Nazir Ahmad KhanSheri Kashmir Institute of Medical Sciences, India
Title: Challenges in the management of breast cancer in an institution with limited resources
Breast Cancer is emerging as a major health problem globally. The incidence and the survival rates vary from country to country. The most important prognostic element for breast cancer is an early diagnosis, as it has an impact on the final outcome of the disease. Current evidence indicates that 70% of patients with breast cancer present in stage I-II in developed countries, while less than 50% of patients present in early stage in low income countries. A total of 1297 patients histologically confirmed to have breast cancer, were enrolled in the study retrospectively. The aim of the study was to assess the factors responsible for delay in treatment and poor survival. Data regarding socio-demographic details, date of diagnosis and treatment commencement were extracted and time to event outcome was analyzed. Also, survival analysis was done using Kaplan Meier method. A total of 19636 cancer patients were registered at state cancer institute, in the northern part of India in Kashmir between 2014 to 2018. Out of which 6.60% patients had breast cancer. There were 43(3.30%) males and 1254(96.70%) were females. The majority (35.2%) of cases were less than 40 years of age followed by 41-50years (30.5%), and 51-60 years (19.6%) respectively. The 5-year overall survival in our study was 85% for stage I patients, 82% for stage II respectively. While as in western countries 5 year survival is 100% in stage I and 90% in stage II. 10% of patients presented in stage I and 42% and 32.2% of patients presented in stage II and III respectively. In 80% of patients treatment was started within 3 months from the date of diagnosis. Several factors are contributing in the delay of diagnosis, which includes late presentation, due to fear of cancer diagnosis, fear of treatment related toxicities, socioeconomic and financial issues. A delay in cancer diagnosis does not decrease a patient’s chances of survival but may also increase medical costs, requiring more invasive treatments. Global efforts and public health measures targeting the whole continuum of cancer control – ranging from primary prevention to early diagnosis, screening, and treatment – are needed to reduce breast cancer mortality and to tackle the overall burden of the disease.
To be updated soon.