Mushahida Batool, Mustafa Arian, Javaid Gardezi.
An experience with breast disease in a surgical unit of a teaching hospital of Lahore.
Biomedica Jan ;21(2):108-12.

Breast cancer is the most common malignancy in women in Pakistan. Our patients suffer from the disease at a younger age than that reported in Western literature. A significant proportion of cases are 35 years old or younger. Our objective was to study the clinical features of the disease, risk factor profile and trends among women with breast cancer at our institution. A prospective case series of 205 women presenting with breast disease and undergoing treatment at Surgical Unit IV, Jinnah Hospital, Lahore, was conducted from January, 1999 to December, 2003. The result showed that 30.73% of the patients had benign breast disease whereas 69.26% were diagnosed as having breast cancer. The commonest benign disease was fibroadenoma (60.3%). Mean age of the cancer patients was 34.56 years ± 11.5 years. Among the cancer group, the commonest presentation was a painless lump (83.8%). The risk factor profile included positive family history of breast cancer in first degree relatives in 11.97% of the patients with breast cancer, nulliparity in 7.75% and oral contraceptive use in 14.08%. The commonest histological type was infiltrating ductal carcinoma (85.2%). Most of the patients presented at stage III (59.85%). Mammography was done in 48% and breast ultrasonograghy in 52% of the patients. Among these 69.7% of the patients underwent modified radical mastectomy and 16.2% had radical mastectomy. Breast conservation was offered to 14.08% patients. Adjuvant chemotherapy was administered to49% patients and 81% received adjuvant radiotherapy. It was thus concluded that women with breast cancer treated at our institution presentsd at a younger age than Western women. Interestingly, majority of our patients have none of the established risk factors for the disease. Despite advances in diagnostic modalities, most of our patients were diagnosed at advanced stages of breast cancer due to late presentation. There is a great need for creating awareness regarding breast cancer amongst women in Pakistan.

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