Twenty years of breast cancer in Iran: downstaging without a formal screening program.
BACKGROUND
breast cancer (BC) is the most common malignancy among Iranian women. Although the relative incidence of BC is low, the cause-specific mortality is much higher than developed countries. The present study surveyed the overall trend of BC in Tehran.


METHODS
all breast pathologic records were studied in five major hospitals in Tehran during three phases (1: 1985-1995; 2: 1996-2000; and 3: 2001-2005). Malignant cases were classified according to the tumor-node-metastasis classification. Data were compared across the study.


RESULTS
Of 9050 medical records from male and female patients with 'breast disease', 2946 females with BC were included. A significant increase in the diagnosis of palpable early BCs (stage II increased, stage III decreased) was observed between phases 1 and 2. A relative increases in stages 0 and I were noted between phases 3 and 2. Nevertheless, 76.8% of cases were T2 or higher and 65.3% had positive lymph nodes in the last phase. The proportion of patients with stage IIIb was increased in phase 3, despite the reduction in phase 2.


CONCLUSIONS
despite the relative improvement in the status of BC patients, the vast majority are diagnosed in advanced stages. Specific screening measures should be implemented in Iran.
Department of Surgery, Cancer Institute, Cancer Research Center, Tehran University of Medical Sciences, Tehran. Electronic address: harirchi@sina.tums.ac.ir.
I
I
Harirchi
Department of Gastroenterology, Digestive Disease Research Center, Shariati Hospital, Tehran University of Medical Sciences, Tehran.
S
S
Kolahdoozan
Department of Community Medicine, Tehran University of Medical Sciences, Tehran.
M
M
Karbakhsh
Department of Surgery, Cancer Institute, Cancer Research Center, Tehran University of Medical Sciences, Tehran.
N
N
Chegini
Department of Surgery, Cancer Institute, Cancer Research Center, Tehran University of Medical Sciences, Tehran.
S M
SM
Mohseni
Department of Mental Health, Iranian Institute for Health Sciences Research, Academic Center for Education, Culture & Research, Tehran.
A
A
Montazeri
Department of Surgery, Cancer Institute, Cancer Research Center, Tehran University of Medical Sciences, Tehran.
A J
AJ
Momtahen
Department of Surgery, Cancer Institute, Cancer Research Center, Tehran University of Medical Sciences, Tehran.
A
A
Kashefi
Department of Surgery, Cancer Research Center, Iranian Center for Breast Cancer, Tehran, Iran.
M
M
Ebrahimi
D000328:Adult; D001943:Breast Neoplasms / Q000453:epidemiology* / Q000473:pathology; D018567:Breast Neoplasms, Male / Q000453:epidemiology* / Q000473:pathology; D055088:Early Detection of Cancer; D005260:Female; D006801:Humans; D007492:Iran / Q000453:epidemiology; D008297:Male; D008875:Middle Aged; D009367:Neoplasm Staging; D055815:Young Adult