Altaf Ahmed Talpur, Abdulghaffar Ansari, Ali Akber Ghumro, Abdul Rashid Surahio.
Late presentation of breast cancer: a dilemma.
J Pak Med Assoc Jan ;61(7):662-6.

Objective: To asses factors responsible for late presentation of breast cancer in Nawabshah. Methods: This descriptive study was conducted at a private and a public sector hospital of Nawabshah, Pakistan, from Jan 2004 to Dec 2008. Results: Sixty females were admitted and selected as study subjects during the study period with mean age of 43.5±10.38 years and range (28-80 years). Patients with poor economic status were 49(81.6%) and remaining 11 (18.3%) were from middle class. Sixteen (26.6%) patients were literate, with 3 of them being educated to secondary level. In our study 58 (96.6%) patients with breast carcinoma noted lumps in respective breasts as incidental findings in breast self-examination. Only in 2 (3.3%) patients family physicians noted a lump and referred them to a proper health care facility. Fifty-eight (96.6%) patients belonged to rural areas. In 95% patients, first visit regarding the breast symptoms was made after 6 months of initiation of symptoms. Three (5%) patients in this study presented in stage I, 15(25%) in stage II, 23 (38.3%) in stage III and 19 (31.6%) in stage IV. Conclusion: Most cases of breast cancer presented in advanced stage probably due to poor economic status, illiteracy and negligence by patients or their family members and general practioners.

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