A recent analysis study on breast cancer screening for low socio-economic status women in various areas of Karachi suggests that these women should undergo proper screening to identify the breast cancer in the first stage, when the metastasis has not taken place.
This step is important to save the lives of the women and enable them to enjoy quality life. It also suggests that with the interval of four years of screening, lives of many women can be saved and it will be cost-effective as compared to the practice of doing it every alternate year.
This cost-effectiveness study is done by Tazeen Saeed Ali of Aga Khan University Hospital and Dr Mohammad Suleman Otho of Civil Hospital Karachi, published in recent issue of newly launched monthly digest "Medical Update", published from Karachi.
The objective of the study was to look and report on cost and effectiveness of the screening for breast cancer by using "Mammography" among women of age greater than 49 years of Central, West, South, Malir and East Karachi. The mammography of women in this age group was done at five different settings, where mammography machine is available including Jinnah Postgraduate Medical Centre, Civil Hospital, Shifa, Malir hospital and KPT hospital.
The study showed that three to four year of interval of screening is cost-effective. However, this is not the end of the screening part.
There is a need to establish the next step, which is determination of the extent of the disease and appropriate treatment planning. A cancer specialist should be engaged to plan for proper testing and studies.
Further tests will be needed depending on the findings by the physician and his institution. Other X-rays, CT scans, Bone scan, MRI study, etc. are performed to determine the extent of the cancer mammography. In the general population, strong evidence suggests that regular mammography screening of women aged 50 to 59 years leads to a 35 percent to 50 percent reduction in breast cancer mortality. However, the mammography at least identifies the women the early stage of breast cancer.
Screening is an important part of primary prevention of development of breast cancer into second or third stage of cancer, where it is difficult to cure. The purpose of screening is to detect the women with the localised lumps (zero and stage one breast cancer). This can enhance the early detection and cure.
Public health policy regarding breast screening in Pakistan is still not given the priority. To be able to help decision-makers at policy level, a pilot program need to be implemented by including cost-effectiveness analysis, it stressed.
It stated that reported breast cancer cases in Pakistan in 1998 by International Association of Cancer Registry are 25,358, in which reported deaths are 11,324.
There are several types of breast cancer. The most common one begins in the lining of the ducts and is called ductal carcinoma.
Another type, called lobular carcinoma, arises in the lobules. Other cancers that begin in the breast are rare. When breast cancer spreads outside the breast, cancer cells are often found in the lymph nodes under the arm (axillary lymph nodes). If the cancer has reached those nodes, it might mean that cancer cells had spread to other parts of the body, other lymph nodes and other organs, such as the bones, liver or lungs, it added.
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