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Breast Cancer in
Pakistan
Breast cancer is one of the most prevalent diseases and Pakistan has one of the highest incidence rates of breast cancer in Asia. Due to several reasons, women in Pakistan are at immense risk of this cancer but are still unable to get the care they deserve.
So, it’s high time for an aggressive breast cancer awareness campaign to detect it early and take adequate measures. The breast cancer statistics in Pakistan are mind-boggling and require the utmost attention from society.
Breast Cancer Stats in Pakistan
The risk of breast cancer in Pakistan is the highest in Asia. According to an estimate, up to 90,000 breast cancer cases are reported annually. But the shocking part is that almost half of them (40,000) women die of this deadly disease yearly.
It’s also reported that 1 in 8 women in Pakistan is at risk of developing breast cancer during their lifetime, which is alarming. Even the adult and teenage girls are at risk of getting this disease.
According to BMC Public Health, the number of breast cancer cases is expected to rise from about 23.1% in 2020 to 60.7% in 2025.
Increasing risk of breast cancer in younger age group in Pakistan
Introduction:
Breast cancer is the most common type of cancer in women worldwide and it is rapidly increasing in developing countries like Pakistan. Breast cancer is a multifactorial disease that is caused by interactions between genetic, environmental, hormonal, and lifestyle factors. The incidence of breast cancer in younger women in Pakistan is on the rise and this poses a significant public health challenge.
Etiology:
The etiology of breast cancer is complex and multifactorial. Some of the most common factors that contribute to breast cancer include:
1. Environmental Factors: Environmental factors such as exposure to radiation, pollution, and endocrine disruptors (chemicals that interfere with the body’s hormonal system) can cause mutations in cells that lead to breast cancer.
2. Hormonal Factors: Hormonal factors such as early menstruation, late menopause, and the use of hormonal contraceptives or hormone replacement therapy can increase the risk of breast cancer in women.
3. Genetic Factors: Some rare genetic mutations can also increase the risk of breast cancer in women. Mutations in BRCA1 and BRCA2 genes are associated with an increased risk of breast cancer.
Pathology:
Breast cancer arises from the cells of the mammary gland. It usually starts in the ducts or lobules of the breast and can spread to other parts of the body if not caught early. The most common type of breast cancer is invasive ductal carcinoma that occurs in the ducts of the breast. Other types of breast cancer include invasive lobular carcinoma and inflammatory breast cancer.
Causative Factors:
Breast cancer is a multifactorial disease and there are several factors that contribute to the increasing incidence of breast cancer in younger women in Pakistan. Some of these factors include:
1. Lack of Awareness: Limited awareness regarding the disease, its symptoms, and risk factors among women in Pakistan is a major cause of increasing incidence of breast cancer in younger women.
2. Lifestyle Factors: Sedentary lifestyle, unhealthy dietary habits, smoking, and alcohol consumption are significant risk factors that contribute to the incidence of breast cancer in young women in Pakistan.
3. Faulty Healthcare System: Lack of specialized treatment facilities and limited access to cancer screening programs are additional factors contributing to the increasing incidence of breast cancer in younger women in Pakistan.
Impact on Younger Age Breast Cancer in Pakistan:
Breast cancer in young women has a significant impact on their lives and on society in general. Younger women with breast cancer often face specific challenges such as fertility concerns, treatment-related side effects, and career disruptions. Breast cancer also has a huge economic impact on families and society as a whole. This is especially true in developing countries like Pakistan where resources for cancer treatments are limited.
Conclusion:
Breast cancer in young women is a significant public health issue in Pakistan. The disease is multifactorial and caused by gene-environment interaction, lifestyle factors, and lack of awareness and access to healthcare services. Early detection through regular screening and awareness campaigns can improve the survival rate of breast cancer in young women. The government and other stakeholders must take affirmative action to increase breast cancer awareness among women, establish specialized cancer treatment facilities and provide affordable screening tests to improve the overall prognosis of breast cancer in Pakistan.
Screening and Early Detection
Importance Of Early Detection And Screening
Early detection of breast cancer is essential because it can help reduce the chance of death from breast cancer. When detected early on, breast cancer is significantly easier to treat and has substantially higher survival rates.
Regular breast cancer screening is important because many women with breast cancer have no symptoms. Getting regular screenings is an essential part of women’s healthcare.
Available Screening Methods in Pakistan
Pakistan does not have a national breast cancer screening program in place. However, some non-governmental organizations (NGOs) and private institutions offer breast cancer screening services in major cities. These services may include mammography, clinical breast examination, and breast ultrasound.
The availability and accessibility of breast cancer screening services vary depending on the region in Pakistan. In some areas, there may be limited access to screening facilities and equipment. Lack of awareness among women about breast cancer screening is also a major challenge.
The Pakistan government has initiated various programs to raise awareness about breast cancer and the importance of early detection. However, the implementation of a national breast cancer screening program is still a work in progress.
Women in Pakistan are encouraged to talk to their healthcare providers about breast cancer screening and to be aware of any changes or abnormalities in their breasts. Early detection and treatment can improve the chances of surviving breast cancer.
Challenges In Screening And Early Detection In Pakistan
There are several challenges in screening and early detection of breast cancer in Pakistan. Due to many obstacles, Pakistani women may not have access to timely detection and treatment The socio-cultural barriers in Punjab, Pakistan,, that prevent women from getting breast cancer screening, diagnosis, and medicine are not well-examined in the literature.
Due to a lack of awareness, 89% of breast cancer patients in Pakistan receive their diagnosis later than necessary, and 59% receive it at an advanced stage. Breast cancer treatment options and early detection are constrained in low- and middle-income countries by stigmatisation and feminine sensitivity concerns concerns.
A cross-sectional survey of 350 women in Rawalpindi and Islamabad, Pakistan, found that some common barriers to mammography included “I would get it done if my doctor advised me” (58%), lack of awareness about a health facility having mammography (54%), dislike of being examined by a male doctor (53%), the lack of transportation (50%), and “permission from my husband” (50%). The study concluded that poor knowledge is one of the main factors affecting the optimal utilisation of mammography services, along with financial, health system, cultural, and fear-related barriers.
Role of bebreastaware organization in awareness and Early diagnosis
Breast cancer is a major public health concern in Pakistan, affecting a large number of women every year. Unfortunately, many women in Pakistan lack access to proper healthcare facilities, making it challenging to diagnose and treat the disease effectively. In this scenario, the role of Breast health and cancer awareness campaigns becomes crucial.
One such campaign is the Bebreastaware organization, which has set up a program at Al Murtaza hospital located in Sadiqabad in south Punjab. The hospital is serving the community by providing physical examination, breast cancer awareness sessions, self-breast examination training, and Diagnostic Ultrasound facility under the supervision of Dr Jawad Mustafa. This program is designed to provide women with the necessary information and tools for early detection and proper treatment.
The hospital’s diagnostic ultrasound facility is particularly important for early detection, as it can identify tumors that are too small to be detected through physical examination. Additionally, the program includes training sessions, where women can learn about self-examination practices and recognize the early signs of breast cancer.
Through its efforts, Bebreastaware is making significant advancements in spreading awareness, educating communities, and providing timely diagnosis and treatment. The organization’s program at Al Murtaza hospital is an essential step towards improving breast health and cancer outcomes in Pakistan.
Advantage of breast ultrasound
Breast ultrasound is a non-invasive imaging technique that does not involve radiation, making it a safer alternative to mammography for women who do not wish to undergo radiation exposure.
- Breast ultrasound is particularly useful in detecting small masses that may not be visible on a mammogram, especially for women with dense breast tissue.
- Ultrasound can also detect the presence of fluid-filled cysts in the breast, which may be benign but should still be monitored over time.
- For women with breast implants, ultrasound can help detect abnormalities or damage to the implant, as well as assess any lumps or masses that may be difficult to detect with mammography.
- Breast ultrasound can also be used to guide biopsies or other minimally invasive procedures.
- In Pakistan, where breast cancer is the most common cancer in women, early detection through breast ultrasound can lead to earlier treatment and better outcomes.
- Breast ultrasound can be performed quickly and easily, often providing same-day results and avoiding the need for additional tests or appointments.
It is important to note that breast ultrasound should not replace regular mammograms as part of breast cancer screening. Rather, it may be used in combination with other tests to provide a more comprehensive assessment of breast health.
Breast ultrasound vs mammography
Breast ultrasound and mammography are both useful imaging techniques for detecting breast cancer, but they have different strengths and weaknesses. Below are conditions in which breast ultrasound may be preferable over mammography:
- Dense breast tissue: Breast ultrasound can be more effective in detecting cancer in women with dense breast tissue since mammography may not be able to distinguish between benign and cancerous tissue.
- Young women: Breast ultrasound may be preferred in younger women since their breast tissue tends to be denser, making it more difficult to detect abnormalities through mammography.
- Confirming findings: Breast ultrasound is useful in confirming suspicious findings discovered during mammography, such as lumps, masses, or cysts.
- Monitoring treatment: Breast ultrasound is used to monitor the effectiveness of breast cancer treatment, such as chemotherapy or radiation therapy.
- Women who are pregnant or breastfeeding: Breast ultrasound is safe for pregnant and breastfeeding women and is often used in these cases.
In terms of age groups that may benefit more from breast ultrasound, younger women (under 50 years old) with dense breast tissue may benefit the most. Women with a family history of breast cancer or other risk factors may also benefit from breast ultrasound, regardless of age.
It is important to note that mammography is still considered the gold standard for breast cancer screening and should be done regularly, typically starting at age 40. Breast ultrasound may be used in conjunction with mammography for women with dense breast tissue or other risk factors, but it should not replace regular mammograms.
BREAST CANCER TREATMENT IN PAKISTAN
Treatment Options
If you or someone you know has been diagnosed with breast cancer, it’s essential to know the different treatment options available in Pakistan.
Treatment Challenges
There are several challenges in accessing breast cancer treatment in Pakistan. Women in Pakistan lack appropriate awareness about diagnosis and treatment for breast cancer due to a range of multifaceted barriers.
There is a shortage of literature examining the socio-cultural factors that inhibit women from breast cancer screening, diagnosis and treatment in Pakistan.
The identified socio-cultural factors included feminine sensitivity, stigmatisation, and aversion to male doctors. Lack of financial resources and apathetic medical services were structural barriers that hindered screening and treatment.
Awareness and Advocacy in Pakistan
Role of NGO's
The government and NGOs are crucial in creating awareness about breast cancer in Pakistan. Pink Pakistan, BeBreastAware and Pink Ribbon are the major non-profit and non-government organisations dedicated to improving women’s lives in Pakistan’s marginalised communities.
These organisations launched several initiatives to empower these women by safeguarding their right to well-being and welfare in our society. They aim to provide women equal opportunities and full and effective participation in leadership roles. It will be at all levels of decision-making in social, political, economic and public spheres of life.
Community Involvement
Community involvement is crucial in creating awareness about breast cancer. These barriers can be addressed by raising awareness and community mobilisation about breast-self exams and treatment. The healthcare system should also consider socio-psychological and cultural factors impeding women’s access to available health facilities.
Breast Cancer Awareness Is Unignorable Need in Pakistan
As a community, we have to fight this menace together. Breast cancer is spreading fast in Pakistan, and it’s our duty to spread awareness and try to save our young and adult females from this deadly disease.