Presentation, diagnosis and management of locally advanced breast cancer: Is it different in low/middle income countries?

Manzoor, Shahneela; Anwer, Mariyah; Soomro, Salim; Kumar, Dileep

doi:10.12669/pjms.35.6.165

Cited by 15 publications

(18 citation statements)

References 22 publications

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“…12 Manzoor S et al also highlighted importance of awareness and patient education to improve the delayed presentation. 18 We observed that benign breast diseases are also perceived as stigma and cause negative connotations and delay in seeking appropriate medical care leading to their progression. Young unmarried females considered it difficult to find husband and getting married, if the disease is disclosed.…”

Section: A H E a D O F P R I N Tmentioning

confidence: 84%

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Factors leading to delayed and challenging presentation of benign breast lumps in young females

Saleem¹,

Tariq

Tariq³

et al. 2022

Pak J Med Sci

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Background and Objective: A delayed presentation of benign breast diseases may lead to a therapeutic challenge when they enlarge enormously or become multiple. Aim of this study was to evaluate the factors leading to delayed presentation of benign breast lumps. Methods: This cross-sectional study was conducted at Madinah Teaching Hospital and Allied Hospital, Faisalabad from January 2019 to October 2021. One hundred and forty five female patients were selected by non-probability purposive sampling. Patients with large size (>5cm) or multiple benign breast lumps were included. An interview was conducted using structured questionnaire translated in Urdu. Factors leading to delayed presentation and social impact scale for stigma were evaluated. Results: Patients had a mean age of 26.52 ± 6.90 years. The average delay of seeking medical care was 8.48 ± 8.41 months. Factors leading to delayed presentation were; lack of knowledge n=112 (77.2%) and parda (religious issues) n=112 (77.2%), followed by poverty n=109 (75.2%), and fear of cancer n=90 (62.1%). All the sub-scales of stigma, i.e., social rejection, financial insecurity, internalized shame and social isolation were high in late presenters, though, only financial insecurity was significantly high in late presenters (p=0.03). Conclusion: Lack of awareness, socioeconomic factors and disease related stigma were the main factors related to delayed presentation in young females with benign breast diseases. Addressing these factors may improve timely diagnosis and management of delayed and challenging cases. doi: https://doi.org/10.12669/pjms.39.1.6647 How to cite this: Saleem S, Tariq S, Tariq S, Irfan S, Javed F. Factors leading to delayed and challenging presentation of benign breast lumps in young females. Pak J Med Sci. 2023;39(1):---------. doi: https://doi.org/10.12669/pjms.39.1.6647 This is an Open Access article distributed under the terms of the Creative Commons Attribution License (http://creativecommons.org/licenses/by/3.0), which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.

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Section: A H E a D O F P R I N Tmentioning

confidence: 84%

“… 12 Manzoor S et al also highlighted importance of awareness and patient education to improve the delayed presentation. 18 …”

Section: Discussionmentioning

confidence: 99%

Factors leading to delayed and challenging presentation of benign breast lumps in young females

Saleem¹,

Tariq

Tariq³

et al. 2022

Pak J Med Sci

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“…Some women may be aware of a palpable finding but have no easy access to treatment or be ignorant of its significance. The lack of screening and resources means that patients are diagnosed with advanced disease the majority of the time 1,6,47 . In addition, in many cases, social stigma related to cancer results in delays in diagnosis and lack of funding/advocacy toward cancer related interventions 48,49 .…”

Section: Discussionmentioning

confidence: 99%

“…The lack of screening and resources means that patients are diagnosed with advanced disease the majority of the time. 1,6,47 In addition, in many cases, social stigma related to cancer results in delays in diagnosis and lack of funding/advocacy toward cancer related interventions. 48,49 A VSI protocol for palpable breast abnormalities helps to address many of these obstacles (Table 4).…”

Section: Discussionmentioning

confidence: 99%

Breast Ultrasound Volume Sweep Imaging: A New Horizon in Expanding Imaging Access for Breast Cancer Detection

Marini

Castaneda

Iyer

et al. 2022

J of Ultrasound Medicine

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“…Breast cancer is the most common type of cancer in females, accounting for 31.8% of all cancers [ 1 ]. Its incidence is increasing, particularly in low socioeconomic groups [ 2 ]. Breast cancer is common above the age of 40 years, and it is the commonest between 41 and 50 years [ 3 ].…”

Section: Introductionmentioning

confidence: 99%

Epidemiology of Carcinoma Breast in Young Adolescence Women

Latif¹,

Perveen²,

Iqbal³

et al. 2022

Cureus

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Introduction The aim of this study was to compare epidemiological characteristics of breast cancer in young adolescent women (YAW) versus older women (OW). Methods This was a cross-sectional prospective observational study, conducted in Ward 3, Jinnah Postgraduate Medical Center, Karachi, Pakistan, from September 2021 to February 2022. A total of 120 female patients were recruited in this study from the Outpatient Department of Jinnah Postgraduate Medical Center, out of which 22 patients were below the age of 40 years and 98 were above 40 years. For breast cancer diagnosis, we used the triple assessment method involving clinical examination, radiology, and histopathology. Diagnosed patients were further evaluated for hormonal status and metastatic workup. Results were noted on a performa, and differences between both age groups were analyzed. Results Out of 120 patients, 22 were younger than 40 years and 98 were older than 40 years. YAW used to present late after the appearance of symptoms. Patients of both age groups mostly presented with breast lumps (68.18% in YAW and 81.6% in OW). YAW presented with larger sizes of lumps and with more nodal involvement as compared to OW. BI-RADS IV (Breast Imaging Reporting and Data System Category IV) was the most commonly observed (27.27% in YAW and 48.97% in OW) mammographic finding in both age groups. Invasive ductal carcinoma was the most common histological type in both age groups (72.73% in YAW and 76.53% in OW). The triple-negative disease was more commonly found in YAW than OW (40.91% in YAW vs 21.43% in OW). We found that usually YAW presented at advanced stages (stages III and IV, 54.55%) and higher grades (grade III, 63.63%). Conclusion Breast cancer in young patients is rare but more aggressive with higher grades, advanced stages, and poor prognostic features. Heredity is mainly the risk factor in young breast cancer patients. There should be proper screening programs for high-risk group for early diagnosis and prompt treatment. Other age-specific concerns such as psychological impact of disease should be addressed as well.

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Presentation, diagnosis and management of locally advanced breast cancer: Is it different in low/middle income countries?

Cited by 15 publications

References 22 publications

Factors leading to delayed and challenging presentation of benign breast lumps in young females

Factors leading to delayed and challenging presentation of benign breast lumps in young females

Breast Ultrasound Volume Sweep Imaging: A New Horizon in Expanding Imaging Access for Breast Cancer Detection

Epidemiology of Carcinoma Breast in Young Adolescence Women

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