Early diagnosis, treatment of breast cancer can prevent 40,000 deaths per year

[Naveed Yaseen]

Muhammad Qasim
Breast cancer is the most common malignancy in women and Pakistan has the highest rate of its incidence in Asia, as it accounts for 38.5 per cent of all female cancers, with 90,000 new cases and 40,000 deaths every year.

Health experts believe that the breast cancer incidence in Pakistani women has been on the rise mainly because of unawareness among general public. In developing countries, 80 per cent of breast cancer patients are at an advanced stage of the disease. About half (43.7 per cent) of all breast cancers are locally advanced, accounting for 40,000 deaths per year. With early diagnosis and appropriate treatment, a patient’s chance of survival is higher than 90 per cent.

October is the month of ‘Pink Ribbon - Breast Cancer Awareness’ worldwide. The Pink Ribbon Campaign is an international symbol of support for breast cancer awareness.

Health experts say that the Pink Ribbon Day, which is being observed today (Monday) on October 26, provides the opportunity to help raise money and awareness for all Pakistani women affected by breast cancer.

“It is not the cancer of breast that is causing problems, rather it is the lack of awareness which is at the root of all problems,” said Head of Community Medicine at Islamabad Medical & Dental College Professor Dr Muhammad Ashraf Chaudhry while talking to ‘The News’ Sunday in connection with the Pink Ribbon Day.

Due to late childbearing, small timing of postpartum breastfeeding and the general lifestyle of women of this day and age, younger women are just as likely to develop breast cancer as women in their 50s, he said adding, “There have been several reported cases of women as young as 20 years of age that have been diagnosed with the disease.”

Talking of the risk factors, Dr Ashraf said the most significant risk factors for breast cancer are gender (being a woman), age (growing older) and family history of cancer.

“Other risk factors are early menses before 12 years of age, late menopause after 55 years, late childbirth after 30 years of age, no children, no breastfeeding, physical inactivity, previous history of breast cancer, higher socio-economic status, low consumption of fruits and vegetables, exposure to pesticides, obesity, alcohol consumption, smoking, high dose radiation to chest, high fat diet and genetic abnormalities.”

To a query, he said the early stages of breast cancer might be asymptomatic.

Most breast cancers present as hard lumps may be associated with the in drawing of the nipple. There may be changes in the skin such as redness, scaling, swelling, changes in texture, and puckering, he said.

He added that by screening, the disease could be diagnosed at an early stage and it might reduce the mortality and morbidity chance from breast cancer. “Various methods of diagnosis are Breast-Self Examination (BSE), clinical examination by a doctor, ultrasound, MRI, and biopsy.”

Dr Ashraf said the triple assessment of any symptomatic breast mass by palpation, radiology (mammography) and fine needle aspiration cytology is the most reliable way to differentiate breast cancer from benign breast masses. Therefore, creating widespread awareness is the principal goal of the Pink Ribbon Campaign.

Explaining further the self-examination, he said women should begin a monthly examination of their breasts at the age of 20, with menstruating women conducting it 5-7 days after the beginning of their period, while menopausal and pregnant women must carry it out on the same date each month.

“Examine all breast tissues. There is no reason to conclude that breast cancer will end up killing you. Early detection and appropriate treatment of breast cancer has 90 per cent chances of survival. It is not an incurable disease and can be treated in more than one ways,” he said.

Talking on the treatment protocols, Dr Ashraf said the treatment includes the combination of surgery, radiation therapy, chemotherapy, and hormone therapy. “The most common treatment of breast cancer is surgery, which may be of two types - mastectomy (complete removal of the breast) and lumpectomy (removal of cancer and small amount of tissue around it).” He, however, added that surgery is not the only way out. “If the cancer is detected at an early stage, you can go through chemotherapy and there is no need for surgery to remove your breast.”

Regarding prevention from the disease, he said at least one-third of cancers are preventable. “Breast cancer prevention starts with your own health habits such as staying physically active, maintaining a healthy weight, avoiding alcohol and smoking, and eating right such as a low fat diet,” he said.

He suggested that women should have children sooner (before 30 years of age) rather than later in life, should breastfeed their babies, restrict the sources of red meat, eat more fruits and vegetables, and avoid exposure to pesticides and a prolonged use of antibiotics and birth control pills. “Women should avoid wearing tight fitting bras 24 hours a day and from the age of 20 onwards, should carry out the self-examination every month as a preventive measure,” concluded Dr Ashraf.

http://www.thenews.com.pk/daily_detail.asp?id=205233