The Effect of Overweight on The Risk of Recurrence in Tunisian Patients with Operable Breast Cancer

Obesity is associated with worse breast cancer outcomes in Western and Asian women. The present study was to determine the relation of body mass index (BMI) to disease-free survival (DFS) in Tunisian patients with operable breast cancer. We retrospectively reviewed data from 223 patients with operable breast cancer treated with primary surgery and adjuvant epirubicin-based chemotherapy. Patients were categorized into lower-BMI (2;N=114) v higher-BMI (>27.5 kg/m2;N=113). Patients’and disease characteristics, including tumor size and lymph node status, were similar between the 2 groups. With a median follow-up of 56 months, there were 42 and 30 DFS events in the lower- and higher-BMI group, respectively (adjusted hazard ratio (HR): 0.74;95% CI, 0.43 to 1.26;p=0.26). A significant interaction (p<0.001) was found between BMI category and time, with a significant DFS advantage for the higher-BMI group after 3 years (adjusted HR: 0.28;95% CI, i to 0.86;p=0.03). We conclude that overweight is associated with a decreased risk of late recurrence in Tunisian patients with operable breast cancer.

Assessment of Psychological Distress among Parents of Children with Cancer

Background and Aims: The diagnosis of pediatric cancer is a potentially traumatic event and a major source of psychological distress for parents. The aim of our study was to determine the prevalence and the risk factors of psychological distress among parents of children diagnosed with cancer. Methods: This is a descriptive study carried out on parents of children diagnosed with cancer and treated in the department of medical oncology at the Habib Bourguiba Hospital in Tunisia. Over a period of four months, from the beginning of December 2020 until the end of March 2021, forty-three parents (34 mothers and 9 fathers) were assessed, using psychometric scales of anxiety, depression and post-traumatic stress according to respectively to the Hamilton anxiety rating scale (HAM), the Beck Depression Inventory (BDI) and the Impact of Event Scale (IES-R). Results: Sixteen percent of the parents had scores indicating acute stress and 21% had scores indicating post-traumatic stress. Eighty six percent of the parents had mild to severe depression and 95% had minor to major anxiety. Post-traumatic stress and anxiety are significantly correlated with the female sex of parents. Significant correlations are also found between post-traumatic stress scores and symptoms of depression and anxiety. However, our study did not show a significant correlation between the others factors studied and the parents’ psychological distress. Conclusion: The prevalence of anxiety and depressive disorders was high among parents of children diagnosed with cancer and a significant correlation was found between stress and anxiety with the female sex of parents. Our results were similar to several studies although other risk factors for psychological distress in parents of children with cancer were described in the literature.

Impact du traitement carcinologique sur le fonctionnement sexuel et l’image du corps des patientes tunisiennes en rémission d’un cancer du sein localiséImpact of Cancer Treatment on Sexual Functioning and Body Image of Tunisian Patients in Remission from Localized Breast Cancer

The diagnosis and the management of breast cancer(BC)affect in a complex way women’s sexual lives and touch the symbol of femininity,which is very important in the constitution of the body image.Our objectives were to assess the sexual functioning and the body image of patients in remission of localized BC,to determine the links between these two parameters,and to study their relationship with the therapeutic modalities.We conducted a cross-sectional,descriptive,and analytical study in the medical oncology and radiotherapy departments of Habib Bourguiba University Hospital Center in Sfax(Tunisia),between February and August 2022.Patients were assessed based on a clinical information sheet and two psychometric scales exploring sexual functioning and body image:Female Sexual Function Index(FSFI)and Body Image Scale(BIS).The sample comprised 74 patients with a mean age of 51.55 years.They were treated by conservative or radical surgery(44.6%and 55.4%,respectively),chemotherapy(87.8%),hormone therapy(79.7%),targeted therapies(36.5%),and radiotherapy(97.3%).A rate of 51.4%of women had sexual dysfunction(SD),87.8%had hypoactive sexual desire and 36.5%had body image disorder.The body image disorder was significantly associated with DS(p=0.001).The total FSFI score(p=0.001)as well as the subscores of desire(p=0.005),arousal(p=0.003),orgasm(p=0.002),satisfaction(p<0.001),and pain(0.03)were significantly lower in patients with body image disorder.The presence of a SD was not associated with any therapeutic modality.In contrast,the presence of body image disorder was significantly associated with the radical type of surgery(p=0.003)and chemotherapy(p=0.001).Our results showed a relatively high frequency of SD and body image disorder in women in remission from BC.These two parameters seem to be closely linked,and this link would be maintained by mastectomy and chemotherapy,which appear to be therapeutic modalities incriminated in the disturbance of body image.Hence the importance of medical follow-up and psychological support for these operated patients to help them overcome all the physical,psychological,and sexual difficulties to which they are exposed.