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The Silent Epidemic – Breast Cancer in Pakistan

“I am too young to die! Why me?” These are the words of a twenty seven year old woman having a son aged 7 months only. Salma had a painless lump in her left breast which she discovered a few days back. She had consulted a surgeon and was recommended an ultrasound of the lump. Ultrasound was done followed by FNAC (fine needle aspiration cytology) by a histopathologist.

After the procedure she had asked the histopathologist with a spark of hope in her eyes while carrying her cute 7 month old son, “I know its nothing! Nothing to be afraid of, but still, I am going for it as my doctor is insisting”.

The histopathologist had hoped the lump to be harmless, as it is very common among the women in their twenties but to her utter shock it came out to be a Category IV lesion (which is considered to be suspicious for malignancy). The histopathologist had no choice but to recommend a biopsy procedure (removal of a piece of tissue from the lump) in order to confirm such a lethal diagnosis. The biopsy test proved to be a highly aggressive form of breast cancer.

Breast cancer is the most common cancer in women both in the developing as well as the developed world. An estimated 508,000 women died of breast cancer in 2011 (according to WHO Global Health Estimates 2013). In Asia, Pakistan alone has the largest rate of breast cancer. An estimated 80,000 cases are being reported annually out of which 40,000 die eventually. THIS MEANS 1 IN EVERY 9 PAKISTANI WOMAN WILL DEVELOP BREAST CANCER AT SOME POINT IN HER LIFE!

Traditionally breast cancer was thought to be a disease of the middle aged and elderly women but surprisingly, today young patients like Salma are being diagnosed every day when they are at the peak of their lives. Salma is, just like every other young woman in her peak, pursuing her ambitions and dreams, leading a happy life with her caring husband not knowing that something is eating her alive inside her body. There are many girls and women like Salma fighting breast cancer and leading a painful life.

The prevalence of breast cancer in young patients is steadily increasing day by day at an alarming rate. Although considered to be rare for women in their twenties, it is the most common cancer in this age group. Unfortunately, studies show that younger patients face more aggressive cancers and lower survival rates than the middle aged or elderly.

A large number of women in Pakistan are diagnosed when cancer has already spread to other body parts, thus making the survival difficult.

A variety of factors are responsible for this, including poverty, lack of education and awareness, lack of access to screening tests, myths, etc. Cancer presents only as a small lump in the breast which grows slowly with the passage of time. Being painless, it is not taken seriously by many women especially in the rural areas, leading to uncontrolled growth. As a general rule, earlier the diagnosis, higher the chances of survival.

Self-examination is the single most useful tool in detecting breast cancer at its early stages. Women must examine both of their breasts on a regular basis to keep an eye on any lumps or masses. Self-examination combined with regular physical exams by a doctor, mammography, and ultrasound serves as an extremely effective tool for early diagnosis of such a lethal but preventable disease.

Note: Names have been changed in this article to protect the privacy of the individuals.