مجله زنان مامائی و نازائی ایران
سال شانزدهم شماره 86 (هفته چهارم بهمن 1392)

Breast cancer is the most common cause of death among Iranian women. A significant number of breast cancer patients are involved metastasis that is an important factor in treatment failure، morbidity and mortality of patients. The aim of present study was comparison of metastatic and non-metastatic breast cancer patients. In this analytical descriptive study، 1615 files of patients with breast cancer who referred to Omid hospital in Mashhad، Iran during 2001 to 2011 were evaluated. 446 patients of them were in metastatic status. Checklists were completed according to each patient''s data. Data were analyzed using SPSS software (version 16)، and chi-square test and t-tests. P value less than 0. 05 was considered significant. In 446 patients with metastatic breast cancer، 100 patients (22. 4%) had metastasis in the first admission and in 346 patients (77. 6%) metastases developed during the treatment or follow up. The most common sites for metastasis were bone (45. 1%) and liver (20%). Immunohistochemical findings revealed that most of patients with brain and liver metastasis were Her-2 positive whereas the majority of patients with bone metastasis were Her-2 negative. There were no significant relationships between the two groups in terms of menstrual status، location of metastasis، positive rates of estrogen and progesterone receptors and Her-2. The most common site of metastasis is bone (more patients with negative Her-2 and positive hormone receptors) while the common sites for metastasis as far as Her-2 positive is concerned are brain and liver with worse prognosis، concerning special attention for aggressive treatment.

Angiomyofibroblastoma is a rare benign tumor that its behaviors are similar to Angiomyxoma. Angiomyofibroblastoma is a soft tissue tumor that often occurs in the vulvar region of premenopausal women. The most patients represent vulvar mass that often diagnosis was confounded with Bartholin’s glandular cyst. It is important that angiomyofibroblastoma distinguish from aggressive angiomyxoma and myxofibrosarcoma. This study presents a rare case of angiomyofibroblastoma of the vagina in a 36 year old woman. Case Report: The subject of the study was a 36 year old woman who has been suffering from a nodule at the orifice of her vagina since 2005 (8 years ago). The lump has grown in the size since 2 years ago. Following the growth of tumor and experiencing discomfort during intercourse the patient consulted with a gynecologist and in the first examination visible spherical lumps based in lower region of vagina at the left and more swelling in fourchette region were observed. Tumor simple removal was done and according to the pathological reports، the removed tumor was in the form of a spherical، solid، soft tissue with light brown color. Histologic examination shows angiomyofibroblastoma. Also، in this patient no systematic or local recurrence was reported after 84 months (7 years) of tumor simple removal. It is important that this neoplasm may occur extra vulvar region and before middle-age and tumor simple removal is the curative treatment.

Among factors related to weakness of pelvic muscles، pregnancy and vaginal delivery are considered as the most important risk factors for fecal incontinence. Because of conflicting results in effect of delivery methods on urinary and intestinal incontinence، this study was designed aim to evaluate the prevalence of urinary and intestinal incontinence in postpartum period and its related factors.

This cross-sectional study was conducted on 429 women، 4 month after their delivery in Khalkhal health centers، Iranduring 2011 to 2012. Sampling method was available. Women were asked to complete the demographic questionnaire and a questionnaire about incontinence symptoms that design by Sandvik. Data were analyzed using SPSS software version 20 and t-test، chi-square and correlation tests. P value less than 0. 05 was considered significant.

Prevalence of urinary and gas incontinence in women with cesarean section was 1. 4% and 0. 9% respectively and in women with vaginal delivery was 1. 9% and 1. 4% respectively that was not statistically significant (p>0. 05). There was no significant association between urinary and gas incontinence and mother age، gravidity، episiotomy، vaginal laceration، number of vaginal delivery and cesarean section، neonatal weight and head circumstance (p>0. 05).

There is no association between method of delivery and urinary and intestinal incontinence 4 month after the delivery.