Breast Cancer - POF Hospital Experience

Objectives: This study was designed to evaluate the magnitude of breast cancer, mean age at presentation to hospital, management plan and outcome of patients presenting with breast cancer at POF Hospital Wah CanttDesign of study: Retrospective Chart Review
Materials and methods: All patients with biopsy proven breast cancer presenting at POF Hospital Wah Cantt from January 2000 to 31st December 2007 were included in the study. The patients’ records were reviewed for history, examination and operative findings. Biopsy reports were confirmed from pathology lab record.
Results: A total of 954 patients presented with breast lump out of which 275 were malignant. 69% patients presented with locally advanced disease. Mean age of the patients was 48 in year 2000 which gradually decreased to 41 by 2007, with an overall mean age of 44.1years. Neo-adjuvant therapy was given to all patients with locally advanced breast cancer to downstage/downsize the tumor followed by mastectomy. Patients were thoroughly evaluated by physical examination, ultrasound abdomen, X-ray chest and bone-scan .10% patients developed bony metastasis and 2 had paraplegia. Lymphoedema was seen in 12%.Overall survival in patients was 25%.
Conclusion: Breast Cancer is not uncommon in our women. Majority of our patients presents late with locally advanced disease. Public awareness and screening are the tools to reduce morbidity and mortality and increase the disease free survival. As most of the patients present with locally advanced disease, breast conserving surgery is still limited to very few patients.

Keywords:  Breast cancer, Locally advanced, Mean age

Introduction

Breast cancer is one of the oldest known forms of malignancies. The earliest known documentation on breast cancer was the Smith Surgical Papyrus (3000-2500 B.C.) written in Africa (Egypt).¹Breast Cancer constitutes a major public health issue globally with over 1 million new cases diagnosed annually, resulting in over 400,000 annual deaths and about 4.4 million women living with the disease. It is the commonest site specific malignancy affecting women and the most common cause of cancer mortality in women worldwide^2,3 Incidence rates are higher in the developed countries than in the developing countries. Incidence rates are also higher in urban rather than the rural areas. In Pakistan, breast cancer is the most common cancer (34.6% of cancer cases) among females.^4,5 It is one of the potentially curable diseases so the main focus should be on early detection and management of this lethal disease.

The recognition in the 1950s that breast cancer was often a systemic disease at presentation shifted the management of primary breast cancer away from a purely surgical approach to a multidisciplinary one that combines systemic therapy, surgery and radiation. As a result surgery for breast cancer is now more conservative with less locally ablative procedures such as quadrantectomy and  lumpectomy. The past three decades have witnessed an enormous growth in the knowledge and understanding of the basic science of the disease especially the genetic and molecular basis of the disease.

The objective of this study was to highlight the magnitude of breast cancer, the mean age of patients and outcome of the patients presenting at POF Hospital Wah Cantt.

Authors Name:

M.A.Nasir Malik,

Omer Salahuddin,

Zafar Iqbal Malik,

Muhammad Azhar,

Omer Dilawar,

Ayesha Salahuddin,

Farzana Aleem

POF Hospital Wah Cantt.