An Overview of Breast Cancer

Abstract

retrospective review of all female breast cancer cases treated at KFSH&RC over a 15-year period. Patients were divided into two groups at the time of their referral to KFSH&RC: metastatic and nonmetastatic. We describe the demographic data, cancer-related information and the treatments offered to all patients. Comparisons were made between Saudi and non-Saudi, and the Saudis were examined in relation to their region of referral and observed to see if any changes occurred during the study period. As well, we tried to compare our results with experience elsewhere. A total of 1584 female breast cancer patients were treated at KFSH&RC between 1975 and 1991. Early breast cancer (Stages I, II) represented 36%, while 64% presented with advanced or metastatic disease (Stages III, IV). The majority of patients were premenopausal (64%). For patients with Stages I-III (1005), mastectomy was performed in 85% and lymph node dissection in 93%. Only 30% had no pathologic lymph node involvement and in 49% of the patients, lymph node dissection was adequate (≥10 nodes removed). Estrogen and progesterone receptors were known in 30% of the patients. Sixty-two percent and 72% of patients referred from the central region and the northern region had Stages II and III, respectively. For the non-Saudis, we observed more premenopausal patients (76%) and fewer Stage III. At 15 years, the relapse-free survival in Stages I, II and III was 33%, 36% and 18%, and the overall survival was 80%, 64% and 45%, respectively. Breast cancer in this population affects younger patients (premenopausal) and a higher proportion present with metastatic or locally advanced disease. Management strategies should incorporate conservative surgery when appropriate, and adequate lymph node dissection. This should be coupled with increasing public awareness and education and institution of screening programs. Overall survival is clearly linked to the stage of the disease.

Risk Factors for Breast Cancer in Jordanian Women

“…Sixty-two percent of women with breast cancer listed in the 1996 JCR were less than 53 years old. Although different from the age distribution of breast cancer cases in most of the Western countries (Stone, 1997), the findings are similar to the distribution of cases reported in a recent national study done in Saudi Arabia (Ezzat et al, 1997) and in the West Bank and Israel (Barak et al, 1988). nine times higher for users than for nonusers (OR=8.62, CI=3.33-22.28), with an increased risk among older women.…”

Systematic Review of Breast Cancer Biology in Developing Countries (Part 1): Africa, the Middle East, Eastern Europe, Mexico, the Caribbean and South America

“…Ezzat et al , in an analysis of 801 Saudi women for the period 1986–1991, found 26% (206/801) had stage four cancer [43]. Of the 595 patients with cancer stages one to three (Table 2), 67% were lymph node positive with 34% having greater than four lymph nodes involved [43]. Ibrahim et al identified a median age at presentation of 42 years with 78% younger than 50 years [44].…”

“…Ezzat et al reported that 33% of cases were ER+ and 28% (n = 271) were PR+ [43]. In a further study of 145 patients, positive Her-2 expression (3+) was observed in 28% of patients and correlated inversely with ER status [54].…”

Surgical Management of Breast Cancer in Saudi Arabia: A Call For Improvement

“…In 1994, 437 cases were reported in the country. 1 At King Faisal Specialist Hospital and Research Centre (KFSH&RC), 1723 patients with breast cancer were treated between 1975 and 1991. 1 We currently receive 250-300 new cases every year.…”

“…1 At King Faisal Specialist Hospital and Research Centre (KFSH&RC), 1723 patients with breast cancer were treated between 1975 and 1991. 1 We currently receive 250-300 new cases every year. Every new patient is assessed by a team composed of a medical oncologist, a radiation oncologist and a surgeon.…”