Mashal Wakeela

BC160402926
Assignment No 1
BT 502
Seminar I
Breast Cancer
Updated Reports
From Pakistan
 Breast Cancer

Breast cancer may be a disease during which cells

within the breast grow out of control. There are
different sorts of carcinoma . The type of carcinoma
depends on which cells within the breast become
cancer. carcinoma can spread outside the breast
through blood vessels and lymph vessels. When
breast cancer spreads to other parts of the body, it's
said to possess metastasized.
 Table of Contents

01 02 03
Types of Breast Clinical Signs Risk Factors
Cancers

04 05
Diagnosis & Updated Reports
Treatment From Pakistan
 Introduction
The pathophysiology of breast cancer is multidimensional and still poorly understood, but
certain risk factors are known. Advancing age and female sex are the most common risk
factors. Genetic mutations, specifically BRCA 1 and 2, account for about 10% of breast
cancers. Other known risk factors include a history of ductal carcinoma in situ, high body
mass index (BMI), first birth at age greater than 30 years or nulliparity, early menarche
(before age 13 years), family history of breast or ovarian cancer, late menopause, and
postmenopausal hormone therapy use. Among women who use postmenopausal hormone
therapy, white women and women with a normal BMI and dense breasts are at greatest
risk. Women with a history of previous chest radiation also are at an increased risk.
01 Types of Breast
Cancer
 Clinical Signs

A palpable breast mass is evident in about 30% of women with breast cancer.
Visible signs associated with breast cancer include dimpling, an orange-peel
appearance (peau d'orange), erythema, edema, blistering, excoriations,
sanguineous nipple discharge, and nipple retraction. Skin changes such as peau
d'orange and blistering are strongly associated with inflammatory breast cancer
and Paget disease of the breast. Sanguineous nipple discharge is associated with
papillary breast neoplasia. Ulcerations can be seen in advanced disease.
Remember to rule out malignancy in patients being treated for mastitis or a
breast abscess that is not improving clinically.
 Risk Factors
1. Non-modifiable risk factors
According to ACS, non-modifiable risk factors for breast cancer include gender, advancing age,
genetic factors, family history, race, ethnicity, dense breast tissue, tobacco smoke, certain benign
breast conditions, previous chest radiations and diethylstilbestrol exposure.
2. Modifiable risk factors
Lifestyle-related risk factors include the number of children given birth to, birth control, hormone
therapy, breastfeeding, alcohol use, overweight or obesity and physical activity.
3. Controversial risk factors
Some factors have uncertain, controversial or unproven effect on the risk of developing breast cancer.
These factors include diet and vitamin intake, anti-perspirants, bras, induced abortions, chemicals in
the environment, and night-shift works.
 Diagnosis
Mammography and ultrasonography are used as initial imaging
modalities. MRI may be used in specific circumstances, such as in
patients with dense breasts, those with a history of breast cancer, those
who are being evaluated for contralateral disease, and those at high risk
for breast cancer.7 MRI also can be used in the presurgical planning of
biopsy-proven breast cancer or in the evaluation of patients with dense
breasts, contralateral disease, or a history of breast surgery or radiation.
MRI can more accurately identify skin changes common in inflammatory
breast cancer, such as skin invasion.
Disease is confirmed by tissue biopsy; samples can be obtained through
percutaneous ultrasound-guided core needle biopsy, excisional biopsy,
stereotactic biopsy, or MRI-guided biopsy. The preferred method for
most patients is ultrasound-guided large-bore core needle biopsy with or
without a vacuum-assisted device.
 Treatment

Surgery
Chemotherapy
Chemotherapeutic options depend on multiple
variables, including hormone receptor status, HER-2
status, presence or absence of metastatic disease, and Treatment of breast cancer, including surgery, depends on the size
Oncotype DX recurrence score. Locally advanced of the lesion, hormone receptivity and histologic markers, presence
disease and triple-negative breast cancer usually are or absence of metastatic or contralateral disease, patient age, and
treated with presurgical neoadjuvant chemotherapy. patient preferences. Surgical options include lumpectomy,
Chemotherapeutic agents include doxorubicin,
mastectomy, and bilateral mastectomy. Breast-conserving surgery
cyclophosphamide, and paclitaxel. Doxorubicin can
cause significant nausea, vomiting, diarrhea, and (lumpectomy) is the preferred intervention for most patients with
fatigue. Some women will experience a discoloration of unilateral disease, but many patients still opt for mastectomy.
their nails.
 Updated Reports From Pakistan
Pakistan, the 6th most crowded
nation on the globe and is a republic
in south central Asia. It shares
universal topographical limits and
social similitudes with India in the
east and southeast, Iran and
Afghanistan on the west and
northwest and China and Soviet
Central Asian Republics in the north.
Political unsteadiness and economic
destruction have ruined our
establishments in general and health
department specifically
In an investigation, it was estimated
that a total of 28,740 patients, cancer
was detected and subjects got
registered at INMOL during the
period from 1st January, 2000 to 31st
December, 2009. Among those almost
6,718 patients reported having breast
cancer. The proportion of occurrence
of breast cancer among women was
41% (38% in the first five years and
42% in the later five years). The ratio
among the female and male
counterpart was 100:2.
 Breast Cancer Statistics
In Asia, Pakistan has the highest rate of breast cancer. Young women also present at a complicated
stage of carcinoma , which incorporates a negative effect on prognosis. In rural areas, rural
women are developing a large number of breast cancers per annum because it's an genetic
disease , which is transmitted from mother to daughter. Pakistani rural as well as urban women
face cervical, ovarian, and uterine cancers. In rural areas of Pakistan, socio-economic conditions
are liable for the poor health of the ladies . At some stage of life, 1 in 9 Pakistani women has
become a patient of breast cancer
 Awareness Campaigns In Pakistan
Pink Ribbon launched the first ever national screening in Pakistan with Breast
Cancer Mobile Mammogram Clinic in collaboration with INMOL Cancer Hospital
in 2009. The mobile unit, for 3 years, reached out to the poorest of the poor women
for free screening services at their doorsteps, saving thousands of precious lives.
They also ran a free breast screening program in 12 cities with the collaboration of
14 partner hospitals for 2 years. The objective of the programme was to serve the
needy women and provide them free services of clinical-examination, ultrasound,
mammography and also assistance for further treatment if required.
They are now planning to extend this program in more cities by joining hands with
other healthcare providers.
 Conclusions
Cancer remains an enormous issue in both developed and
emerging countries, especially breast cancer. In Pakistan,
breast cancer is found to be a chief form among all other
sorts of cancers. there's an upward trend ongoing and
prevalence of breast cancer because of lack of facilities and
awareness among the patients. Currently no authentic data is
out there regarding morbidity and mortality of carcinoma
which might be because of lack of patients' follow up. Besides
this, although cancer registries are developed and our
functional but they appear to be in their preliminary stage
for designing the protocols for diagnosis and treatment of the
cancer and aren't capable provide complete statistics on
carcinoma for early disease prevention.
 Thanks!

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