Browse > Article
http://dx.doi.org/10.7314/APJCP.2012.13.2.693

Clinicopathologic Profile of Breast Cancer Patients in Pakistan: Ten Years Data of a Local Cancer Hospital  

Khokher, Samina (Surgical Department, INMOL Hospital)
Qureshi, Muhammad Usman (Nauman Associates)
Riaz, Masooma (Medical Physics)
Akhtar, Naseem (Medical Physics)
Saleem, Afaf (Central Park Medical College)
Publication Information
Asian Pacific Journal of Cancer Prevention / v.13, no.2, 2012 , pp. 693-698 More about this Journal
Abstract
Breast cancer is the most frequent cancer of women worldwide, with considerable geographic and racial/ethnic variation. Data are generally derived from population based cancer registries in the developed countries but hospital data are the most reliable source in the developing countries. Ten years data from 1st Jan 2000 to 31st Dec 2009 of a cancer hospital in Pakistan were here analyzed by descriptive statistics to evaluate the clinicopathologic profile of local breast cancer patients. Among 28,740 cancer patients, 6,718 were registered as breast cancer. The female to male ratio was 100:2. Breast cancer accounted for 23% of all and 41% of female cancers. Some 46% were residents of Lahore, with a mean age of $47{\pm}12$ years. Less than 1% were at Stage 0 and 10%, 32%, 35% and 23% were at Stage I, II, III and IV respectively. Histopathology was unknown in 4% while 91%, 2% and 1% had invasive ductal carcinoma (IDC), invasive lobular carcinoma (ILC) and mucinous carcinoma respectively. Rare carcinomas accounted for the rest. Tumor grade 1, 2 and 3 was 11%, 55% and 34% among the known. Profile of breast cancer patients in Pakistan follows a pattern similar to that of other developing countries with earlier peak age and advanced disease stage at presentation. The male breast cancer accounts for higher proportion in the local population. Local women have higher frequency of IDC and lower frequency of ILC and DCIS, owing probably to a different risk profile. Use of hospital information systems and establishment of population based cancer registry is required to have accurate and detailed local data. Promotion of breast health awareness and better health care system is required to decrease the burden of advanced disease.
Keywords
Breast cancer clinicopathologic profile; gender dependence; cancer hospital data; Pakistan;
Citations & Related Records
연도 인용수 순위
  • Reference
1 Agarwal G, Pradeep PV, Aggarwal V, et al (2007). Spectrum of breast cancer in Asian women. World J Surg, 31, 1031-40.   DOI
2 Albreksten G, Heuch I, Thoresen SO (2010). Histologic type and grade of breast cancer tumors by parity, age at birth and time since birth: a register based study in Norway. BMC Cancer available at http://www.biomedcentral.com/1471- 2407/10/226 accessed on 10th Dec 2011.
3 American Cancer Society (2007) Global Cancer Facts & Figures. Atlanta 2007.
4 Anderson BO, Yip CH, Ramsey SD, et al (2006) Global Summit Health Care Systems and Public Policy Panel. Breast Cancer in Limited Resource Countries: Health Care Systems and Publicy. Breast J, 12 Suppl 1,154-69.   DOI
5 Australian Institute of Health and Welfare & Australasian Association of Cancer Registries 2010. Cancer in Australia: an overview, 2010. Cancer series no. 60. Cat. no. CAN 56. Canberra: AIHW.
6 Autier P, Boniol M, Middleton R, et al (2011). Advanced breast cancer following population based mammographic screening. Ann Oncol, DOI:10.1093/annonc/mdq633.
7 Aziz Z, Iqbal J, Akram M (2008) Effect of social class disparities on disease stage, quality of treatment and survival outcomes in breast cancer patients from developing countries. Breast, 14, 372-5.   DOI
8 Aziz Z, Sana S, Saeed S, et al (2003). Institution based tumor registry from Punjab: five year data based analysis. J Pak Med Assoc, 53, 350-3.
9 Badar F, Faruqui ZS, Uddin N, et al (2011). Management of breast lesions by breast physicians in a heavily populated south asian developing country. Asian Pac J Cancer Prev, 12, 827-32.
10 Barrett SV (2010). Breast cancer. J R Coll Physicians Edinb, 40, 335-9.   DOI
11 Bhikoo R, Srinivasa S, Yu T, et al (2011). Systematic review of breast cancer biology in developing countries (Part 2): Asian subcontinent and South East Asia. Cancer, 3, 2382-401.   DOI
12 Bhurgri Y, Bhurgri A, Nishter S, et al (2006). Pakistan - country profile of cancer and cancer control 1995-2004. J Pak Med Assoc, 56 ,124-30.
13 Bhurgri Y, Kayani N, Faridi N, et al (2007). Patho-epidemiology of breast cancer in Karachi "1995-1997". Asian Pac J Cancer Prev, 8, 215-20.
14 Chopra R (2001). The Indian scene. J Clin Oncol, 19, 106S-11S.
15 Contractor KB, Kaur K, Rodrigues, et al (2008). Male breast cancer: Is the scenario changing. World J Surg Oncol, DOI:10.1186/1477-7819-6-58.
16 Echeverria SE, Borrell LN, Brown D, et al (2009). A local area analysis of racial, ethnic and neighbourhood disparities in breast cancer staging. Cancer Epidemiol Biomarkers Prev, 18, 3024-29.   DOI
17 Gilani GM, Kamal S, Akhter S (2003). A differential study of breast cancer patients in Punjab, Pakistan. J Pak Med Assoc, 53, 478-80.
18 El Saghir, Khalil MK, Eid T, et al (2007). Trends in epidemiology and management of breast cancer in developing Arab countries: A literature and registry analysis. Int J Surg, 5, 225-33.   DOI
19 Ferlay J, Shin H, Bray F, et al (2010). Globocan 2008, Cancer incidence and mortality worldwide: IARC Cancer Base No 10. Lyon, France: international Agency for Research on Cancer, 2010.
20 Foo CS, Su D, Chong CK, et al (2005). Breast cancer in young Asian women: Study on survival. ANZ J Surg, 75, 566-72.   DOI
21 Gorin SS, Heck JE, Cheng B, et al (2006). Delays in breast cancer diagnosis and treatment by racial/ethnic group. Arch Intern Med, 166, 2244-52.   DOI
22 Green M, Raina V (2008). Epidemiology, screening and diagnosis of breast cancer in the Asia-Pacific region: Current perspectives and important considerations. Asia-Pac J Clin Oncol, 4, S5-13.   DOI
23 Gress DM (2002). Your cancer registry: more than just case counts. Oncol Issues, 17, 28-31.
24 Hanif M, Zaidi P, Kamal S, et al (2009). Institution based cancer incidence in a local population in Pakistan: Nine year data analysis. Asian Pac J Cancer Prev, 10, 227-30.
25 Hebert JR, Ghumare SS, Gupta PC (2006). Stage at diagnosis and relative differences in breast and prostate cancer incidence in India: comparison with the United States. Asian Pac J Cancer Prev, 7, 547-55.
26 Igene H (2008). Global health inequalities and breast cancer:an impending public health problem for developing scountries. Breast J, 14, 428-34.   DOI
27 Jemal A, Siegel R, Ward E, et al (2009). Cancer statistics 2009. Ca Cancer J Clin, 59, 1-25.   DOI
28 Ihekwaba FN (1994). Breast cancer in men in black Africa: a report of 73 cases. J R Coll Surg Edinb, 39, 344-7.
29 Jamal S, Moghal S, Mamoon N, et al (2006). The pattern of malignant tumors:Tumour registry data analysis, AFIP, Rawalpindi, Pakistan(1992-2001). J Pak Med Assoc, 56, 359-62.
30 Jemal A, Bray F, Center MM, et al (2011). Global Cancer statistics. Ca Cancer J Clin, 61, 69-90.   DOI
31 Kerlikowski K (2010). Epidemiology of ductal carcinoma in situ. J Natl Cancer Inst Monogr, 41, 139-41.
32 Khokher S, Mahmood S, Khan SA (2010). Response to neoadjuvant chemotherapy in patients with advanced breast cancer: A local hospital experience. Asian Pac J Cancer Prev, 11, 303-8.
33 Leong SPL, Shen ZZ, Liu TJ, et al (2010). Is breast cancer the same disease in Asian and Western countries? World J Surg, 34, 2308-24.   DOI
34 Li CI, Daling JR, Malone KE, et al (2006). Relationship between established breast cancer risk factors and risk of seven different histologic types of invasive breast cancer. Cancer Epidemiol Biomarkers Prev, 15, 946-54.   DOI
35 Li CI, Uribe DJ, Daling JR (2005). Cinical characteristics of different histologic types of breast cancer. Br J Cancer, 93, 1046-52.   DOI
36 Lim SE, Back M, Quek E, et al (2007). Clinical observations from a breast cancer registry in Asian women. World J Surg, 31, 1387-92.   DOI
37 Lokuhetty MD, Ranaweera GG, Wijeratne MD, et al (2009) Profile of breast cancer in a group of women in a developing country in South Asia: Is there a difference? World J Surg, 33, 455-459.   DOI
38 Merkin SS, Stevenson L, Powe N (2002). Geographic socioeconomic status, race and advanced stage breast cancer in New York city. Am J Pub Health, 92, 64-70.   DOI
39 Malik IA. (2002) Clinico-pathological features of breast cancer in Pakistan. J Pak Med Assoc, 52, 100-104.
40 Malik AM, Pathan R, Shaikh NA, et al (2010). Pattern of presentation and management of Ca Breast in developing countries. There is a lot to do. J Pak Med Assoc, 60, 718-721.
41 Miao H, Verkooijen HM, Chia KS, et al (2011). Incidence and outcome of male breast cancer:An international populationbased study. J Clin Oncol, DOI: 10.1200/JCO.2011.36.8902.
42 Moore MA, AriyaratneY, Badar F, et al (2009). Cancer epidemiology in South Asia- Past, present and future. Asian Pac J Cancer Prev, 10 Suppl 2, 49-67.
43 Ngowa JDK, Yomi J, Kasia JM, et al (2011). Breast cancer profile in a group of patients followed up at the radiation therapy unit of the Yaounde general hospital, Cameroon. Obstets Gynaecol International, doi:10.1155/2011/143506.
44 O'Malley CD, Prehn AW, Shema SJ, et al (2002). Racial/Ethnic differences in survival rates in a population-based series of men with breast carcinoma. Cancer, 94, 2836-43.   DOI
45 Ozmen V (2008). Breast cancer in the World and Turkey, J Breast Health, 4, 6-12.
46 Parkin DM, Bray F, Ferlay J, et al (2005). Global Cancer Statistics 2002. CA Cancer J Clin, 55, 74-108.   DOI   ScienceOn
47 Pestalozzi BC, Zahrieh D, Mallon E, et al (2008). Distinct clinical and prognostic features of infiltrating lobular carcinoma of the breast: Combined results of 15 international Breast Cancer Study Group clinical trials. J Clin Oncol, 26, 3006-14.   DOI
48 SEER Cancer Statistics Review 1975-2005. National Cancer Institute [http://seer.cancer.gov/csr/1975-2005/]
49 Sariego J (2009). Patterns of breast cancer presentation in the United States: does geography matter? Am Surg, 75, 545-50.
50 Saxena S, Rekhi B, Bansal A, et al (2005). Clinico-morphological patterns of breast cancer including family history in a New Delhi hospital, India, a cross-sectional study. World J Surg Oncol, 3, 67-8.   DOI
51 Sharif MA, Mamoon N, Mushtaq S, et al (2009). Morphological profile and association of HER-2/neu with prognostic markers in breast carcinoma in Northern Pakistan. J Coll Phys Surg Pak, 19, 99-103.
52 Shavers VL, Harlan LC, Stevans JL (2003). Racial/ethnic variation in clinical presentation, treatment and survival among breast cancer patients under age 35. Cancer, 97, 134-7.   DOI   ScienceOn
53 Siddiqui M.S, Kayani N, Sulaiman S, et al (2000). Breast carcinoma in Pakistani females: A morphological study of 572 breast specimens. J Pak Med Assoc, 50, 174-7.
54 Stead LA, Lash TL, Sobieraj JE, et al (2009). Triple negative breast cancers are increased in black women regardless of age or body mass index. Breast Cancer Res, 11, R18.   DOI
55 Valsecchi MG, Steliarova-Foucher E (2008). Cancer registration in developing countries: luxury or necessity? Lancet Oncol, 9, 159-67.   DOI
56 Wikipedia (2011). Accessed on 5th Dec 2011 from http:// en.wikipedia.org/wiki/List_of_countries_by_life_ expectancy