دوشنبه, دسامبر 23

 According the recent reaches, Breast cancer (BC) is the most common, often diagnosed, and the leading cause of cancer mortality among the Afghan population, with an estimated 5‐year prevalence of 5930 cases, 3173 newly diagnosed cases, and 1783 deaths in 2020.

BC incidence rates are highest in high‐income countries, while BC mortality rates are highest in low‐income countries due to inadequate screening and less efficient therapies.

Mortality and Morbidity Due to Breast Cancer

BC accounts for around 14.3% (12.5% globally) of all newly diagnosed cancer cases and 11.3% (6.9% globally) of all cancer deaths. It had roughly a 4.5‐fold higher incidence rate and a 2‐fold higher mortality rate in high‐ and very high‐HDI countries than in low‐ and medium‐HDI countries.

BC accounts for around 14.3% (12.5% globally) of all newly diagnosed cancer cases and 11.3% (6.9% globally) of all cancer deaths. It had roughly a 4.5‐fold higher incidence rate and a 2‐fold higher mortality rate in high‐ and very high‐HDI countries than in low‐ and medium‐HDI countries.

BC is associated with psychological, mental and physical complications pre and post-surgery.

What are the risk factors?

Age: A woman’s risk of breast cancer rises rapidly until her early 60s, peaks in her 70s, and then declines.

Nulliparity: Nulliparous Women and early menarche (under age 12) and late natural menopause (after age 55) are associated with an increase in risk

Childbirth after age 30: Women whose first full-term pregnancy occurred after the age of 30 have an elevated risk

Family history: A significant family history of breast or ovarian cancer imparts a high risk of developing breast cancer or deleterious mutations (BRCA1, BRCA2, or others)

Personal history of breast cancer or some types of proliferative conditions: A prior history of chest wall radiation increases the risk of breast cancer years later. Alcohol consumption, high dietary intake of fat, and lack of exercise may also increase the risk of breast cancer.

Breast Cancer Diagnostic Screening:

  • Mammography
  • Ultrasound
  • MRI
  • Histopathology
  • Cytology
  • Lab screening

Can we prevent Breast Cancer?

Use of selective ER modulators (SERMs), including tamoxifen and raloxifene, or aromatase inhibitors for prevention of breast cancer in women with no personal history of breast cancer but at high risk for developing the disease is very useful.

Some women at high risk may consider prophylactic mastectomy or oophorectomy.

Screening diagnostic tests detect breast cancer before it has spread to the lymph nodes in about 80% of the women evaluated. This increases the chance of survival to greater than 85% at 5 years.

The key factors in finding the early warning signs of breast cancer:

  • Communities Awareness about the breast cancer, its prevalence, early warning signs and diagnostic methods.
  • Training self-breast examination to all young girls and women  
  • Routine mammography screening in all women at age of 40 years and above annually
  • Routine Ultrasonography screening in all women at age of 36 and above annually
  • Refresher training for Gyn/Obs consultants and midwifes regarding detecting early warning signs.
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