Child gigantomastia revealing juvenile giant fibroadenomas

Breast masses in children and adolescents are uncommon. They can be caused by tumors such as fibroadenomas and phyllode tumors. These masses can cause gigantomastia, due to their rapidly increasing size. We report the case of a 12 years old patient admitted in our department for a rapidly growing gigantomastia evolving in a matter of 8 months. Imaging features were in favor of juvenile giant fibroadenomas and diagnosis was confirmed by biopsy. Juvenile giant fibroadenomas are rare and represent 0.5–2% of all fibroadenomas, their exact aetiology is unknown. They affect children and adolescents, with a predominance in African-American females. They may cause breast enlargement and asymmetry. The rapid growth causes anxiety and is the main cause of consultation. These tumors although benign, have to be treated rapidly because they can destruct up to 80% of the surrounding normal breast tissue, and conservatory treatment cannot be done.

Let's Talk About Sex: Parents' and Teens' Comfort Levels During These Discussions

The purpose of this study was to assess parents’ and teens’ views on talking about sex and birth control and their level of comfort in discussing these topics. The methodology consisted of telephone surveys with 988 adults and in person interviews with 797 teens within two counties in South Carolina. This study found that more teen females than males communicated with adults about discussing sex or birth control and mothers were most likely to be sought out. Over half of the teens indicated that they had talked to another adult about sex or birth control and the person most likely sought out was an adult friend. Most parents agreed that they talk openly with their teens about waiting to have sex as well as using condoms and other birth control. Similarly, most parents reported they felt very comfortable talking to teens about sex or birth control with women and African-Americans reporting greater comfort. Teens indicated that they felt very comfortable talking with their parents about sex, with African American females and White males reporting more comfort than White females. These results may indicate that teens are interested in seeking sexual health information from parents, including adult friends. Adults’ willingness to engage in these topics with teens is vitally important. In our study, racial and gender differences were found in comfort level of both parents and teens talking about sex.

Uterine Cancer Mortality in White and African American Females in Southeastern North Carolina

The residents of southeastern North Carolina (NC) are exposed to multiple socioeconomic and environmental risk factors and have higher mortality rates for a number of diseases. Uterine cancer mortality is known to vary dramatically by race, so we analyzed uterine cancer mortality in populations defined by zip codes in this area to investigate the contributions of various environmental risk factors to race-specific disease patterns. Methods. Zip code specific mortality and hospital admissions for uterine cancer from 2007 to 2013 were analyzed using the NC State Center for Health Statistics data and the Inpatient Database of the Healthcare Cost and Utilization Project datafiles, respectively. Results were adjusted for age, income, education, health insurance coverage, prevalence of current smokers, and density of primary care providers. Results. Uterine cancer mortality rates were generally higher in African American (32.5/100,000, 95% CI = 18.9–46.1) compared to White (19.6/100,000, 95% CI = 12.3–26.9) females. Odds ratios (ORs) of uterine cancer death were higher in White females (OR = 2.27, p<0.0001) residing within zip codes with hog concentrated animal feeding operations (CAFOs) (hog density >215 hogs/km2) than in White females residing in non-CAFO communities. African American females living near CAFOs had less pronounced increase of uterine cancer death (OR = 1.08, p=0.7657). Conclusion. White females living in adjacent to hog CAFOs areas of southeastern NC have lower rates of mortality from uterine cancer than African American females, but they have higher odds of death compared to their counterparts living in other NC areas. African American females living near CAFOs also have modest increases from their high baseline mortality. While the observed associations do not prove a causation, improving access to screening and medical care is important to mitigate this health issues in southeastern NC.

Prognostic significance of hormone receptor (ER/PR) status in endometrial carcinoma in black women: Implications with lymph node metastasis.

e18099 Background: Histological examination of tumor tissues is necessary for deciding if endometrial surgery should include lymph node sampling. Studies have demonstrated that loss of estrogen and progesterone receptors (ER/ PR) independently predicts lymph node metastasis and poor prognosis. African American females in comparison to their Caucasian counterparts are diagnosed at a later stage, with higher grade, poorer prognostic histological types and worse outcomes. Our study aimed to investigate if the correlation between hormone receptor status and lymph node metastasis holds true in African American females which could aid in treatment strategies. Methods: We reviewed African American females (n = 70) diagnosed with Endometrial Cancer at our institution from 2015-2018 including endometrioid/non-endometrioid histology, FIGO stage I-IV, grade 1-3 for ER/PR receptors and presence or absence of pelvic lymph nodes based on preoperative endometrial curettage and post-surgical pathology specimens. Statistical analyses were performed using Fisher’s Exact test exploring associations between categorical variables (ER/PR and Lymph nodes Metastasis). All statistical tests were two-sided and considered significant if P value < 0.05. Results: The mean age of our sample was 61 ± 13 years. Mean BMI was 36±10kg/m2. Majority of our patients were postmenopausal (59 out of 70, 84%). FIGO Stage 1 and 2 constituted 72% (50 out of 70). Endometrioid histology constituted 39 out of 70 (55%) cases and non-endometrioid histology which includes serous, mixed and carcinosarcomas constituted 45% of the cases. Loss of estrogen receptor(ER-) was observed in 19 of 70 patients (27%) and loss of progesterone receptor(PR-) was seen in 22 patients (31%) which was significantly associated with lymph node metastasis (p value < 0.05).On subgroup analyses significant association was observed between PR+ and absence of lymph node metastasis in cases of endometrioid cancer (p value < 0.05) . Nevertheless, there was no statistical significant association (P value .10) between ER receptors and lymph node metastasis in patients with endometrioid cancer. In non-endometrioid histology both ER- and PR- were found to have statistical significant lymph node involvement. Conclusions: Loss of ER and PR receptors independently predicts lymph node metastasis in endometrial cancers in African American females.