Tumors were staged using the AJCC (American Joint Committee) manual book third edition (2006). Patients with ductal carcinoma in situ were considered to be at Stage 0. All data were integrated into a single computerized database designed Venetoclax concentration
specifically for this study. Patients were divided by ethnicity into two groups: Jews and Arabs. Summary statistics were obtained using established methods, and analyses of the data utilized the Fisher's exact or chi-square tests. Association between categorical groups were assessed using the chi-square test. Mean values were compared using the student t-test for independent groups. Two tailed p values of 0.05 or less were considered to be statistically significant. A total of 1140 cases were studied��872 Jewish and 268 Arab women. Patient characteristics are presented in Table 1. Mean age at diagnosis was 59.5 years, significantly lower in Arab women (49.9) compared with Jewish women (59.4) (p < 0.0001). No significant difference was found in mean age at menarche or at menopause in the two study groups. The mean number of children was 4.2 in Arab women and 2.5 in Jewish women, and Arab women had a lower rate of first-degree relatives (4.5%) than Jewish women (13.5%) (p < 0.0001). As shown in Table 2, tumor size at diagnosis was < 2 cm in 25% of Arabs compared to 53.8% of Jews (p < 0.0001). Tumor sizes 2 and 3 (T2 and T3) were more frequent in Arabs than in Jews. Locally extensive tumor (T4) was found in 19% of Arabs and in 5.4% of Jews (p < 0.0001). A significantly greater number of Arab women presented with metastases selleck chemicals
to axillary lymph nodes than Jewish women (p < 0.0001), and significantly more Jewish women were diagnosed at Stage I than Arab women: 49.2% versus 19% (p < 0.0001). Conversely, significantly more Arabs (33%) had progressed to Stage III disease than Jews (7.6%) (p < 0.0001). Breast conservative surgery was performed significantly less frequently in Arabs than in Jews (p < 0.0001). In both study groups, most breast cancers were invasive ductal and lobular carcinomas. Ductal carcinoma in situ was found in only 3% of Arab women compared to 7.8% of Jewish women (p < 0.01) (Table 2). Tumor histological grade was higher in Arabs than Jews. Well-differentiated cancer was found in 44.9% of Jews compared with only 12% of Arabs (p < 0.0001), while poorly differentiated histology was found in 12.8% of Jews and 28.8% of Arabs (p < 0.0001). Estrogen and progesterone Vemurafenib
receptor status was lower in Arabs than Jews (p < 0.01), and HER-2 overexpression was found in 35.4% of the former group compared to 22% of the latter (p < 0.0001). Although BC is the most common malignancy found in Middle Eastern women, few published studies have reported its clinical and pathological features in this population compared with Western and American women.20 The incidence of BC is lower in Palestinian Arab than in Jewish women in Israel, and has been steadily increasing during the last decades.