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Abstract

Breast cancer is the most common cancer in women both in the developed and less developed world. Breast cancer survival rates vary greatly worldwide, ranging from 80% or over in North America, Sweden and Japan to around 60% in middle-income countries and below 40% in low-income countries. The low survival rates in less developed countries can be explained mainly by the lack of early detection programs, resulting in a high proportion of women presenting with late-stage disease, as well as by the lack of adequate diagnosis and treatment facilities. The menace of breast cancer has not spared Pakistan with its incidence reaching up to almost 35,000/100,000. 30.8% of all cancer deaths in Pakistan are due to breast cancer. Given that Pakistan is a low resource setting we designed a screening program based on examination for the detection of breast cancer. The study was piloted in the rural area of Rehri-goth. Pre-medical volunteer students were trained on breast self-examination. The volunteers went door to door creating awareness in the community regarding the danger signs of breast cancer and the importance of self-examination. All participants who identified any danger sign were called to the outreach centre of AKU for clinical breast examination followed by diagnostic mammography. In a seven days period, 526 houses were reached and 93 women were educated. 18 women were examined by a surgeon in the outreach centre. 2 women were filtered for a diagnostic mammography. The potential participants were taken to Karachi for mammography. One of them had Paget�s disease. The other woman was diagnosed with stage II breast cancer. Although mammography has been established as the gold standard for screening breast cancer in the community, yet, in a low resource setting like Pakistan, breast self examination followed by clinical breast examination can serve as a useful tool.

Biography