title: Trends of breast cancer and its management in the last twenty years in Aden and adjacent governorates, Yemen.
abstract: BACKGROUND
  Breast cancer is the most common cancer of women and the principal cause of death in middle aged women. The objective of this study was to describe the trend of breast cancer and its management in Aden and adjacent south-eastern governorates of Yemen during the last 20 years.
  
  
  METHODS
  This is a retrospective analysis of previous studies on patients with breast cancer in Aden and adjacent south-eastern governorates, Yemen (January 1989 through December 2007). The studied variables were: sex, age, time and type of presentation, disease stage, pathological types and the performed surgical treatment. The sources of information were the treatment registry of Aden health office, archives of Al-Gamhouria teaching hospital; major referral and other public and private hospitals in Aden and Aden Cancer Registry.
  
  
  RESULTS
  The total number of patients was 476, 99% being females. The age range was 19-88 years. The most affected age was 30-50 years (60.5%), 95% presenting after one month of having breast symptoms. Forty-five percent presented with signs of advanced local disease, while 59.2% had palpable axillary lymph nodes on presentation. Early breast cancer (stages I-II) occurred in 47%, and late breast cancer (stages III-IV) in 51.5%. Invasive ductal carcinoma was the commonest pathology (89.3%). The main surgical treatment was mastectomy (modified radical mastectomy (50%).
  
  
  CONCLUSIONS
  Breast cancer is predominantly a disease of young with late presentation and advanced disease. Improving health awareness and earlier diagnosis of the disease by health education, encouraging breast self-examination, and providing the mammography equipment and mammary clinics in hospitals are recommended. Establishment of oncology and radiotherapy centers in Aden is a necessity.
authors.affiliation: Department of Surgery, Faculty of Medicine, University of Aden, Yemen. dr_harhra@yahoo.com
authors.forename: Nasser Aa
authors.initials: NA
authors.lastname: Harhra
authors.forename: Huda O
authors.initials: HO
authors.lastname: Basaleem
mesh_terms: D000328:Adult; D017677:Age Distribution; D000368:Aged; D000369:Aged, 80 and over; D001943:Breast Neoplasms / Q000453:epidemiology* / Q000473:pathology / Q000601:surgery; D018567:Breast Neoplasms, Male / Q000453:epidemiology* / Q000473:pathology / Q000601:surgery; D002278:Carcinoma in Situ / Q000453:epidemiology* / Q000473:pathology / Q000601:surgery; D018270:Carcinoma, Ductal, Breast / Q000453:epidemiology* / Q000473:pathology / Q000601:surgery; D018275:Carcinoma, Lobular / Q000453:epidemiology* / Q000473:pathology / Q000601:surgery; D005260:Female; D006801:Humans; D008207:Lymphatic Metastasis; D008297:Male; D015411:Mastectomy, Modified Radical; D008875:Middle Aged; D009367:Neoplasm Staging; D012189:Retrospective Studies; D015006:Yemen / Q000453:epidemiology; D055815:Young Adult