OBJECTIVE: The aim is to identify the ideal screening age for women in developing countries and to determine the suitable method for early detection of breast cancer based on age and readiness of the community. MATERIALS AND METHODS: A 30-year retrospective review (from 1984 to 2014) was undertaken at King Fahd Hospital of the University, Al-Khobar, Saudi Arabia. Medical records of those diagnosed with breast cancer from the outpatient department and hospital admission records were reviewed, focusing mainly on demographic data, age, and time at presentation. Radiological and histopathological records were also reviewed for confirmation of diagnosis. Age-based statistical review was undertaken of the female population within the hospital catchment area. RESULTS: The total number of patients was 1.832, accounting for 0.8 % affected patients when plotted against the 235,339 females within the catchment area. Considering the standard screening age of 40 years, patients were divided into two groups: group I included those below the age of 40 years at the time of diagnosis, accounting for 641patients (35%), and group II included those above the age of 40 years, accounting for 1191 patients (65%). Group I patients were mostly reassured in primary healthcare centers, diagnostic modalities were used with reservation, relying solely on ultrasonography 276 (43%); whereas in group II patients, mammography was used liberally, which aided in the diagnosis in all 1191 (100%). CONCLUSION: Despite the undisputable notion that breast cancer has higher predilection for women above the age of 40 years, there is a substantial subset of affected younger women in developing countries, which contradicts this concept. However, the scarcity of structured sessions in developing countries dictates Western-based early detection strategies, but the validity of such programs is culture-governed. Rigorously tailored screening programs directed towards individual communities are mandatory. Reducing the screening age by a decade in developing countries may increase the capture of early breast cancer and improve the outcomes.
OBJECTIVE: The aim is to identify the ideal screening age for women in developing countries and to determine the suitable method for early detection of breast cancer based on age and readiness of the community. MATERIALS AND METHODS: A 30-year retrospective review (from 1984 to 2014) was undertaken at King Fahd Hospital of the University, Al-Khobar, Saudi Arabia. Medical records of those diagnosed with breast cancer from the outpatient department and hospital admission records were reviewed, focusing mainly on demographic data, age, and time at presentation. Radiological and histopathological records were also reviewed for confirmation of diagnosis. Age-based statistical review was undertaken of the female population within the hospital catchment area. RESULTS: The total number of patients was 1.832, accounting for 0.8 % affected patients when plotted against the 235,339 females within the catchment area. Considering the standard screening age of 40 years, patients were divided into two groups: group I included those below the age of 40 years at the time of diagnosis, accounting for 641patients (35%), and group II included those above the age of 40 years, accounting for 1191 patients (65%). Group I patients were mostly reassured in primary healthcare centers, diagnostic modalities were used with reservation, relying solely on ultrasonography 276 (43%); whereas in group II patients, mammography was used liberally, which aided in the diagnosis in all 1191 (100%). CONCLUSION: Despite the undisputable notion that breast cancer has higher predilection for women above the age of 40 years, there is a substantial subset of affected younger women in developing countries, which contradicts this concept. However, the scarcity of structured sessions in developing countries dictates Western-based early detection strategies, but the validity of such programs is culture-governed. Rigorously tailored screening programs directed towards individual communities are mandatory. Reducing the screening age by a decade in developing countries may increase the capture of early breast cancer and improve the outcomes.
Authors: Benjamin O Anderson; Roman Shyyan; Alexandru Eniu; Robert A Smith; Cheng-Har Yip; Nuran Senel Bese; Louis W C Chow; Shahla Masood; Scott D Ramsey; Robert W Carlson Journal: Breast J Date: 2006 Jan-Feb Impact factor: 2.431
Authors: Benjamin O Anderson; Susan Braun; Susan Lim; Robert A Smith; Stephen Taplin; David B Thomas Journal: Breast J Date: 2003 May-Jun Impact factor: 2.431
Authors: Heikki Joensuu; Tiina Lehtimäki; Kaija Holli; Liisa Elomaa; Taina Turpeenniemi-Hujanen; Vesa Kataja; Ahti Anttila; Mikael Lundin; Jorma Isola; Johan Lundin Journal: JAMA Date: 2004-09-01 Impact factor: 56.272
Authors: Bernard Fisher; Stewart Anderson; John Bryant; Richard G Margolese; Melvin Deutsch; Edwin R Fisher; Jong-Hyeon Jeong; Norman Wolmark Journal: N Engl J Med Date: 2002-10-17 Impact factor: 91.245