Breast cancer risk factors and stage at presentation

ABSTRACT

Breast cancer is the most common cancer in females all over the world. In American females, it is accounting for 32% of all cancers. It is well-known that there are major risk factors for cancer of the breast, such as, advanced age, positive family history and history of cancer in the same or other breast. Minor factors have been associated with breast cancer, such as, mammogram abnormalities, biopsy confirmed a typical hyperplasia, early menarche and late menopause etc' etc. Not enough studies have concentrated on reviewing the risk factors in Bahrain; therefore, we have embarked on this study 1,2. To review and assess the staging and risk factors of breast cancer. Surgery Department, Salmaniya Medical Complex. Retrospective/Prospective study. It is a retrospective/prospective clinical review involving 52 breast cancer patients operated upon by the senior author over five years period [1999-2005]. Presentation, diagnostic approach, and management were evaluated. Age at presentation, age of menarche and menopause were recorded. The risk factors, such as age at first delivery if any, lactation, hormonal therapy and if there were any past history or family history of breast or other related cancers. The stage of the disease at presentation was reviewed. Mortality and morbidity were recorded. All patients were females. Age at diagnosis was below 30 years in 2 patients [3.8%], between 30-39 years in 12 patients [23.1%], between 40-49 years in 21 patients [40.4%], 50 years or more in 17 patients [32.7%]. The mean age at menarche was 12 years of age. Sixteen patients [30.8%] were at menopause. The mean age at menopause was 48 years. Thirty-seven patients had child birth [71.2%], unmarried or nuliparous were 10 patients [19.2%]. Age at first delivery was ranging between 16 and 40 years of age. Number before percentage 59.6% of the patients breast fed their infants. Only 11 patients [22%] were using oral contraceptive pills [OCP]. One patient was on hormonal replacement therapy. Family history of breast cancer was positive in 18 patients [34.6%]. Two patients had history of breast cancer of the other breast. Thirty-seven patients [71.2%] had early breast cancer [T1, T2, N0, N1, M0] and 15 patients [28.8%] had advanced breast cancer [T3, T4, N1, N2, M0 -1]. There was no local recurrence, and three mortalities to date. More than half of our patients [67.3%] were below 50 years at presentation whereas internationally it is prevalent above fifty years [85%]. There was a significant high incidence of positive family history [35.3%] in comparison to international studies [5-15%]. In this study, breast cancer was still diagnosed late. In this study, locally-advanced breast cancer was 28.8%, which may improve as breast screening program is being implemented