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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.Patients and 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. [ABSTRACT FROM AUTHOR]

Introduction: Due to the tack of systematic screening programmes for early detection of breast cancer in Iran and the predominance of advanced cases, we aimed to study the extent and determinants of patient delay in women with advanced breast cancer. Materials and methods: In this 1-year cross-sectional study, all consecutive women with advanced breast cancer (stages IIb, III or IV) who initially presented to a university hospital were studied. Results: Sixty-eight percent (136/200) of cases had delayed their first visit by >1 month and 42.5% by > 3 months. The median patient delay was 12 weeks. Delay was associated with: older age, being married, lower income, less education, place of residence (small cities), negative family history of breast cancer, belief in the fatality of breast cancer, tack of access to healthcare services, tack of knowledge of breast cancer symptoms, and denying the importance of breast self-examination. The main reasons given for the delay were: lack of knowledge regarding the necessity of such a visit, fear, negligence, tack of access to physicians, and poverty. Discussion: In contrast to some other studies, this study found that married women and those with a negative family history of breast cancer waited longer than others before seeking care. Public education initiatives focused on encouraging women (especially high-risk groups such as older women, married women, and those living in small cities or villages) to see a doctor promptly for evaluation of breast symptoms can decrease delay and improve patient outcome. [ABSTRACT FROM AUTHOR]

Objectives: Although Gross hematuria in patients receiving anticoagulants is not very common, it is one of the most common reasons of consulting with urologists. It is recommended to investigate urinary tract malignancies but simultaneous approach to anticoagulation and hematuria so as the optimum balance could be attained, is not clearly defined in the literature yet. We aim to answer pitfalls of hematuria management in anticoagulant receiving patients in this manuscript., Materials and Methods: In a prospective case control study during 2017-2019, we observed and collected the data of patients receiving anticoagulant therapy and suffered from gross hematuria with coagulation parameters in prophylactic or therapeutic range in an academic hospital affiliated to Tehran University of Medical Sciences. SPSS 24th version was used for descriptive analysis of collected data., Results: Sixty-six patients encountered hematuria while receiving anticoagulant therapy. Although hematuria was more common in male patients, its recurrence was higher in female patients. It started mostly in first 72 h of therapy and was anticoagulant-dose dependent. Degree of hematuria was mostly mild or moderate by visual estimation and controlled easily by holding the anticoagulant therapy for less than 2 days. Anti-platelet therapy, urinary catheterization and patient's activity did not have any effect on re-bleeding rate., Conclusion: Considering the fact that ruling out the urinary tract malignancy is mandatory in these patients, moderate and severe hematuria can be controlled simply by short term holding the anticoagulant therapy while continuing antiplatelet therapy albeit there is possibility to continue them in mild cases. Removing urinary catheters and decreasing the patient's mobility are not recommended. In order to decrease the recurrence of hematuria, re-establishing anticoagulation with LMWH and non-Vitamin D dependent oral agents rather than continuing Heparin and Warfarin might be helpful.

Objectives: Social Stigma is potentially a major problem in multiple sclerosis patients which strongly affects the quality of life. The aim of this study was to determine the prevalence of perceived stigma in patients with MS in a sample of Iranian population., Methods: This cross-sectional study was performed on 305 MS patients who were referred to Iranian Multiple Sclerosis Society in 2014. The main variables were perceived stigma, age, sex, marital status, educational level, occupation, duration of the disease, type of symptoms, disability expanded status scale, family history and economic status. Social stigma was measured through a 20-item questionnaire which was developed by authors and the reliability was assessed in a pilot study., Results: The frequency of perceived stigma was significantly associated with occupation, disease duration, and visibility of symptoms, level of disability and the economic condition. There were no significant relationships between perceived stigma and age, sex, marital status, level of education and family history. About 44 percent of patients preferred to hide their disease from others and 52.6 percent believed that this disease would stigmatize them in society. Nearly, half of patients preferred not to mention their disease in job interviews., Conclusion: Recognition of the impacts of perceived stigma on various aspects of the patients' lives are necessary to find appropriate strategies to deal with stigma and its consequences. Training programs can improve the patients' skills for coping with stigma. Furthermore, programs aimed to upgrade public knowledge and reduce the negative attitudes toward the disease should be promoted.

To estimate the years of life lost (YLL), registered deaths due to Iraq-Iran war (1980-2005) were identified considering ICD10 codes of Y36.0 to Y36.9. Estimated YLL was calculated by taking age-weighting options and discount rates. Population life expectancy in each corresponding year was retrieved from the national health database. During 1980-2005, 178,298 Iranian men and 5325 Iranian women died in war. The mean death age was 22.8 ± 9 years, 96.6% occurred during the years of war (September 1980-August 1988). In the years after the war (1988-2005) 6243 (3.4%) of deaths occurred as the result of complication of the war-related injuries or implanted landmines/unexploded ordnances (ICD10 code: Y36.8). YLL in Iraq-Iran war among Iranian victims were calculated as 10,479,405.0 years considering the age weighting and discount rate equal to 0. Age-adjusted YLL were estimated as 10,169,546.2 years in males. Female cases that comprised 2.9% of total victims lost 309,858.8 years. The mean YLL was calculated as 57.1 years for each Iranian victim killed in Iraq-Iran war. The war-related YLL was estimated more than 10 million years that comprised a majority of young men. This study is the first step in estimation of disability adjusted life year (DALY) of Iraq-Iran war on Iranian side.

Background: Tehran University of Medical Sciences has two streams of medical student admission: an established high school entry (HSE) route and an experimental graduate entry (GE) route., Aim: To compare the cognitive skills, personality traits and moral characteristics of HSE and GE students admitted to this university., Methods: The personal qualities assessment tool (PQA; www.pqa.net.au ) was translated from English to Persian and then back-translated. Afterwards 35 individuals from the GE and 109 individuals from the 2007 to 2008 HSE completed the test. The results were compared by t-test and Chi-square., Results: The HSE students showed significantly higher ability in the cognitive skills tests (p < 0.001). They were also more libertarian (p = 0.022), but had lower ability to confront stress and unpleasant events (p < 0.001), and had lower self-awareness and self-control (p < 0.001)., Conclusion: On the basis of their personal qualities, the GE students had more self-control and strength when coping with stress than the HSE students, but the latter had superior cognitive abilities. Hence it may be useful to include cognitive tests in GE students' entry exam and include tests of personal qualities to exclude those with unsuitable characteristics.

Background: Spring cleaning is a popular tradition in Iran as well as in many other countries. The purpose of our study was to determine the pattern and compare the incidence of spring cleaning related injuries in Tehran, in the years 2007 and 2008., Methods: In the year 2007, a household survey was performed in Tehran by random cluster sampling. The survey was repeated in May 2008 with the same clusters and starting points, but different households. The incidence of spring cleaning related injuries, the age and sex of injured person(s), the mechanism, type and cost of injuries were recorded through semi-structured interviews. The incidence rates of injuries and injuries leading to health visits (severe) according to sex and age groups were calculated. Data were analyzed using SPSS and STATA statistical softwares., Results: The incidence of all and severe spring cleaning related injuries were 3.8 (3.0 - 4.8) and 1.6 (1.1-2.3) per 1000, respectively. The most common mechanisms of injuries were falls, followed by cutting and lifting heavy objects or overexertion. Falls were also the main mechanism of severe injuries. The most common injuries were open wounds, followed by superficial injuries (including contusions) and sprain and strain. Among severe injuries, the most frequent injuries were open wounds and contusions, followed by dislocations. The injuries were most common among women with an incidence of about 8.4 per 1000 in women older than 18 years of age (severe injuries: 3.4 per 1000 (2.2-5.1))., Conclusion: The incidence of spring cleaning related injuries is high enough to raise concern in health system authorities. It could be estimated that about 23,927 to 38,283 persons get injured during the spring cleaning in Tehran at the beginning of every Persian new year. In addition, about 8,773-18,344 of these cases are expected to be severe enough to lead to medical attention (considering 7,975,679 as the population of Tehran at the time of study). Improving awareness of families, especially young women, regarding the scope and importance of spring cleaning safety can be suggested as the first population-based strategy to decrease the incidence of these injuries.

Objective: The high burden of injuries in Iran necessitates the establishment of a comprehensive trauma care system. The purpose of this paper is to describe the current status of trauma system regarding the components and function., Methods: The current status of trauma system in all components of a trauma system was described through expert panels and semi-structured interviews with trauma specialists and policy makers., Results: Currently, various organizations are involved in prevention, management and rehabilitation of injuries, but an integrative system approach to trauma is rather deficient. There has been ongoing progress in areas of public education through media, traffic regulation reinforcement, hospital care and prehospital services. Meanwhile, there are gaps regarding financing, legislations and education of high risk groups. The issues on education and training standards of the front line medical team and continuing education and evaluation are yet to be addressed. Trauma registry has been piloted in some provinces, but as it needs the well-developed infrastructure (regarding staff, maintenance, financial resources), it is not yet established in our system of trauma care., Conclusions: It seems that one of the problems with trauma care in Iran is lack of coordination among trauma system organizations. Although the clinical management of trauma patients has improved in our country in the recent decade, decreasing the burden of injuries necessitates an organized approach to prevention and management of trauma in the context of a trauma system.

Background: Iran has one of the highest rates of road traffic crash death rates throughout the world and road traffic injuries are the leading cause of years of life lost in the country. Using child car safety seats is not mandatory by law in Iran. The purpose of this research was to determine the parental willingness to pay (WTP) for child restraints in Mashad, the second most populated city in Iran with one of the highest rates of road traffic-related deaths., Methods: We surveyed 590 car-owner parents of kindergarten children who were willing to participate in the study in the year 2009. We asked them about the maximum amount of money they were willing to pay for car safety seats using contingent valuation method., Results: The mean age of children was 33.5 months. The median parental WTP for CSS was about $15. Considering the real price of CSSs in Iran, only 12 percent of responders could be categorized as being willing to pay for it. Family income level was the main predictor of being willing to pay., Conclusions: The median parental WTP was much lower than the actual price of the safety seats, and those who were of lower socio-economic class were less willing to pay. Interventions to increase low-income families' access to child safety seats such as providing free of charge or subsidized seats, renting or health insurance coverage should be considered.

Background: The purpose of this research was to examine whether waterpipe smokers experience increased risk of motor vehicle crashes., Methods: In a telephone survey, a random sample of Iranian drivers were asked to report their age, gender, vehicle age, whether their vehicles were equipped with anti-lock braking system (ABS), average daily drive time (DDT), whether they smoked cigarette or waterpipe, whether they had diabetes mellitus (DM), number of traffic crashes during the last calendar year and whether the crash involved a pedestrian or another vehicle., Results: A total of 2070 motor vehicle owners with the mean age of 41.6 ± 11.45 were interviewed. The annual incidence of Road Traffic Crashes (RTC) was 14.9%; 14.0% involved a collision/s with other vehicles and 0.9% with pedestrians. There was an association between the RTC and male gender, DDT, being a cigarette smoker, being a waterpipe smoker and DM in univariable analysis. The association between RTC and being a waterpipe smoker and also cigarette smoker was significant in multivariable analysis after adjustment for DDT., Conclusions: Being waterpipe and/or cigarette smoker and DDT were the independent predictors of the number of traffic crashes in Poisson regression model. If the increased risk of RTC among waterpipe or cigarette smokers is seen in other studies, it would be beneficial to promote tobacco cessation and control strategies through injury prevention initiatives.

Objectives: To investigate the relationship between perceived risk and risk-taking behaviors during the Iranian Last Wednesday Eve Fireworks (ILWEF)., Methods: A random sample of 2475 Tehranian households were asked on perceived risk of injury, risk-taking behaviors, experience of injuries, and their perception of ability to manage the harmful events during the ILWEF., Results: Lower perceived injury risk and higher perceived ability of managing an injured household member were associated with participation in fireworks practice and incidence of injury., Conclusion: These findings can be of practical importance to increase safety during festivals by improving risk perception in the community.

The aim of this cross-sectional study was to show the characteristics of breast cancer across a period of 15 years according to pathological records in Tehran, Iran. In the year 1985, a 20-year study was designed and developed in five major hospitals in Tehran to study the burden and characteristics of breast cancer in Iran. This study is based on the data collected from 1986 through 2000. SPSS version 13 was used for statistical analysis. In this study, 1612 female breast cancer records were reviewed. The mean age of patients was 47.95+/-12.42 years with a median of 47 years. Over the study period, the proportion of tumors diagnosed at T2 increased with a decline in the proportion of T3 cases. Similarly, the percentage of stage II cases at diagnosis increased, whereas stage III decreased. We detected a decrease in tumor size and downstaging of female breast cancer in Tehran, Iran. This can be attributed to the overall improvement in the level of health in Iran and also educational activities that teach women how to perform breast self-exam and when and why to ask for breast examination.

Background: Injuries are a major health problem in developing countries. Recently, the occurrence of injuries and those related to mortality have increased dramatically in Iran. We have conducted this study to report domestic research publications in the field of trauma from 2000 to 2006 in Iran., Methods: The contents of 128 biomedical journals were analyzed. Sina Trauma Data Bank (STDB) was selected as an indicator of trauma related articles that have been published in Iranian biomedical journals., Results: The number of trauma related articles in Iran increased during the seven year period (2000 - 2006), but the percentage of total publications was not significantly different. The mean number of authors per article was 2.7+1.3 (1 to 12) and all first authors were Iranian. Females constituted 15.4% (n=156) of first authors. Original articles were the most frequently published articles (n=871; 86.2%). Treatment of injuries and ensuing complications were the most common topics (42%) followed by war injuries (14.1%). Traffic accidents, as the leading cause of trauma death in Iran, were investigated in 27 (2.7%) articles., Conclusion: According to our results, it seems that more attention from researchers and health-policy makers towards trauma is necessary in our country. In addition, publishing a journal with the main theme of injury and trauma could be an effective means for increasing the proportion of trauma related articles.

In a cross-sectional study, all trauma patients hospitalized for 24 hours or more over a 4-month period in Taleghani hospital, the only referral teaching centre in Kermanshah city, were studied (n = 779). Mean age was 34.7 (standard deviation 19.9) years. Male, unemployed and illiterate patients predominated. Road traffic accidents, falls and interpersonal violence were the most common mechanisms of injury. Among road traffic accident victims, pedestrians were the most vulnerable group. A total of 7.8% of patients died, mostly due to head injuries (78.7%). Our findings also showed the importance of head trauma as the main anatomical site of injury.

Childhood injuries cause significant mortality and morbidity in Iran, like in other developing countries. This study was undertaken to describe the pattern of pediatric trauma in a multi-center hospital-based study. Pre-hospital and hospital data were prospectively gathered on all hospitalized trauma patients admitted to six major trauma hospitals in Tehran from August 1999 to September 2000. Data from patients 12 years of age and younger were analyzed for this article. About 15.1% of the hospitalized trauma cases belonged to children. Mean age was 7.35 +/- 3.25 years and 69.1% of cases were male. Most of the cases were injured accidentally. More than half of the cases were injured due to falls, followed by road traffic accidents. Injuries in streets were the most common, followed by injuries at home. Recently, several injury prevention strategies have been designed and developed in Iran, and it is hoped these may contribute to decreasing the burden of childhood injuries in Iran.

Background: Entering puberty is an important milestone of human growth and maturation associated with marked physiological and psychological changes., Aim: To assess normal pubertal development in Iranian girls to define normal and precocious puberty., Methods: The present study included a cross-sectional sample of 4,020 normal Iranian girls living in Tehran, aged from 6-20 years. Pubertal assessment was made according to Tanner staging. The mean ages of attaining secondary sexual characteristics were estimated using probit analysis. Weight and height were measured and body mass index (BMI) was calculated., Results: The mean age at breast bud stage (B2) was 10.15, pubic hair stage (PH2) was 10.48, and menarche was at 14.54 years. The mean age at attainment of puberty was compared with those of other populations., Conclusion: Girls of the present study started pubertal development at an age similar to other populations but reached menarche later. Differences between the present study and other studies can be attributed to various genetic, ethnic, geographical, and nutritional factors.

Introduction: Healthcare workers (HCWs) are at substantial risk of acquiring blood-borne infections through contact with body fluids of patients. The main objectives of this study were to determine the epidemiological characteristics and risk factors of the occupational exposures to body fluids., Methods: This cross-sectional study was conducted from December 2004 to June 2005 among HCWs from three University hospitals in Tehran, Iran, who had the potential for high risk exposures during the year preceding the study., Results: Of 900 HCWs studied, 391 (43.4 percent) had at least one occupational exposure to blood and other infected fluids. Overall, 476 exposures had occurred (0.53 exposures per person-year). The highest exposure rate (per person-year) was observed among housekeeping staff nurses (0.78) and nurses (0.63), and occurred most commonly in the medical wards (23.0 percent). HCWs with a working experience of more than ten years had an odds of exposure of 0.5 times compared to those with less than five years' job experience. Percutaneous injury was reported in 280 participants. The history of hepatitis B (HBV) vaccination was positive in 85.9 percent of the exposed HCWs. Hand-washing and consultation with an infectious disease specialist was reported in 91.0 and 29.0 percent of the cases, respectively. There were 72 exposures to human immunodefiency virus, HBV and hepatitis C, with exposure to HBV being the most common. In 237 of the exposure occasions, the viral status of the source was unknown., Conclusion: Type of job, years of experience and specific hospital wards were the risk factors for exposure.

Context and Objective: The presence of scapular fracture is believed to be associated with high rates of other injuries and accompanying morbidities. The aim was to study injury patterns and their overall outcomes in patients with scapula fractures., Design and Setting: Cross-sectional study of trauma patients treated at six general hospitals in Tehran., Methods: One-year trauma records were obtained from six general hospitals Among these, forty-one had sustained a scapular fracture and were included in this study., Results: Scapular fracture occurred predominantly among 20 to 50-year-old patients (78%). Road traffic accidents (RTAs) were the main cause of injury (73.2%; 30/41). Pedestrians accounted for 46.7% (14/30) of the injuries due to RTAs. Falls were the next most common cause, accounting for seven cases (17.1%). Body fractures were the most common type of scapular fractures (80%). Eighteen patients (43.9%) had isolated scapular fractures. Limb fracture was the most common associated injury, detected in 18 cases (43.9%). Three patients (7.3%) had severe injuries (injury severity score, ISS >or= 16) which resulted in one death (2.4%). The majority of the patients were treated conservatively (87.8%)., Conclusions: Patients with scapula fractures have more severe underlying chest injuries and clavicle fractures. However, this did not correlate with higher rates of injury severity score, intensive care unit admission or mortality.

Introduction: Poisoning is considered a significant health problem in the elderly. This study aimed to portray the pattern of poisoning in the elderly population of Tehran., Methods: This cross-sectional study included all patients aged 60 years and older with acute poisoning who attended the emergency department of the Loghman-Hakim hospital over a six-month period (n=299)., Results: Episodes of poisoning were more common in men (70.9%) and the majority of incidents took place in the patient's own home (84.3%). Most episodes were accidental (53.2%) followed by attempted suicide (32.4%). Opioids and opiate products accounted for 54.02% of the non-pharmaceutical substances that were involved in episodes of poisoning. Overdose with opioids and opiate products, was higher in male patients than in female patients. The most frequently involved drug groups were benzodiazepines, antidepressants, and analgesics. The most common cause of accidental poisoning was overdose by drug abusers. The Poisoning Severity Score was minor in 25.4%, moderate in 52.2%, and severe in 17.1% of patients. Asymptomatic patients accounted for 5.4% of the total. Unfortunately, 11.7% of patients died. The main agents involved in the fatal cases were opioids and opiate products., Conclusion: The commonest method of accidental poisoning was overdose in opioid and opiate abusers. Attempted suicide was also very common comprising about one third of all cases. The high mortality observed in this study warrants attention to the risk factors and prognostic factors of poisoning in elderly.

Introduction: The global epidemic of opiate use continues to spread and is an increasing burden especially in developing countries. Acute opiate overdose (AOO) is one of the most dramatic complications of drug abuse. The purpose of this study is to examine the epidemiology of acute opiate overdose in a poisoning center in Tehran., Methods: In this cross-sectional survey, patients who attended the emergency room of Loghman-Hakim hospital - the only poisoning center in Tehran - and diagnosed with acute opiate overdose over a six month period were included., Results: Overdose was more common among men (91.2%). The mean and standard deviation of age was 36.9+/-15. The most frequent opiate agent was opium (56.5%) followed by heroin. Opium was most commonly used by regular users, as a single agent and through ingestion. Benzodiazepines, antidepressants and alcohol were the most common agents consumed accompanied with opiates. The mortality rate was 8.8% which was not significantly different between cases of heroin and opium overdose., Conclusion: Opium was the major cause of overdose in our study. This result suggests that opium is not a harmless form of addiction although it is regarded as a thing of the past in many countries.

Although falls from trees are rare, the consequences can be severe. Over 13 months in 6 hospitals in Tehran 49 (0.57%) of 8500 registered trauma patients had fallen from trees. The mean age was 31 years (range 6 to 74 years) and 21 (42.9%) were aged < 20 years. Home and recreational/sports grounds were the most common sites of trauma. Most falls occurred during leisure time; only 3 (6.1%) were occupation-related. Eleven patients (22.4%) sustained a fracture of the spinal column; 2 of them became permanently paraplegic and 2 others who had severe thoracic vertebral fractures and paraplegia on first observation were transferred to other hospitals for treatment. Due to the severity of this type of injury, especially among the young, effective preventive efforts may be necessary.

Background: Many studies have recently noted a shift in the causative mechanism of facial injuries away from traffic accident to assaults., Aims: Our study aimed to investigate patterns of facial injuries in trauma patients during 13 months study of trauma patients in six general hospitals in Tehran., Material and Methods: Trauma patients who were hospitalized for more than 24 hours and had sustained injuries within seven days from admission were included in the study. Of the 8000 trauma patients, four hundred (5%) sustained facial injuries., Results: Male to female ratio was 4.5:1. Among them, 53.3% were aged 11-30 years. Traffic accidents were by the far the commonest cause of injury. Motorcyclists who wore a helmet sustained facial fractures less often during traffic accident than those patients who did not wear helmet. Soft tissue injury and facial bone fracture comprised 43.3% and 40.8% of facial injuries, respectively. The majority of Soft tissue injuries (79%) were located extra orally. The mandible and nasal bone were the most commonly fractured facial bones. Victims of assault sustained more severe injuries compared to those involved in falls and traffic accidents., Conclusions: Use of helmets by motorcyclists and the separation of pedestrians routes from motor vehicles could reduce the number of victims and consequently injuries due to road traffic accidents. For implementation of effective prevention programs for reduction of facial injuries due to assault, it seems to be necessary to conduct studies investigating causes and pattern of injuries resulting in assault.

Introduction: Breast Cancer is the most common cancer in Iranian women. This study aims to demonstrate the characteristics of breast diseases- and especially breast cancer- according to pathologic records in Tehran, Iran., Methods: In this cross-sectional study, all records of pathologic specimens (biopsy or mastectomy) categorized as "breast diseases" from 1996 to 2000 in five teaching hospitals in Tehran were studied. For each patient, sex, age, breast pathology, pathological staging of malignant lesions, side and location of the tumor and the type of surgery were reviewed by a trained general practitioner. SPSS version 10 was used for statistical analysis., Results: The mean age of women with breast cancer was 48.8. The highest frequency of malignancies was observed in the 40-49 age group (31.8%). Twenty-three percent of breast cancers were observed in women younger than 40 years. About 83 percent of malignant lesions in women were in T2, T3 or T4 at diagnosis. Only about 4 percent of women with breast cancers had tumors in stage I or in-situ carcinomas. Nearly 70 percent of the cancers were detected only after lymph node involvement. Only 4.3 percent of our female cases had the chance of conservative mastectomy. Twenty-eight percent of specimens from biopsies in women were malignant., Discussion and Conclusion: In Iran, breast cancer affects women at least one decade younger than their counterparts in developed countries. A considerable proportion of our cases (96%) were in stage II or III at diagnosis. These results show advanced cases at presentation in Iran which further mandate a national cancer detection program involving more effective public education and encouragement of women for breast self-examination and participation in screening campaigns.