Saturday December 04, 2021

Experts discuss changing pattern of breast cancer in Pakistan

October 25, 2021
Experts discuss changing pattern of breast cancer in Pakistan

“Breast cancer is one of the most common cancers in Pakistani women. The average risk of a woman in the Pakistan developing breast cancer sometime in her life is about 13 per cent. This means there is a one in nine chance she will develop breast cancer. Breast cancer also has become the most common cancer globally, according to the World Health Organisation. It accounts for 12 per cent of all new annual cancer cases worldwide.”

These statistics were shared by Brig (retired) M. Zubair Sheikh, CEO, Neurospinal & Cancer Care Postgraduate Institute, at a webinar and a free breast cancer screening camp held on Saturday in connection with World Breast Cancer Awareness Month 2021 being observed in October.

“The free camp has information on the stages of breast cancer, screening and prevention, symptom management, people's experiences of the disease, spiritual support and more. These get-togethers enable us to share stories, celebrate those who have survived and are thriving, as well as celebrate those who have left us. We also have guest speakers from cancer experts who can educate us all on preventive measures and how to catch typical symptoms early,” Brig Zubair explained.

“If you notice a lump, do not panic because eight out of 10 cases of breast lumps are not cancerous (benign), but the sooner a cancer is caught, the more treatable it is. A person who is diagnosed with breast cancer in its early stages has a 90 per cent survival rate, so we really want to catch it early.”

Dr Azhar Rashid, consultant clinical & radiation oncologist at the Neurospinal & Cancer Care Postgraduate institute, Karachi, CME coordinator at the Pakistan Society of Clinical Oncology (PSCO) and secretary of the faculty of Radiotherapy in College of Physicians & Surgeons Pakistan (CPSP), also shared his views and experiences.

According to the expert, an organised public awareness campaign needs to be launched in the country to increase the public information of knowing factors producing breast cancer at village and town levels.

Dr Azhar lamented that women in Pakistan were unaware of the seriousness of the disease and had shied away from talking about breast cancer, taking precautions, or getting them tested. It’s high time we united against breast cancer to protect our women from this cruel killer that devours 50,000 innocent Pakistani women every year.

“We are targeting to attract around 1,500 women with this free breast cancer screening camp. Our main aim is awareness and self-examination. Detecting breast cancer in the early stages can increase chances of getting well considerably.”

“Last year, around 100,000 leaflets on breast self-examination and other cancer diagnostic procedures were distributed. This year for the month-long campaign there will be a state-of-the-art breast clinic at the NCCI, doctors, nurses and female healthcare staff will be available to discuss breast examinations and give advice on correctly checking oneself. A screening mammogram and ultrasound will be offered for eligible and suspected cases,” said Dr Azhar.

“Detecting breast cancer early is the key to the best possible outcomes. It’s important to have regular screening mammograms,” said Prof Muhammad Ali Memon, ex-director & chief oncologist, Atomic Energy Medical Centre, JPMC, Karachi & Consultant Clinical Oncologist at the NCCI. “Although prognosis and detection have improved in recent years, breast cancer awareness, healthy lifestyle choices and screenings are still vital to reducing the effects of breast cancer.”

A few factors associated with an increased risk of breast cancer include being female, increasing age, a personal history or family history of breast cancer, obesity, hormone therapies for symptoms of menopause and inherited genes that increase breast cancer risk.

Breast cancer primarily affects women but can also affect men. Several factors determine what type of breast cancer you have, your prognosis, and your treatment options.

Dr Muhammad Ali Memon also highlighted the link between obesity and breast cancer and said weight loss was associated with lower breast cancer risk in postmenopausal women, according to a landmark study. Women with weight loss greater than or equal to five per cent had a 12 per cent lower breast cancer risk compared to women with a stable, with no interaction by body mass index. Weight gain of greater than or equal to 5 per cent was not associated with risk of breast cancer overall but was associated with a 54 per cent higher incidence of triple negative breast cancer.

“Adopting a low-fat dietary pattern and moderate, relatively short-term weight reduction was associated with a statistically significant reduction in breast cancer risk for postmenopausal women.

“Many studies show that moderate or vigorous exercise is linked with a lower risk of breast cancer and many other cancers. It’s recommended to get 150 to 300 minutes of exercise a week – ideally 300, avoid smoking including sheesha and e-cigarette: alcohol, even minimal consumption, increases the risk of breast cancer, breastfeeding for at least several months, ideally, the first year, is an added benefit of reducing the risk of breast cancer,” advised Prof Muhammad Ali.

Guest speaker Prof Sughra Parveen, breast and general surgeon at the NCCI, explained that breast cancer occurs when some breast cells begin to grow abnormally and divide more rapidly than healthy cells do and continue to accumulate, forming a lump. Cells may spread through the breast to lymph nodes or other parts of the body.

“Self-breast exams are a wonderful way to know your body and track any differences; most breast cancers are discovered by women during regular daily activities like bathing or scratching,” Dr Sughra Parveen said. “Breasts are naturally lumpy and bumpy. They constitute glands, ducts, connective tissue and fat, so anything or any lump you notice is different should be checked out even if it may be nothing.”

The expert said: “A breast lump can be termed localised swelling, bulge, or bump in the breast that is not similar to the breast tissue surrounding it or in the same area of the other breast.

“You will be shocked to know that infection, trauma, cyst, fibroadenoma, or fibrocystic breasts can be the culprits behind the lumps. Moreover, lumps in the breast can be seen in both males and females. However, in females, the occurrence is higher. In case, the lump you have is cancerous which is confirmed in the diagnosis, and then it is time to take appropriate action.”

According to various studies, cancerous lumps are mainly witnessed in the upper outer quadrant of the breast that is the part of your breast located near the armpit.

If the lump is cancerous then it may not be painful but it will surely be firm, irregular at the edges, may change constantly and can be found in the upper quadrant of the breast. A lump is a non-cancerous lump if it is smooth, rubbery, round, small, and is getting smaller.

She said that mammogram screening should begin at age 40, unless you have a family history of breast cancer. In this case, it is recommended you start earlier at 35, or, depending on the type of history, starting even earlier than this may be advised.