Reviewer ’s report  
 
Title: Clinicopathologic and prognostic features of breast cancer in young women: A series from 
North of Morocco  
 
Version: 1 Date: 20 Jun 2017  
 
Reviewer: Lauro Bucchi  
 
Reviewer's report:  
 
I have reviewed the manuscript entitled "Clinicopathologic and prognostic features of breast 
cancer in young women: a series from North of Moroc co" by J. Bakkach and Colleagues. I have 
some comments that could improve the manuscript if addressed.  
 
Introduction  
71-75. Please move this paragraph to the Discussion section.   
93. "We conducted …". "We are conducting …" seems more appropriate. Also,  this section 
should begin with  a new paragraph.    
 
Methods  
103. Please provide here the number and percentage of women aged 40 years or younger.  
103-107. Redundant statements. The information is also provided in the Introduction.       
109-110. " … m issing information was completed at recruitment …". This is unclear to me. 
Probably, missing information was obtained at follow -up visits.  
120. Please insert a paragraph indicating the follow -up schedule. In addition, I do not understand 
the term "… rece ived … ". What do the Authors mean?  
121. Please specify " … 5 -year overall survival …".   
 
Results  
131. " … and 37 … under 36 years". Please delete this sentence. Information on the median age 
is sufficient.            
132. Please change 'are' to 'were'. Also, I never heard the word Amazighs before. I suggest to add 
'Berbers' in parentheses.  
136. " … may be referred …". Do the Authors mean that these women were only potentially 
eligible for genetic counseling and were actually not referred for it? Which type of women does 
the genetic study target?      
140. ACR. Please spell out.  
146-157. There are many redundancies. Repetition of data that are in Table 3 in unnecessary.   
170. "Five -year recurrence rate was 11.1%".  This statement is unnecessary.  
171. " …12 -49 months …". I do not understand this upper limit. The Authors present 5 -year 
follow -up data. At least some patients have necessarily been followed -up for 60 months or more.    
The figures should be present ed better.  
 
Discussion  
The length of this section should be substantially reduced. In particular, I recommend that 
literature data be cited less extensively.     
194-196. I strongly invite the authors to reconsider the sentence "If this epidemiological s ituation 
… guidelines". On which evidence do they base their view that women aged 40 years or younger 
should be screened?               
197-205. Please move this section to line 192.  
199-201. " … absence of mass screening may increase the observed dispa rity and suggests an 
under -estimation of breast cancer among older women". This sentence is unclear. The absence of 
screening cannot alter incidence rates. The likely under -registration of older patients, alone, 
seems insufficient to explain the fact that breast cancer incidence in Morocco peaks at age 40 -49 
years (line 68). The latter information should be adequately mentioned in this paragraph. 
Theoretically, a potential explanation to take into consideration is that incidence is sharply 
increasing in the  younger age cohorts. Has such a trend been observed in Morocco?      
305. Here, the term 'trend' is not appropriate.  
 
Tables  
Table 1. Please provide the total number of patients in the title.  
Table 2. Please provide the total number of patients in the title. I would suggest to change the 
title to "Clinical characteristics".   
Table 3. Please provide the total number of patients in the title. I would suggest to change the 
title to "Histopatholo gical characteristics". The data reported in the section titled "Evolution" can 
be given in the text.   
Table 4. Please provide the total number of patients in the title. Also, the numbers must be 
checked. The % of surgically untreated is 16.7%. The propo rtion of inoperable cancers in the text 
(lines 158 -159) is different. Please clarify.    
 
Figures  
Titles. ' … for all patients…' is unnecessary. It is better to give the number of patients.  
Are the methods appropriate and well described?  
If not, please specify what is required in y our comments to the authors.  
 
Yes 
 
Does the work include the necessary controls?  
If not, please specify which controls are required in your comments to the authors.  
 
Yes 
 
Are the conclusions drawn adequately supported by the data shown?  
If not, please explain in your comments to the authors.  
 
Yes 
 
Are you able to assess any statistics in the manuscript or would you recommend an  
additional statistical review?  
If an additional statistical review is recommended, please specify what aspects req uire further  
assessment in your comments to the editors.  
 
I am able to assess the statistics  
 
Quality of written English  
Please indicate the quality of language in the manuscript:  
 
Needs some language corrections before being published  
 
Declaration of competin g interests  
Please complete a declaration of competing interests, considering the following questions:  
 
1. Have you in the past five years received reimbursements, fees, funding, or salary from an  
organisation that may in any way gain or lose financially fr om the publication of this  
manuscript, either now or in the future?  
 
2. Do you hold any stocks or shares in an organisation that may in any way gain or lose  
financially from the publication of this manuscript, either now or in the future?  
 
3. Do you hold or are you currently applying for any patents relating to the content of the  
manuscript?  
 
4. Have you received reimbursements, fees, funding, or salary from an organization that 
holds  or has applied for patents relating to the content of the manuscript?  
 
5. Do you have any other financial competing interests?  
 
6. Do you have any non -financial competing interests in relation to this paper?  
 
If you can answer no to all of the above, write 'I declare that I have no competing interests' 
below.  If your reply is yes to any, please give details below.  
 
I declare that I have no competing interests.  
 
I agree to the open peer review policy of the journal. I understand that my name will be included  
on my report to the authors and, if the man uscript is accepted for publication, my named report  
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