (n = 879), they had a primary education level in 71.09% of cases (n = 728), the vast majority were married 92.28% (n = 945). Multiparous represented 58.78% (n = 602) of the sample, nulliparous 18.26% (n = 187), women living in rural areas 30.17% (n = 309), in urban areas 69.82% (n = 715). The test was positive in 43 patients (4.19%) but squamocylindrical junction was not visible in 17% of cases. The preparation of acetic acid and lugol: good preparation in 100% of cases; the conditions of use are not respected in 27% for acetic acid and 38% for lugol. Conclusion: Routine screening for cervical cancer (SCC) by visual methods is essential to decrease the incidence of invasive cervical cancer.