Help Beat Women’s Cancer

Breast cancer is the most common cancer in women worldwide. It is estimated that more than 1.7 million new cases of breast cancer occurred among women worldwide. Breast cancer is related to genetic, cultural, environmental and life-style factors. Variations in diversity among different ethnic groups and geographical area exist.

The incidence of breast cancer in Pakistan is highest in Asians after Jews in Israel and 2.5 times higher than that in neighboring countries like Iran and India, accounting for 34.6% of female cancers. Pakistan has the highest rate of breast cancer in Asia Pacific as 1 out of 9 females in the country is at risk of the disease. Breast cancer is the most common cancer in Pakistan as different studies shows it kills nearly 40,000 women every year. According to World Health Organization, breast cancer rates are getting worse and it is not sparing even younger age group. One in 8th women in Pakistan faces breast cancer during her life.

A cross sectional study on Breast cancer was carried out in the medical center of Oil and Gas Development Company Islamabad. The purpose of this study was to find out the incidence of breast cancer in different age groups of females and its response to the available treatment in Pakistan. The period of study was from July 2017 to June 2018. Stage 2 patients responded well with surgery and chemotherapy. Two of the stage 3 patients who were between the ages of 30-40 years developed bone metastasis during chemotherapy period. Prognosis was very poor in stage 4 patients. Three of the stage 4 patients died during the study period. They were of the ages 28 years, 35 years and 64 years respectively.

The incidence of breast cancer is 30-40 per cent among women in 40-year age in Pakistan as compare to 10 percent in the same group in the West.Increased number of obese young females in Pakistan. Obesity increases the chances of breast cancer and breast cancer related deaths.  Women who gain weight in adult life before menopause are at increased risk of developing breast cancer.

Studies have revealed that in the Pakistani women risk factors for breast cancer includes:

  • Age of menarche,
  • use of oral contraceptives,
  • Central obesity,
  • Polycystic ovaries,
  • Null parity,
  • Late age at first pregnancy,
  • Lack of breast feeding.

There is role of genetics in the development of Breast Cancer. These genes are called BRCA 1 and BRCA2, accounts for 25% of all breast cancer cases. Alterations with these genes are associated with increased risk of breast and ovarian cancer especially before the age of 50. These women could benefit from screening, risk assessment, genetic counseling, gene testing and appropriate medical interventions

Breast cancer is about 100 times less common among men than among women. For men, the lifetime risk of getting breast cancer is about 1 in 1,000.

Risk Factors for developing Breast Cancer :

  • Age

Risk increases with age.

  • Obesity

Obesity increases the chances of breast cancer and breast cancer related death.  Women who gain weight in adult life before menopause are at increased risk of developing breast cancer.

  • Diet.

High fat intake can increase the risk of breast cancer while high vegetable and fruits consumption may give protection against breast cancer. Results were supported by the findings of earlier cohort studies.

  • Smoking

12% increase in breast cancer risk among women who started smoking at a younger age. 21% increase in risk among women who started before the birth of their first child.

  • Diabetes

A meta-analysis was conducted including 16 studies published between 2000 and 2010. The combined evidence supports that diabetes was associated with a statistically significant 23% increased risk of breast cancer.(Liao S1, Li J, Wei W, Wang L, Zhang Y, Li J, 2011).

  • Physical Activity

73 studies conducted around the world, showed a 25% average risk reduction among physically active women as compared to the least active women. Better results are seen in postmenopausal women, women who are normal weight, have no family history of breast cancer, and are parous. (Lynch BM1, Neilson HK, Friedenreich CM 2011).

  • HRT

Many Epidemiological studies shows relation between HRT and Breast Cancer. An increased incidence of 60% to 85% is seen in recent long-term users of HRT, whether estrogen alone or estrogen plus progestin. Longer use of HRT (odds ratio [OR], 3.07 for 57 months or more; 95% confidence interval [CI], 1.55-6.06). Current use of combination therapy (OR, 3.91; 95% CI, 2.05-7.44) were associated with increased risk of lobular breast cancer.

  • Breast Feeding

Acts through differentiation of breast tissue and reduction of the lifetime number of ovulatory cycles. A Systematic review yielded 30 case-control studies and 1 cohort study published between 1999 and 2007. Of the 27 studies that assessed the effect of ever breastfeeding compared with never breastfeeding, only 11 found significant protection against breast cancer.

  • Osteoporosis

Lower age at menarche, longer overall duration of lifetime ovulation and higher bone density were associated with higher risk of breast cancer. BMD, which is affected by lifetime exposure to estrogen, is also related to risk of breast cancer. Estrogen therapy in osteoporotic women, even if raising the risk of breast cancer by 70% as suggested by some studies, would not elevate their risk to the level experienced by their non-osteoporotic counterparts.

“Research Dr. Nasira Tajamal”